Bipolar disorder is a mental health condition that causes you to experience manic or depressive episodes. The severity and frequency of these episodes will help your healthcare provider determine the type of bipolar disorder you have.
Bipolar I disorder occurs when you have at least one manic episode, which is then followed by a major depressive episode, or a hypomanic episode (less severe than manic).
Bipolar II disorder is when you have a major depressive episode that lasts at least two weeks and a hypomanic episode that lasts at least four days.
Mania is a symptom associated with bipolar I disorder. You may experience the following during a manic episode:
- abnormally elevated mood
- persistently irritable mood
- abnormally energetic mood
According to the DSM-5, a medical reference commonly used by healthcare professionals to aid in diagnosis, a manic episode lasts at least a week, unless you are hospitalized. It may last less than a week if you are hospitalized and successfully treated.
Your behavior is very different from normal behavior during a manic episode. While some people are naturally more energetic than others, those experiencing mania have an abnormal level of energy, irritability, or even goal-directed behavior.
Some of the other symptoms you may experience during a manic episode include:
- feelings of inflated self-esteem and self-importance
- feeling like you don’t need sleep, or need very little sleep
- becoming unusually talkative
- experiencing racing thoughts
- being easily distracted
- engaging in risky behaviors, such as shopping sprees, sexual indiscretions, or making big business investments
Mania can cause you to become psychotic. This means you have lost touch with reality. Manic episodes shouldn’t be taken lightly. They affect your ability to perform as usual in work, school, and social activities. Someone experiencing a manic episode many need to go to the hospital to keep from hurting themselves.
Manic episodes can vary from person to person. Some people can recognize they are heading toward a manic episode, while others may be in denial.
Reach Out to Your Healthcare Team
The first and most important thing to do if you think you are experiencing mania is to reach out to your mental health provider. This could include a psychiatrist, psychiatric nurse practitioner, counselor, social worker, or other mental health professional. If you have a loved one or family member who is familiar with your illness, they may also help you receive support.
Identify Medications That Help
Healthcare providers typically treat acute manic episodes with medications known as antipsychotics. These drugs can reduce manic symptoms more quickly than mood stabilizers. However, long-term treatment with mood stabilizers can help prevent future manic episodes. Examples of antipsychotics include olanzapine (Zyprexa), risperidone (Risperdal), and quetiapine (Seroquel). Examples of mood stabilizers could include lithium (Eskalith), divalproex sodium (Depakote), and carbamazepine (Tegretol). If you have taken these medications in the past and have some understanding of how they work for you, you may want to write down that information in a medication card or have it added to your medical record to help you receive timely treatments and medications.
Avoid Triggers That Worsen Your Mania
Alcohol, illegal drugs, and mood-altering prescription drugs can all contribute to a manic episode and affect your ability to recover. Avoiding these substances can help you maintain your emotional balance. It may also help make recovery easier.
Maintain a Regular Schedule Whenever Possible
When you are living with bipolar disorder, having structure in your daily life is vital. This includes eating a healthy diet while avoiding caffeine and sugary foods that could affect your mood. Getting enough regular sleep can also help you avoid manic or depressive episodes. It can also help reduce the severity of any episodes that do occur.
Watch Your Finances
Going on spending sprees can be one of the major symptoms of mania. You can cope with this by limiting how easily you can access your finances. For example, keep enough cash to maintain your everyday lifestyle around your home, but not extra cash. You also may want to keep credit cards and other spending methods in places where they are more difficult to use. Some people find it helpful to give their credit cards to a trusted friend or family member, while others avoid obtaining credit cards altogether.
Set Up Daily Reminders
If you are worried you’re close to the onset of a manic episode, contact your mental health provider as soon as possible to discuss your symptoms. Create reminders for taking your medications and maintaining a regular bedtime. Consider using phone or computer notifications to help you keep your schedule.
Manic episodes can happen to anyone with bipolar disorder, even if you have worked to tightly control your condition. Recognizing symptoms as early as possible can help.
In the recovery period, it’s time to start regaining control over your life and schedule. You can discuss with your mental health provider and loved ones what you’ve learned from the episode, such as possible triggers. You can start re-establishing a schedule for sleeping, eating, and exercising.
It’s important to think about what you can learn from this episode and how you can help yourself in the future. This will help you later engage in mania prevention.
Following a manic episode, many people gain insight into what may lead to their episodes. Examples of common mania triggers can include:
- drinking alcohol or abusing illegal drugs
- staying up all night and skipping sleep
- hanging out with others known to be an unhealthy influence
- going off your regular diet and/or exercise program
- stopping or skipping your medications
- skipping therapy sessions
By keeping yourself on a routine as much as possible, you can work to prevent mania. You should immediately contact your doctor or any loved ones who can help if you suspect you may be heading toward a manic episode.
You may wish to consider creating a “Wellness Recovery Action Plan” if you or a loved one has bipolar disorder. These plans help you account for important decisions and contact persons you may need if you get into a crisis. The National Alliance on Mental Illness recommends these plans as a means to avoid a crisis or have easy resources to reach out to. Examples of items on this plan include:
- phone numbers of key family members, friends, and/or healthcare providers
- phone numbers of local crisis lines, walk-in crisis centers and the National Suicide Prevention Lifeline at 1-800-273-TALK (8255)
- your personal address and phone number
- medications that you are currently taking
- known triggers for mania
In addition to this plan, you can also create a Psychiatric Advance Directive. This legal document appoints a family member or loved one to act on your behalf while you are experience a manic or depressive episode. Doing this can ensure that your wishes, such as where you’d like to be taken, are carried out if you are in crisis.
You can also think about holding a “fire drill” for a future manic episode. This is a simulation where you imagine you are going into a manic episode. You can practice who you would call, and ask them what they would do to help you. If you find any missing steps in your plan, now’s the time to fix them.
While no one likes to think about manic episodes, it’s important to be aware of them and seek support in advance. Examples of organizations that can help include the National Alliance on Mental Illness (www.NAMI.org) and the Depression and Bipolar Support Alliance (DBSAlliance.org).