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.
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
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.
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.
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
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.
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.
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.
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.
If necessary, I take my “rescue” medication, and I make note what time I took it.
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.
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.
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?
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