Bipolar disorder: Preventing a manic episode
Here are some steps you can take to help prevent a manic episode.
- Learn the early warning signs of a manic episode.
These signs may include:
- Needing less sleep or being more active than usual.
- Feeling very happy or very grouchy.
- Being easily distracted and having racing thoughts.
- Talking more than usual.
- Keep track of your mood every day.
After you know your early warning signs, check your mood each day to see if you may be heading for a mood swing. Write down your symptoms in a journal. Or record them on a chart or a calendar. When you see a pattern or warning signs of a mood swing, seek treatment.
- Keep a stable sleep pattern.
Go to bed about the same time each night, and wake up around the same time each morning. Too much or too little sleep or changes in your normal sleep patterns can alter the chemicals in your body. And this can trigger mood changes or make your symptoms worse.
- Stay on a daily routine.
Plan your day around a good routine. For example, eat meals at regular times, and make exercise or other physical activity a part of your daily schedule. You might also practice meditation or another relaxation technique each night before bed.
- Don't use alcohol or illegal drugs.
It may be tempting to use alcohol or drugs to help you get through a manic episode. But this can make symptoms worse. Even one drink can interfere with sleep, mood, or medicines used to treat bipolar disorder.
- Get help from family and friends.
You may need help from your family or friends during a manic episode. This is even more important if you have trouble telling the difference between what's real and what isn't real (psychosis). Having a plan in place before any mood changes occur will help your support network help you make good decisions.
- Reduce stress at home and at work.
Try to keep regular hours at work or at school. Doing a good job is important, but avoiding a depressive or manic mood episode is more important. If stress at work, school, or home is a problem, counseling may help.
- Keep getting treatment and counseling.
It can be tempting to stop treatment during a manic episode because the symptoms feel good. But it's important to keep getting treatment as prescribed. It helps you to avoid taking risks or having to face problems caused by a manic episode. If you have concerns about treatment or the side effects of medicines, talk with your doctor. Don't adjust the medicines on your own.
What is a bipolar disorder manic episode?
Some mood disorders are characterized by manic episodes, periods of abnormally high energy. Behavior may be diagnosed as a manic episode if:
- An abnormal and continuously elevated (happy or energetic) mood or an irritable mood occurs and lasts at least a week.
- During this elevated or irritable mood, at least three of the following symptoms are present:
- Inflated self-esteem or unrealistic feelings of importance
- Decreased need for sleep (feeling rested after only a few hours of sleep)
- Talkativeness (more than usual)
- Racing thoughts
- Being easily distracted by unimportant things
- An increased focus on reaching job or personal goals
- Involvement in irresponsible activities that might have dangerous consequences, such as engaging in increased sexual activity, making foolish business deals, or spending large sums of money
- The behavior is severe enough to cause an inability to function properly in a job, in social situations, or in relationships with others. It is possible you may need to seek hospitalization if the behaviors become so severe that you need help to prevent harming yourself or others.
- The symptoms are not caused by substance use.
- Psychosis may be present.
If you or someone you love is experiencing a manic episode, it is important to seek help. Many treatments are available.
Helping someone during a manic episode
You may feel frustrated around a person with bipolar disorder who is having a manic episode. The high energy level can be tiring or even scary. The person may also actually enjoy the mania and may not take medicines, which can make the episode last longer. Also, the person may say and do unusual or hurtful things. Here are some ways you can help during a manic episode.
- Spend time with the person.
People who are manic often feel isolated from other people. Spending even short periods of time with them helps them feel less isolated. If the person has a lot of energy, walk together. This allows the person to keep on the move but share your company.
- Answer questions honestly.
But don't argue or debate with a person during a manic episode. Avoid intense conversation.
- Don't take comments or behavior personally.
During periods of high energy, a person often says and does things that they would not usually say or do. This can include focusing on negative aspects of others. If needed, stay away from the person and avoid arguments.
- Prepare easy-to-eat foods and drinks.
It may be difficult for the person to sit down to a meal during periods of high energy, so offer easy to eat foods. Examples are peanut butter and jelly sandwiches, apples, cheese and crackers, and juices.
- Keep surroundings as quiet as possible.
Help them avoid a lot of activity and stimulation.
- Allow the person to sleep whenever possible.
During periods of high energy, sleeping is difficult and short naps may be taken throughout the day. Sometimes the person feels rested after only 2 to 3 hours of sleep.
Call a health professional if you have questions or concerns about the behavior of a person who has bipolar disorder. Always call a health professional (or 911 or other emergency services) if you think they are in danger of causing any harm to themself or others.
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