You may be able to short-circuit a developing mood episode through early intervention, but to do so, you must first be able to identify the early warning signs. In this post, I point out some common early warning signs of an oncoming bipolar mood episode (depression, mania, or mixed) and ask you to share your early warning signs.
One of the most challenging aspects of bipolar disorder is that those who have it often lack insight, meaning that in the midst of a major mood episode, their mood radar stops working. Consider teaming up with a loved one you trust to provide the objective insight you need. Remember: The earlier you intervene, the better chance you have of keeping a full-blown mood episode at bay.
Major depression is usually easy to recognize. You’re exhausted. You feel a deep sense of despair. Perhaps you even feel achy. You’re dragging your body through this thing called “Life.” The early warning signs, however, can be difficult to detect:
The early warning signs of mania are typically labeled “hypomania” and often result in feelings of euphoria and power – not exactly the sorts of things people typically seek treatment for. However, this is exactly the phase of a manic episode that requires early intervention.
One of the most objective symptoms to monitor is sleep – needing less sleep is a huge red flag and often easier to see than the mood changes of mania. Routinely keeping track of how much sleep you are needing and getting can be valuable in tracking mood states – impending, existing, and receding.
Common warning signs of an impending manic episode include the following:
When mania begins to escalate, loved ones can lose their insight, as well, especially if they feel threatened or hurt. It’s important to keep in mind that this is the disorder saying or doing hurtful things and not the person who has bipolar. This can be extremely difficult, but do your best to get your loved one the medical help he or she needs.
Notice that irritability and anger come up in both poles – these are common signs of both mania and depression. Because these feelings are so generic, they can be hard to use as a marker of a specific type of mood episode, but they are markers of brewing mood changes. Similarly, impaired concentration is often part of both depression and mania; the difference typically centers on the quality of the thinking – slowed and dulled in depression versus racing and feeling exceptionally clear in mania.
A mixed episode is the worst of both worlds. It includes symptoms of both depression and mania occurring every day for at least one week. If you notice the early warning signs for depression and mania alternating or co-existing over the course of a typical day, it’s usually a sign that a mixed-mood episode has arrived or is fast approaching. One minute you feel as though you can conquer the world, and the next you feel as though the weight of the world is crushing you – or you feel both sensations at the same time – a horribly disorienting and painful experience.
Bipolar disorder presents itself differently depending on the type of mood episode and the individual. What sorts of early warning signs do you typically experience? Which signs do you remain on the lookout for? If you have bipolar, do you have a friend or relative on call to help you keep watch? Whether you have bipolar or have a loved one with bipolar, please share your insights and experiences in dealing with the early warning signs.
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When I am entering mania, I feel “thin” and bouncy and don’t want to go to bed at bedtime. I stretch the going to bed routine out just like a child. If I do stay up all night I find I am not tired the next day and don’t sleep again until late the next night.
When I am entering depression, I just want to stay home, I stop doing things I like such as knitting, I don’t want to see anyone, and I start “surfing” about depression or suicide.
I can tell that I am moving toward mania when I become easily angered and aggressive toward my loved ones. I normally have a short temper but when I’m becoming manic it is completely different, more hateful and it doesn’t blow over quickly.
When I start to feel depressed - usually seasonally - I lose interest in my job and things I usually enjoy. I don’t usually notice that I’m depressed until it’s gone on for a while, sometimes a couple of months.
What usually can trigger a change in me is social situations, holidays and family tension. It usually has signs such as speaking loudly and arguing with
my family. Most of the time I am hypo-manic, and when I slip into depression, look out! I get confused and have lapses in memory.
I have a question. Since I am mostly hypo-manic, sometimes I get So wound up(like I take amphetamines)
that I shift into panic-mode, or fear. I can´t stop
shaking and afraid to leave the house. Paranoia?
What is this? Is this bi-polar, mania, or is this just an anxiety disorder? It doesn´t feel like it
Thanks very much,
nirmal
When I become manic I start making risky stock trades through my discount brokerage account. This is on money that I can’t afford to lose. I also start becoming very sexually promiscuous by going to see a lot of sps or escorts or prostitutes. In different parts of the country these sex workers go by different titles.
I also start blogging on financial sites with powerful views such as that this financial manager should lose his job etc. I start becoming very grandiose and omnipotent. I start to think that I am better than everybody else even though I don’t even have a job–lol.
Then all of a sudden I’ll start becoming a total recluse and will stay in my bachelor apartment for days without being able to even go out of my apartment at all.
I will start feeling worthless and experience extreme lows!
DEAR Candida Fink MD…
THESE STATED SYMPTOMS SEEM LIKE VERY SUPERFICIAL CLUES, BECAUSE THEY ARE SO COMMON AND NORMAL TO GO THROUGH… I HAVE HEARD FROM A SOCIAL WORKER… THAT WHEN THESE SYMPTOMS INTERFERE WITH YOUR FUNCTIONING… THEN IT IS A GOOD IDEA TO SEEK PROFESSIONAL HELP…
BEST WISHES…
GERSHON…
Some clues I’m heading into hypo mania:
**blurt out things I don’t necessarily want to reveal (as stated above) like my having bipolar or my mother committing suicide or my suicide attempts or talking about my kids’ accomplishments so I sound like I’m bragging instead of just being a proud mom; then I’m really embarrassed to have to see these people again.
**no patience for people making mistakes or not putting in their full effort (for example, at work) & then I’ll do something out of character like leave a note, not necessarily nasty, but pointing out their mistakes. I did that & got a note back from a lady with whom I had a good relationship & she wrote that when I was “perfect” she would take my advise under consideration. I later wrote her a note apologizing & said I was having a bad day & that I didn’t want to destroy our friendship & asked for forgiveness.
**calling or emailing people that I have not had contact with in YEARS & they are like “Who??” Then they figure out who I am & are wondering why the heck I contacted them. I just feel this urge to talk, talk, talk & connect with people… I put an index card by my computer & in my wallet about not contacting people by letter, phone, email, smoke signals, ANYTHING when hypo manic as I do embarrassing things AGAIN. I told my husband I need to move to Russia where they will not understand my English at least & will not know what the heck I am babbling about.
**feel extremely high self-esteem (very rare for me & such an incredibly wonderful feeling; it is hard to give this up).
**feelings of elation & a physical feeling of adrenaline coursing through my body as if I have taken a drug of some sort (amphetamine). Almost like electricity.
**sleep only 2-3 hours a night & have extremely high energy
**turn music up high in the car while driving & basically act like a teenager (I’m 55).
**join every club, organization or cause there is (I call them my “crusades”) & put so much effort into them that I quickly rise to the top & become president or on the board of directors or even on TV to represent them & I’m “normally” (whatever that is) a shy person.
It is very hard for me to give up the hypo mania as it can last for 5-6 mos. & I am actually a much “better”, more likable & productive person than when “stabilized.” My husband prefers that person (as I exercise like a fiend & have a great body, too, whereas on meds I gain weight & get sluggish). I’m the life of the party & HAPPY. I much prefer being her (hypo manic), too. But when I crash after a long episode I usually have dire results (overdoses).
Depression for me is very fast: Pretty much suicidal thoughts & crying easily. Low self-esteem & thinking everyone has horrible opinions about me. Don’t want to go out in public. Feel so worthless that I don’t even want to bother to call doc.
It’s just that the “stable” me is pretty boring & not as “happy” as the hypo manic me…
I am generally an edgy person. I am extremely moody with my children and my husband. Sometimes I am happy and easy going. However, most of the time I am a queen bitch. I usually feel really happy when I have money to spend. Every time I go out I feel the urge to purchase something. Shopping makes me happy. I can spend 5,000 dollars a day on things. The sucky part is after I am done shopping and spending money that I really don’t have I feel terrible. I feel guilty, poor,and like I have no friends. I experience both mania and depression sometimes simutaneously. However, when I am shopping I usually get extremely happy and euphoric. Another thing is I always feel like people are talking about me. I don’t see myself having any true friends. My general disposition is sad. I feel like crying just talking about it. I think that is partially what drives people away. I’m boring and I talk alot when given the opportunity because I am usually pretty lonely.
im one of those people who were the “shy girl” growing up. i didnt talk much so i was labeled wierd more misunderstood but (whatewver) i noticed when people would try and be friendly i would ramble on in conversations just couldnt shut up. but any who..i was the sweetest person u could ever know (couldn’t hurt a fly) but than there was this other side of me i gave it a name (Samie) ou see starts back to when i was six i always wanted my teacher to call me samie but she wouldn’t do it…and as the years passed i wanted people to call me samie but they wouldnt…than before i knew it i was playing everything on Samie like my behavior…why i was snapped at my teacher, why i punched my brother in the stomach. samie is very radical and unruly. has no regards for anyone not even the body she occupies…dumb me thinking that it was just severe depression and a bad case of anxiety had my care provider to prescribe me some medicine…a generic anti-depressant for effexor the dosage was too strong..i was started off w/ 35mg for like 1-2 weeks i dont remember the exact time…sorry anyways than i started a stronger dosage i had to take once i nthe morning and once at night (75 mg) which made me sick if i didnt eat w/ it and severely dropped my blood sugar..im anemic w/ a ulcer since (2004) but now im taking a different drug but it just made me worse…especially on my birthday (july 15) a few days ago. i threw a tantrum like a child when i couldnt go anywhere and im 22 i was acting so immature…than i started screaming and throwing stuff i just thought i had snapped…i think i did after words my nervous were shaky and couldnt really talk w/o stuttering. i just didnt make any since.
My highly successful, academically and career-wise, daughter just married a man she’d known for 3 months after a break up with a guy she’d dated for years. THe groom is nothing like her–at all: not educated; has no monetary potential; never had a career job; needed a green card…. None of my daughter’s friends can tell her what they are really thinking because she would cut them out of her life if they did. They have all expressed their disbelief to me. One of these friends told me that my daughter once suggested that she might be bi-polar, that she felt something was wrong with her. She definitely has the “push of speech” going on often, and she can be withdrawn and feel out of place and hateful about her appearance one minute and then the life of the party the next. I wonder where the line is between normal and sick, and whether this marriage might be the product of an episode. Can anyone say for certain?
I think I am usually in mixed episodes becasue I have all the above symptoms but It seems they are very rapid like the mixed episode describes.
I am struggling with a friend who has bi-polar. Something I want to say to those who like their mania…to the outsider (the friend or family member) watching you in your mania is like watching a person who has been a sober alcoholic relapse. I am sure for the alcoholic the first few drinks “feel good”, of course the consequences are not immediate so the alcoholic says the same things “I feel happy, calm, peaceful” but the other person knows that the swing works both ways and the higher you go the lower you fall…and then you will want us there to help. So while you are running around in your mania “getting things done” we are in complete dread. It is a fact your mania won’t last forever. I can speak for me, I would rather have you predictable and maybe for you that is boring but I live stable why can’t you.
I am just sad that my friend is lost to me until she accepts she needs to live a stable life which means not playing with her meds, and seeing her doctor when they stop working. Mania sucks for the people in your life …or at least it sucks for me.
My daughter is married to a man that was diagnosed with Bipolar last year and has a severe form of it with the rapid cycling and inability to hold down a job for more than a few weeks at most.
I knew that he was Bipolar from the first day she introduced us 13 yrs. ago since my mother was Bipolar will her early death at age 49.
Now she is having to deal with this hell at least until she can get out of nursing school and able to support she and her children.
For those of you who believe people like you better in your manic mood? No we don’t. It’s all in your mind. We would much rather have you in a stable, normal, mood.
During my most recent stint in the hospital, I began to wonder how much the medication is to make the patient feel better, and how much it is to make living with the patient easier for everyone else.
Guess I got my answer from these comments.
help what is rapid recycling?
Why don’t you cotton picking criticizers help us to understand what a normal person ’s moods R? Why do U criticize when we’re asking 4 ur help? And can U tell me if during your husband’s mania or depression does he hear voices? This would b most help ful to know from anyone out there taking care of a bi polar person. Hey!!!! Don’t knock my manic state. One year I made over 100,000.$ during my 4 month manic state. Wrote so beautifully my work was picked up by the best and will b a movie, also.
My mom has a severe case of bipolar and
It scares me that I too have it. I’m 16 about to
turn 17 in september and I’m getting scared…
what did you guys do when you were my age?
Hi, Not Sure–
What makes you think you have bipolar? I don’t want to say the only thing to fear is fear itself, but too much worry can certainly add to one’s stress level, which is never a healthy thing. I think remaining aware without letting your concerns consume you is the best approach, but that’s usually easier said than done.
Thank you, I just have these times where I\’m reallllly depressed. I\’ve been thinking about death a lot.. how maybe everything would be better if I wasn\’t here? I don\’t want to get into it but I might just be depressed. I\’m not sure but I just watch my mom and sometimes I see me in her
Your depression could stem from having bipolar, from whatever your family situation is, from other things in your life, or from something else entirely. Do you have a counselor you can speak with at school or through your church? A trained counselor or therapist, perhaps in conjunction with your doctor, may be able to help you sort out what’s going on, deal with whatever is causing it, and make you start feeling better.
I have recently been wrestling with my own bouts of depression and thought I could tough it out. I took my doctor’s advice and started taking an antidepressant, and in a matter of weeks, my entire outlook changed. I began looking forward to waking up in the morning and started to truly enjoy my work and family time again.
Feeling like crap is no fun. I encourage you to seek help and start enjoying your life. You may not realize it, but the time you start seeking help is when you begin to see how much the people around you really love you and care about you.
I have been married for 1 years. My husband left me last me last year saying he wanted peace and to be left alone. He also said he wanted a skinny girl with big breasts. I thought it was mid life crisis.
We got back together last year but I noticed over the years and especially when we got back together that his bhaviour was very strange. Bad mood swings, explosions.When e was in a high he bought properties and shares wuthout thinking. He has dekusions of grnadeur and he can become very abusive and then the next day he is a total sweetheart.
That is ho I ave been living. I am quite sure he has bipolar because of his manic/depressive mood swings and irrational behavior.
One day he tells me how grgeous other women are and he wants to be with them. Then the next day he will tell me how in love with me he is.
Does this sound like bipolar?
*** amendment
I have been married for 10 years !!!
As a person who suffers from bi-polar disorder and having a sibling with it I know the struggles. My brother and I were adopted as young children after many many bad experiences but were lucky enough to find good loving parents to adopt us. My biological parents suffered from some mental disorders though they were never fully diagnosed but bi-polar was there. Unfortunately my symptoms manifest themselves differently than my brother’s. As I am studying to become a psychologist I have had to come to terms with my disorder and understand the warning signs. My disorder symptoms are extremely similiar to Suzanne’s but one component that I have is EXTREME anger that ANYTHING can provoke since I am perpetually angry. This is NOT fun! You alienate people. My depression was more pronounced than the mania and I am now on anti-depressants that checked my tendency to anger but there are still problems. My family only sees the great strides from my previous behavior of tantrums that resulted in hospitalization of family members and many hard feelings. I made a choice to get help when I was left with no other option. My brother has MANY manic episodes and Few depressive ones but his change very rapidly and he has yet to see that he has a problem and misuses the meds he is given. There are underlying issues but trust me when I say that NO ONE likes the person in the Manic stage AT ALL! We look at you and your actions not your thoughts and feelings and unfortunately we HAVE to live and function in society and that is difficult when someone is afraid to act when around you for fear of not knowing your mood. GET HELP for your loved ones suffering because they NEED it. I have found that it is hard to tell someone they have a problem when close to the manic state but depression is easier to fob off and associate with a “down” mood that is temporary because of a bad day or bad situation and this is reinforced when the depressed state does in fact go away. Tape or videotape the person in each state and allow them to see for themselves what everyone else sees. I know my mom always threatened to tape us to show what we really said and meant and how hateful we were. i of course scoffed and said that it isn’t as bad as you are making it out to be. Little did I know it was WORSE then anyone could imagine especially when those who held me in favor and I looked up to and admired couldn’t look at me the same after witnessing one of my tantrums!
Good life everyone. I would not say I’m struggling right now but I am going through a cycle of change. I am female and with that comes the added factor of how much hormones can help or hinder my medication. I was finally diagnosed in October of 2007 and I’ve been taken Lamictal the whole time, lucky me. It’s been a godsend. When I first started taking it I had the flu like symptoms that lasted the whole time I was loading. I’m up to 150mg and for the past six months I’ve been taking Seroquel to help me sleep. I also learned early on that having my menstrual cycle kicks me into a very depressive state…however, that might have changed. I’ve been using the Nuva ring and using it so I won’t have a period. This month though my body just felt so raw and irritated that I stopped and wow, what a difference in my mood. I am constantly checking in with myself to see what I am feeling and if I know why. Honestly though it feels like a crap shoot most of the time. Am I feeling this way due to medication, hormones or a life situation? When I stopped the birth control I felt the flu like symptoms for a few days and I know I had a hypo manic episode. I know because life was way beyond good for a few days, my speech was rapid and my memory was shot all to hell. That is when I know I am manic. When I am depressed the first thing I notice is my swearing, I’m like a fountain of foulness. And my irritation level goes through the roof, my body is literally raw from interacting with people. And right now I’m starting to feel raw and I don’t know what to do. I have a life situation that carries a HUGE amount of stress and I’m afraid for my mental health. I honestly don’t know what to do. Do I need to adjust my meds? Do I need a different anti-anxiety med? Will meditation help? I can’t avoid or get away from this situation until it is resolved. I just know I’m going to be very aware of my moods and do my best. It’s all we can do.
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