You might feel helpless when someone you know experiences a manic episode. Here’s how you can confidently step in if they ask for help.
A bipolar disorder manic episode is a period of heightened energy that lasts at least several days. It may include an unprompted sense of euphoria, confidence, or irritability.
Both mania and its less severe form, hypomania, are key components of bipolar disorder. Bipolar disorder is a neurocognitive condition characterized by shifts in mood. It’s categorized into several diagnostic types.
When someone is experiencing mania, their behavior may be difficult to understand from the outside. Neighbors, co-workers, friends, or family may feel alarmed, confused, or frustrated with not knowing how to help.
By recognizing potential warning signs of a manic episode, the loved ones of those with bipolar disorder can empower themselves and respond productively to these difficult situations.
We intend to provide you with the facts, guidance, and encouragement to do just that.
Leading up to a manic episode, you may notice a loved one with bipolar disorder exhibiting energy levels or giddiness not typical for them.
Maybe they’ve become increasingly obsessive about a project, really impatient, or super chatty. This unpredictable behavior may start negatively affecting their relationships and interfering with work or home life.
Signs of a manic episode
Knowing these key signs and symptoms can make all the difference:
- psychomotor agitation (body tics)
- an urge to share inner thoughts, called pressured speech
- not sleeping enough or at all, but still having seemingly boundless energy
- rash financial decisions
- easily distracted
- hypersexual behavior
- loss of appetite
- angry outbursts
- paranoia, irrational thoughts, or delusions of grandeur
There’s a common myth that mania is mostly positive, but it can be uniquely exhausting and is serious.
Manic episodes are primarily associated with bipolar I disorder, while hypomania and its symptoms are associated with bipolar II disorder and cyclothymia.
Here’s a quick breakdown of the different types of bipolar disorder and their main characteristics for diagnosis:
|bipolar I disorder||✓||✓|
|bipolar II disorder||✓||✓||✓|
|cyclothymia||only some symptoms needed for diagnosis||✓||only some symptoms needed for diagnosis|
Preparation starts with upfront communication.
If the person you know who has bipolar disorder — or any mental health condition, for that matter — has not first communicated a clinical diagnosis, or asked explicitly for your eyes and ears in managing public-facing manifestations, it’s not recommended to step in.
It’s that person’s choice to disclose their condition or not. It’s not up to our prerogative to step in, uninvited.
If they’ve asked you in advance for help if an episode of mania or hypomania escalates, learning to identify the warning signs and symptoms of an oncoming manic episode can provide context for perhaps uncomfortable or harmful behavior and help you two customize a strategy.
Here’s more guidance on how to talk with someone about their mental health condition in general.
Tips to prepare for potential manic episodes
If you’re asked to help your loved one with bipolar disorder during a manic episode, you might consider adding the following to your arsenal:
- With their permission, get contact info of others in your loved one’s inner circle who also know about their condition. This may be their therapist, doctor, psychiatrist, other friends and family, co-workers, or mentors.
- Join an online support group for yourself to learn different approaches and be validated as an advocate.
- Fortify your emotional intelligence and don’t take things personally during a manic episode.
- Practice candid replies to their reflective questions after the episode, such as:
- “Did I hurt your feelings when I said ___?”
- “Was I out of line when I ___?”
- Learn to let your “no” be calm, assertive, and clear.
- Validate them by actively listening.
In a high-stress situation like responding to a manic episode, you may feel at a loss.
We know asking questions like these can be difficult in the moment, so below are some flexible tips on how to talk with someone during a manic episode:
Only use the below tips and advice if the person with a mental health condition has opened up about their condition.
Unsolicited inquiries can violate their personal boundaries and have the opposite effect on your intention to help.
- “How has your medication maintenance been going? Are there any recent changes you feel comfortable sharing with me?”
- “I’m learning that routine is super helpful for reducing symptoms. And you mentioned you wanted to make some everyday improvements. How can I help?”
- “I think you should talk with your doctor about how you’re feeling. They would probably appreciate the update.”
- “Is there anything going on around us this time of year that’s triggering to you?”
- “You’re in a support group, right? Is there someone in addition to me who you trust and can reach out to today?”
- Remind them you love them or care about them.
- Remember that research suggests they may be sensitive to touch, sound, or smell.
- Try to maintain a calm, steady tone of voice (not loud or abrasive).
- Try to delay or redirect potentially harmful impulses, if possible. You can suggest they wait on any big purchases, sudden trips, or making major life decisions.
- Offer to go on a stroll with them, or do a shared activity together.
- Don’t put your physical safety at risk. Disengage or seek medical or law enforcement help if needed.
- Don’t ignore warning signs or symptoms hoping they’ll just “go away on their own.”
- Don’t take things personally.
- Don’t argue or fight with someone experiencing a manic episode.
- Don’t escalate the situation by raising your voice or crossing the plane of their personal space.
- Don’t take them to, or participate in, an overstimulating environment, if possible.
- Don’t encourage or provide the use of substances, including alcohol. It can further impair judgment, worsen manic symptoms, or have dangerous interactions with medications for mania.
Some manic episodes are more serious than others and may require you to seek professional help right away.
Remember, your safety and well-being comes first. If you believe your loved one is a threat to themselves or others, get immediate medical help.
In a severe manic episode, a person may experience what’s called an episode of bipolar disorder psychosis, where they have trouble deciphering what is reality and what isn’t.
During an episode of psychosis, people may experience:
- scary, paranoid thoughts
Episodes of psychosis may lead to injury or self-harm if not handled by healthcare professionals right away.
Do not try to manage a possible bipolar disorder–induced episode of psychosis on your own. Get help without delay at a nearby emergency room or psychiatric facility.
Manic episodes may also tip directly into depressive episodes, which can include suicidal ideation.
While family, friends, or partners are not responsible for another’s mental health, you can be priceless members of their support network and advocates in their journey.
Educating yourself on bipolar disorder can help give you the means and opportunities to safely and productively navigate someone’s manic episodes alongside them.
By following the tips above, you can be best prepared for future manic episodes while maintaining boundaries and reinforcing your relationship.