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As mentioned in my post for the Versatile Blogger Award, I travel a lot. It’s nearly always business travel, so although I enjoy it, I can’t just do as I wish. I have to be ready to perform, both for giving talks and also networking and meeting up with colleagues. At the same time, I have to accommodate my crazy brain as much as possible to stay sane.

Triggers and Travel

Travel often makes me hypomanic due to impacts on sleep: changing time zones, badly timed flights, and late nights out followed by early mornings. That last one is a matter of setting limits and sticking with them – easier said than done. I don’t know how well I’ll be able to resist a late night at the bar for a few drinks with friends, but doing that is bad for my stability.

The time zones issue is just tough. Sleep aids like melatonin help for adjusting to new time zones and sleeping on overnight flights. So does my required dose of Dramamine. I otherwise don’t sleep well on planes. It’s possible to pre-adjust for time zone shifts, but most of my trips aren’t long enough to merit such micromanagement. I just try to stick to my usual sleep schedule (in bed by 11 PM, up at 6 AM) or at least get the same number of hours of sleep (6.5 – 7.5).

Another factor that screws up sleep is travel timetables. From a small regional airport, every destination (other than major hubs) is at least two flights away. 80% of the available itineraries involve 6 AM departures, for which I have to arrive by 5 AM (4 AM for a major airport), and that means getting up around 4 AM (3 AM) at the latest. See the problem here? Yeah. Return flights often arrive between 10 and 11 PM. I usually need a meal and some winding down time after arriving, so arriving at 10 PM means a late night, which can also hurt.

Bipolar-Friendly Travel Itineraries

The trip I’m on right now is the first since my bipolar diagnosis and subsequent lifestyle changes. The itinerary goes from the East Coast to the West Coast to the UK. That’s +3 hours and then -8 hours in time zone shifts. Ouch. We’ll see how well mood stabilizers help, but I’ve created a very different itinerary than before.

Avoiding crazy travel hours means only daytime flights, with the exception of overnight transatlantics, which are the only option heading east. It means no departures earlier than 10 AM to avoid having to get up earlier than 6 AM to allow enough time for logistics. The latest arrival I have for this trip is 10:39 PM returning from London, and while that’s not great, there weren’t any other options given other constraints.

The net effect? It costs more. Flights are more expensive when they don’t leave at 6 AM or involve red-eyes. I have to spend a whole day traveling in each direction, which is a huge sacrifice since the dimenhydrinate for motion sickness makes it hard to work. I have to schedule decompression time – going to Europe requires arriving in the morning on the day before an event so that I can try to get my sleep sorted enough to think straight. I need an extra night on both sides of my trip, which means added hotel costs – not cheap in London, let me tell you! The payoff should be a little less insanity and quicker recovery from the travel. Fingers crossed.

I’m also spending one night at home on the East Coast between the trips, to allow a modicum of adjustment between PST and GMT. It means giving up a day of a conference that I really enjoy, and I’m sad about missing out on time with friends. On the bright side, my husband is coming along to London, which is a treat for both of us. His calming effect on my otherwise erratic sleep habits will really help. I’m also taking along my small portable light box, so I can bathe in bright light each morning to help wake up in different time zones and manage overcast destinations like Seattle and London.

Flying with a Ton of Medications

Another travel detail relevant to bipolar disorder is medications. When do you take them? How do you carry them? I’m just going to take them at the same times as usual in each time zone. My meds aren’t likely to have really nasty effects if the doses get a little close together for one day.

Security issues related to medications are a different matter. You have the right to request private screening to maintain confidentiality. US law requires declaring all medications and syringes when traveling abroad, but I’ve never seen that enforced for pills. Other countries’ regulations may be different, so it’s a good idea to check those details in advance. I’ve visited several countries and never had any problems with carrying prescriptions, even before I was taking the pill bottles along.

You must carry the labeled prescription bottles (particularly for international travel) to demonstrate that the medications are actually yours if questioned. Bringing along all my meds makes me feel like a true mental case. I was used to carrying one or two bottles, but look at what I’m taking along now…

Five prescriptions, plus daily supplements in extra-large pill minder.

Medications should always be in a carry-on. Never ever risk losing them in a checked bag that might not make it to your destination! I hate that they rattle in my bag like I’m some kind of druggie, but I could muffle them by stuffing the bottles with cotton balls or tissues.

If you have to carry liquid medications or syringes it gets more complicated. In this situation, it’s really important to check in advance about all the details: limits on volume, whether they go in your 3-1-1 baggie, what to expect at security, syringe management, and what counts against carry-on limits. CPAP machines are a carry-on; coolers for cold liquids might be too.

If you unexpectedly run out of meds when traveling, many pharmacies will dispense a refill based on the labeled bottles you have in your possession. I would expect additional complications with controlled substances. Some US-legal drugs are not available abroad and vice versa. That’s also true for OTC items like melatonin. Prices are different, usually much higher in the US, but insurance might not be accepted (keep the receipt for a claim.) The best bet is to get the prescription written for enough meds to see you through, but sometimes early refills are possible.

I’ve never been questioned about medications but I have had my bags searched because I was carrying them in too many small containers scattered throughout my luggage. I explained that I keep a dose in every bag in case I forget them when thrown off my usual daily schedule. The TSA agent explained that this looks suspicious, so it’s best to keep all the meds together.

So in summary, bipolar travel costs more, takes more time, requires additional planning and compromises, and is more complicated overall. I’m hopeful that my new travel rules will result in better stability. Being able to perform at my best is especially important when I’m a workshop organizer and an invited speaker!