For individuals with bipolar disorder, every day contains the possibility of a new manic episode. Although some people might enjoy the high energy and high mood that accompany mania, these good things have the potential to turn bad in an instant. Serious manic episodes can often result in risk-taking that could lead to injuring yourself or others, poor financial decisions or even involuntary hospitalization. Mania has the potential to destroy social and work relationships. Because bipolar disorder is a chronic, relapsing illness, medication alone is not sufficient; vigilance and symptom maintenance are also important.
Mania often manifests as:
Delusions of grandeur, i.e., feeling all-powerful, destined for greatness
Talking rapidly or excessively
Reckless behaviors, e.g., spending too much money, substance abuse
Warning signs of an oncoming manic episode
To lessen the intensity of a manic episode, be aware when one is imminent and take precautionary measures. Prior to the manic episode, people with bipolar disorder often experience prodromal symptoms, or warning signs. These warning signs are individualized and highly personal. Patients with bipolar disorder need to be aware of their own prodromal symptoms so that they can be prepared for the manic episode.
Some common prodromal symptoms include:
1. Needing less sleep
Individuals with bipolar disorder can suddenly find themselves waking up at 5 a.m., feeling bright and rested, even though they usually wake up at 8, or they might find themselves going to sleep at 3 a.m., with no apparent ill effects the next morning. Although it might feel good to have a little more time in the day, needing less sleep could mean a manic episode is on its way. A few extra hours of productivity can easily turn into several weeks of sleepless nights. People with bipolar disorder might want to keep a sleep journal so that they are aware of their normal sleeping patterns.
2. Wanting to be louder, more intense
Before experiencing a full-fledged manic episode, people with bipolar might feel a little extra boost of energy. They might want to go out and party, even though they usually spend the night watching Netflix. They might wear brighter colors, listen to energetic music and develop a louder speaking voice. They might dominate more conversations or exercise more frequently. This heightened energy is less intense than the energy experienced during the manic episode but can easily shift into its more destructive form.
3. Experiencing grandiosity
People with bipolar disorder are unlikely to experience delusions of grandeur prior to a manic episode, but they might develop a greater sense of self-worth than usual. They might start planning for goals that they cannot realistically accomplish, or they might overvalue their own skills.
4. Feeling persecuted
Individuals who are approaching the onset of a manic episode might feel more victimized than usual. They tend to worry that people are judging them or plotting against them. They might be irritable or more likely to take offense.
Patients with bipolar disorder should keep a diary so that they can understand how their behavior patterns change prior to a manic episode. This way, they can anticipate when a manic episode is likely to begin.
How to prepare for an upcoming manic episode
Once individuals with bipolar disorder are aware of their prodromal symptoms, what can they do to prevent an oncoming episode? Although these steps do not guarantee that a manic episode can be stopped, they can mitigate some of the symptoms and reduce the harm experienced during the episode.
Here are some ways to prepare for a manic episode:
1. Cut back on alcohol, caffeine and illegal drugs
Drugs that alter brain chemistry can exacerbate both manic and depressive symptoms in individuals with bipolar disorder. When patients are teetering on the edge between mania and hypomania, these drugs can easily fuel the worst of their symptoms.
2. Talk to a doctor
When people with bipolar disorder suspect that a manic episode is imminent, they should let their doctor know as soon as possible. Based on the patient’s symptom profile, the doctor might know ways to reduce risks and might be able to recommend changes in medication to counteract the oncoming episode.
3. Inform family and friends
People with bipolar disorder should let their loved ones know when a manic episode is likely to occur. This way, friends and family can be prepared for the behavior changes that occur during mania. They can also provide support and look out for the patient with bipolar disorder.
4. Stay on schedule
Although it might be tempting to stay up late or skip meals, people with bipolar disorder should attempt to stay on schedule as best they can. A constantly shifting sleep schedule and meal schedule can stress the human brain and trigger an episode.
Intense or stressful situations can hasten the onset of mania. People with bipolar disorder should practice relaxation exercises, such as meditation, to decrease their levels of physiological arousal. They should also avoid stressful situations, such as taking on extra projects at work or helping a friend move.
Sovereign Health Group provides multiple therapy options for people struggling with mental illness. Treatment plans are personalized for individuals based on their symptom profile and needs. For further questions about how Sovereign treats bipolar disorder, please contact 866-524-5504.
Written by Courtney Lopresti, Sovereign Health Group writer