4 Physical Signs of an Impending Manic Breakdown

Last Updated: 17 Nov 2020
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Skin issues and tinnitus are just a few physical signs of mania to be on the lookout forrecognizing them can help you be prepared.


When you live your life in a perpetual hypomanic haze—like I did for years— it’s hard to know whether you’re simply feeling a natural high or if you’re on the verge of a breakdown.

Over the years, I’ve noticed there are some physical symptoms that start to pop up to warn me that my body might be headed for a crash landing. Here are a few signs of mania to look out for if you’re worried that you may be on the verge of a breakdown:

  1. Skin Issues: Just prior to my last breakdown, I experienced a horrifying bout of psoriasis and cystic acne. I saw a dermatologist who wrote me several prescriptions, but no matter how many shampoos or steroids I tried, the skin conditions would not go away.
  2. Problems with Sleep and Focus: Though I was constantly fatigued and had difficulty concentrating during the day at work, my imagination would run rampant at night and I would get lost in creative project after creative project.
  3. Tinnitus: Around this time, I also began to hear ringing in my ears. I even visited an endocrinologist to see if my problem was autoimmune related or hormonal; it didn’t occur to me that it could be mental.
  4. Appearance Obsession: Lastly, I began to become super into my appearance and wanted to sparkle from each and every viewpoint. But growing up with the nickname “Suzie Sparkles,” I paid it no mind. I was on the up and up and nothing could stop me! That is, until I cracked—hospitalization, restraints, inpatient, outpatient, the whole nine yards.

Looking back, I had been so involved in my search for the perfect specialist that I completely missed the simplest diagnosis—I was totally stressed out. It’s mind-boggling to me that a relatively innocuous problem could cause such catastrophe in a person’s life. So, I beg you to study your body appropriately and to take a well-rounded approach to your wellness and find a doctor who can read the warning signs. What have you found to be your physical triggers? Please leave your comments below!

Learn more:
Dealing With a Dual Diagnosis: How to Break the Cycle
Life with Bipolar—Do People Say, “You’re Too Intense?”

About the author
Brooke Hilton is a writer, mental health advocate, and 2018 Master of Social Work candidate at the University of Southern California. An aspiring LCSW, Brooke plans to use her clinical education and financial acumen to transform the dual diagnosis treatment industry. An avid writer, Brooke has struggled with bipolar 1 disorder and substance use disorder for over 15 years. She is a contributing author at Bp Magazine, MindBodyGreen, Thrive Global, and The Mighty. Writing is a powerful way to cope, and Brooke wants to share her experiences and help raise awareness of those who are suffering in silence. Previously, she worked on Wall Street at companies like Wells Fargo, BlackRock, and Houlihan Lokey. She pursued an MBA from New York University in 2010 and a BA from the University of North Carolina – Asheville in 2003. A strong believer in a balanced approach to wellness, Brooke also received her fitness trainer certification from the International Sports Science Association in 2016.
82 Comments
  1. Well I am a newbie to knowing that I am BP 1. It still stuns me to even acknowledge it.

    My first delusions were in USMC boot at Parris Island, kind of a fitting place to go crazy. I thought that I could control the rain, later it was a LOT of irrational decisions which landed me in jail for AWOL where I had my first out of body delusion. Then the blackouts started and I lost friends and eventually family support. The USMC gave me a general under honorable discharge even though t he exit physical clearly stated that I had “Delusions of Grandeur”. I was simply kicked to the curb without knowing that I was a danger to myself and others because NO ONE told me what I had. I thought that I was just a bad person and that I could fix my behavior.

    I had hurt my back in the military and after a back surgery in 1976 I filed for VA disability for having a bad back. “DENIED” without any mention from the VA about the “Delusions of Grandeur” and what that meant or that it was the reason that I had hurt my back in a manic state. The denial triggered a depression which left me in a condition unable to function and the denial was never appealed. That became a finalized claim as far as the VA was concerned, “no disability for you”. In the years since then I have gone through so many jobs I’ve lost count. I’ve spent myself into bankruptcy and have jumped all around the country working but never for long and never able to save to retire. Now I’m 68 with nothing to retire on and know that I know what I am can clearly see the trail of possibilities that have been left behind me along with the destruction and betrayal.

    I wonder how different my life would have been if the USMC had given me the proper medical discharge and pointed me at the VA for treatment back in 1973. I wonder where I would be today if in 1976 the VA had told me about delusions of grandeur and bi-polar and treated me rather than defending their bonus money by denying benefits. I am now 68, still working and experienced a new blackout incident 2 days ago that has me terrified that I may hurt my wife or grandkids. I am an old man that is still a ticking time bomb waiting to go off that will not even remember what I have done.

    The USMC will probably not fix my discharge type and the VA will never give me the disability that I should have had since at least 1976. With the proper treatment and medications I’d have a retirement nest egg but because no one was looking out for me that isn’t the case. It just doesn’t seem fair but there doesn’t seem to be any place to turn to that can make this right.

    I’ve written to Trump, Senators Portman and Brown, my congressman and the VA asking for a fair shake on this an NOTHING. I can’t even get a copy of my records while it appears they are just waiting me out knowing that at 68 I’ll be dead soon enough and they’ll not have to give any disability payments. There is no shortage of texts and emails asking me for political donations though.

    I can’t work on the meds but without the meds I may have a blackout. I just don’t know what to do.

    Anyone have an ideas on fixing this situation?

  2. This is crazy because I’ve been having all of those symptoms plus back acne for about 6-8 weeks. Nothing helps the acne & psoriasis. I just talked to my therapist today & we agreed that I seem to be heading into a manic phase so I’m meeting with my psychiatrist on Monday. Weird that I came across this article.

  3. I’ve was diagnosed bi-polar 20 years ago. I take high doses of Depakote, Lamictal and Trileptal religiously. I got tinnitus almost immediately after starting the medication regimen. I’ve told numerous doctors and they act like I’m crazy. I’m not hearing things except a constant buzz. It gets louder the closer to the time for taking a dose or if I’m late. It’s like an alarm clock at this point. I do catch recognize heading into a manic stage these days. I hate these meds and want to get off them or at least change. Suggestions? Big pharma medications alter your body and create false addiction.

  4. Oh sleep patterns,
    .I haven’t slept in a while no matter much beer I can drink, I just wake up not feeling good, which is maybe another ploy to forget what I don’t understand,…I’m new to this and appreciate those who have come before me… My ears were ringing this morning, I hoped it the heart attack that would make it all quiet…nope, still got to deal with real life…good luck guys and thanks for the article

    1. …ears are still ringing

  5. Thank you for this. I personally developed IBS before I was properly diagnosed and got help for bipolar. The constant stress of hypomania (along with an intense work schedule and stressful home life) caused me to develop a range of digestive issues, including a stomach ulcer. At its worst, I couldn’t even eat a bowl of vegetable soup without having severe stomach cramps for the rest of the day. It makes sense that being hyped up and angry all the time, and not eating well will affect the digestive system.

    My PMS symptoms were worse too. I had cramps that were so debilitating I had to see a doctor right away. I would also have severe cramps after sex and after orgasm. I had tinnitus, cystic acne, and eczema breakouts. I had frequent yeast infections, too. Many of these symptoms can point to an auto-immune disorder, but I don’t have one. Since being on medication, I no longer have many of these symptoms. A note to the author: the one medication that works for my cystic acne is Spironolactone. It’s not a steroid and it doesn’t interfere with mood stabilizers.

    1. Unfortunately spironolactone does interact with lithium. I was on spiro for awhile before starting lithium and my skin looked better than it ever had. Once I started the lithium even a reduced dose of spiro caused me to start experiencing symptoms of lithium toxicity. Just a warning to other folks out there!

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