What I Do When Mania Starts

Last Updated: 6 May 2020

Mania can sneak up on me. When I recognize that I’m about to experience an episode, I turn to specific steps to keep it from escalating.

A woman gazes out at a sunset as she places headphones on. The setting sun is visible between her ear and the right headphone. Represents tactics for managing mania with bipolar.

Sudden Onset of Mania

Manic episodes in bipolar disorder can be scary. Often, due to a phenomenon called anosognosia (where a person is not aware of their own behavior or illness), I can find myself drifting into a manic phase fairly quickly and without noticing.

The most important steps I can take to keep a manic episode down are similar to what I do when I am feeling well.

What Do I Do When a Manic Episode Is Beginning?

  1. Ask my support system to let me know when my behavior is off. Spending sprees, pressured speech, akathisia (the need to move aimlessly), obsessions that pop up out of nowhere—these are prime symptoms for me when I am starting a manic phase. I need to be made aware of such behaviors.
  2. Set up a plan of action to put into motion if manic symptoms appear. Such a plan may involve calling my treatment team with a report of my symptoms, reducing my access to money or credit cards, or making a verbal contract not to harm myself in any way.
  3. Make arrangments with my doctor to have a last resort, “rescue” medication available to calm my racing thoughts. (I have permission to take an extra 1 mg of a common sedative prescribed by my doctor if I simply cannot slow the thoughts down any other way.)

What If I Am Alone When I Feel the Onset of Manic Behaviors?

  1. First, I call on my husband to serve as a check on my thinking. Even if I’m away from him, I need to validate my experiences and feel less alone.
    I tell him what I am thinking, and I ask his opinion of what is going on in my head. He’s not a clinician, but, since we’ve been married almost 27 years, you could say that he is the person who is an expert on my behavior.
    Other trusted people who can check your behavior may be parents or close friends who have seen you through episodes. People whom you trust with your safety and who have experience with your bipolar symptoms.
  2. If, between us, my husband and I determine that I am acting oddly, we contact my therapist and psychiatrist to make an urgent appointment. Whoever we can get in to see first, that’s who we see.
  3. In the meantime, I put on calming music. I have a collection of nature music I use to calm my thoughts when in a stressed or manic state of mind.
  4. I also do simple yoga positions for relaxation. My favorites for those times when I’m feeling extremely anxious or borderline manic are the “cat” and “cow” poses—I get down on my hands and knees and alternate arching and lowering my spine, with my hands lined up under my shoulders and my knees lined up under my hips. 
  5. If necessary, I take my “rescue” medication, and I make note what time I took it.
  6. This next step can be the trickiest: I go to bed on time.
    Sometimes this part of managing my mania is the hardest to do because I may have all kinds of nervous energy and want to do housework or writing work or engage in some other amusement, like watching television late into the night.
    But I have learned that trying to stick to my sleep routine—even if I am feeling restless—is a better option that staying awake all night, furiously cleaning the baseboards with a toothbrush. I give my body a chance to rest even if my mind seems determined not to allow it.
  7. Once I have an appointment with someone in my treatment team, we set up a specific plan. Of course, what we decide to do varies, depending on the specifics I’m facing at the time. But, still, the last step is the same. The final step, as you might suspect, is follow-through.
  8. Last, I make a determined effort to fully comply with the plan my treatment team sets up. It may mean a medication change, more frequent counseling sessions, or hospitalization. I trust my team, so I take their guidance to heart.

What Do I Do When Mania Seems Alluring?

The most concerning behavior, of course, is not wanting to stop the mania from happening. Even if you feel like you’re “only” hypomanic, know that mania is waiting around the corner. I remind myself that it could do some serious damage if I get caught under its spell. Untreated or mismanaged mania can destroy relationships, sense of self/mind, finances/credit rating, and more—if we let it.

These are the steps that work for me. They might be different from what works for you. But the biggest takeaway is to know what mania isn’t all fun and games. It’s a dangerous escalation of bipolar, and it needs to be addressed.

What steps do you take when you feel the beginnings of mania or recognize early hypomanic behaviors?

About the author
Julie Whitehead lives and writes from Mississippi. A reporter for the Mississippi Center for Investigative Reporting, she writes on topics concerning mental health, mental health education, and mental health advocacy. Julie was diagnosed with bipolar I disorder in her midthirties in 2006. She blogs about her experiences and daily life with bipolar at the site Day by Day. She has a bachelor’s degree in communication, with a journalism emphasis, and a master’s degree in English, both from Mississippi State University. She is also earning an MFA in creative nonfiction from Mississippi University for Women. Julie can be found on Facebook and Twitter.
  1. I hate that I have to take steps to stop the hypermania from escalating ! It’s my most productive happy state but also the most dangerous because it can so quickly become the tipping point to full blown manic episode of destruction. I utilise my husband and a trusted friend to monitor my speech and energy levels as they are my first signals …too much energy and non stop chatting . Then it’s off to the doc or psych and regime of mindfulness and strict routines around sleep and eating. Tweaking of meds may be neccessary. This has allowed me to function relatively normally since diagnosis in 2007 in my 40s. I work, am married ,have grown children and grandchildren . I do this to keep all of them ,I came so close to losing them all .

  2. I cycle rapidly. Usually every five or six days. I have been on medication in some form of another for 20 years but I have been either treatment resistant or it has caused severe issues. One medication gave me hallucinations – visual and auditory. Another gave me a thyroid tumor which caused a sixty pound weight gain and three years of daily chronic joint pain I’m still recovering from. I also have lesions in my brain that may or may not be demyelinating and could be causing MS symptoms. I have lost every job I’ve ever had and now have no income and am supported by my husband. I have filed for SSDI but am not yet even 40 so will likely be denied even though I am unable to work at the present time. I would like to hope I am not permanently disabled but I don’t know. It depends on when you ask me how I will answer you. I don’t want to be manic but I don’t really like being depressed and hopeless, either. When I start to feel hopeful and want to talk to people or become interested in intellectual pursuits I know that I am becoming manic and likely won’t sleep for days until I crash again. It won’t matter if I take ambien. It won’t matter if I exercise or eat organic. It won’t matter that I take my supplements and talk to my therapist. I banned myself from reading the news so last night I read the first three pages of Oh Pioneers! and realized that it was the second of Willa Cather’s books that I had read where she described Bohemian Immigrants as being “brown”. This led me down an internet search rabbit hole that lasted the better part of six hours. I’m from the Midwest and my ancestors were reportedly Bohemian and I’m very tan compared to most other people, even other descendants of Czech immigrants and I’ve always wondered about that but this is not the first time I have totally obliterated my precious overnight hours researching something that easily could have waited, seeing as how I am unemployed. But I’m not spending money, I’m not having reckless sex, I’m not doing drugs. I’m reading online journals and news articles and learning about history and…actually I can’t tell you now what I learned. But I could not have slept even if I had wanted to. I would have lay awake and tossed and turned trying to get comfortable with my muscles in my legs involuntarily twitching. And my therapist says that is not ADHD “hyperfocus” which is what I always thought it was. It’s hypomania. I have to learn to recognize it. But I have no tools to stop it from coming. And it’s very welcome compared to the hell of the depression where I am whiny and intolerable to everyone and crying all the time and people get tired of me feeling sorry for myself and I get tired of living in a world that hates disabled people. Yeah…this absolutely sucks. And I was not always like this. I used to be manic most of the time and the world loved and rewarded me for it. Until I was not. When I could no longer produce work 24 hours a day, the world didn’t want me. But I live in a rural part of the US. They still fire women for getting pregnant here and get away with it- routinely. I am happy to be married bc if I wasn’t I would be living in a shelter. But even so I don’t know that I can last long this way.

  3. When I get manic I clean and rearrange my house.

  4. I for example generally avoid advanced/creative writing, because that is major trigger. My mind starts racing and I often get euphoric and delusional. I also do things extra slow on purpose to maintain calm and control. Specific activities that can trigger and worsen mania are cleaning, shopping, surfing on Internet, fast walking, writing. So when I notice signs of imbalance I try to monitor myself in daily action, simplify thinking (no fantasies, no abstract thinking, inner dialogues..), cut down on contact making and talking, slow down movement, focus on breathing a lot. I do feel sad when refusing myself to do things or do things in a manner that makes me feel strong, smart, happy, connected. Like packing groceries like a Ninja-Einstein Tetris-Pro. But it gives better longterm results to keep it simple and move slow.

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