Effectively managing bipolar disorder includes knowing the early signs of an episode. It also means having a plan to address these signs before they escalate into hypomania, mania or depression.
According to authors Janelle M. Caponigro, MA, Eric H. Lee, MA, Sheri L. Johnson, Ph.D, and Ann M. Kring, Ph.D, in their book Bipolar Disorder: A Guide for the Newly Diagnosed, common warning signs of mania or hypomania include: feeling irritable, sleeping less, having more energy, driving faster, talking faster, starting new projects, feeling more self-confident, dressing differently, having increased sexual feelings and feeling impatient.
Every person has his or her own unique warning signs. For instance, you might notice that your day is filled to the brim with activities, and you stop taking breaks. You might start spending several hundred dollars on items you don’t need. And others might comment on how overly enthusiastic you are.
To figure out your warning signs, think back to your latest manic episode and what symptoms and experiences precipitated it. It’s also helpful to ask others for input and keep a daily mood chart.
When you’re noticing these warning signs (or you just don’t feel like yourself), the authors recommend contacting your treatment team.
They also elaborate on three types of strategies to employ when signs point to a hypomanic or manic episode: calming yourself; protecting against negative behaviors (such as overspending); and managing medications and therapy.
Here are suggestions from Bipolar Disorder for each type of strategy to help you manage warning signs and prevent a full-blown manic episode.
- Get at least 10 hours of sleep per night. Interestingly, before today’s medications for bipolar disorder were developed, sleeping was one of the chief treatments for mania. “In fact, sleeping for a long time for three or four days in a row can be enough to restore mood and prevent relapse.” If you have a hard time falling asleep, rest in a quiet room (without any technology or other distractions).
- Limit your activities and tasks. If you’re not able to scale back, focus only on the most important activities.
- Don’t spend any more than six hours being active each day. Spend the rest of the time relaxing.
- Don’t try to exhaust yourself. Trying to tire yourself out through exercise or other kinds of stimulating activities actually doesn’t quiet energy; it just increases it.
- Avoid stimulating surroundings. This includes crowded parties, shopping malls and any other places you find energizing.
- Avoid stimulating foods and beverages. Avoid coffee, soda, energy drinks and any vitamins or over-the-counter medication with caffeine.
- Avoid drugs and alcohol. The authors suggest cutting out alcohol entirely when you’re noticing symptoms.
- Engage in calming activities. This includes taking a walk, practicing yoga, breathing deeply and listening to relaxing music.
- Create a list of go-to activities that help to slow you down. These are small actions, such as talking to a friend who calms you.
Protecting Against Negative Behaviors
- Limit your spending. For instance, you might ask your credit card company to lower your limit or ask a loved one you trust to keep your credit cards for a certain time.
- Postpone big decisions. Wait until you can review them with your treatment team or a trusted loved one. Also, give yourself a day to reflect on the pros and cons of a potential decision.
- Avoid letting yourself feel high “a little longer.” Remember, the higher you go, the harder you’ll fall. Working to minimize early warning signs sooner helps you prevent symptoms from progressing into an episode.
- Ask trusted loved ones to tell you if your behavior is out of the norm.
- Avoid putting yourself in potentially triggering situations. These include new romances, unsafe sex and conflict.
Managing Medication and Therapy
When people with bipolar disorder are hypomanic or manic, they commonly think they don’t need their medication. However, instead of not taking your medication (this can be dangerous), consult your prescribing physician. They may change or increase your medication, which can help to stave off a manic episode.
If you’re working with a therapist, you might want to increase your appointments or move them to an earlier time or day.
Bipolar disorder is a serious illness, and it can be tough to pinpoint your warning signs and to manage them. But by thinking ahead, brainstorming with your treatment team and having a plan of strategies that work for you, you can get better and stay well.