Living and functioning with bipolar disorder takes a tremendous amount of effort. Even with treatment, every aspect of our daily lives has to be evaluated to see whether or not it will have an effect on the disorder. We do this to minimize impact. Everyone with bipolar disorder has triggers that can bring on depressive, hypomanic or manic episodes. So, not only do we have to find them, but we have to go through our day trying to avoid them. We also have to look out for signs that an episode is on the horizon, but those are even harder to spot, especially when you don’t really know what you’re looking for.
First, you need to familiarize yourself with the symptoms of full depressive, hypomanic and manic episodes. Then you can start to look for earlier, more subtle signs. At first glance, the warning signs of an oncoming episode look similar to the actual symptoms of an episode.
Early warning signs of a depressive episode include:
- Problems sleeping or sleeping more than usual
- Losing interest in activities or socializing
- Decreased energy
- Unexplained, physical aches and pains
- Feelings of guilt or worthlessness
- Crying for no reason
- Increased anxiety
- A hypomanic or manic episode
Early warning signs of a hypomanic or manic episode include:
- Needing less sleep
- Higher energy levels
- Increased self-confidence or optimism
- Talking more and faster
- Easily distracted and flighty
- Having more ideas
- Making lots of plans
- Unpredicted, inappropriate behavior
If you’ve experienced these symptoms before, it may be easy to go through these lists and think, “Yeah, that sounds familiar.” The problem is, it’s difficult to recognize it when you’re actually in it. Most of the time, mood changes don’t happen overnight. There is a buildup that leads to the full episode, so the small changes may go unnoticed until it’s too late.
Another issue is that the items in these lists are incredibly similar to the symptoms of the episodes themselves. They’re made up of generic terms and aren’t exactly personal. That’s why it’s up to you to figure out what they mean in your case. It’s called your relapse signature.
My symptoms, for example, look more like this:
My early warning signs of depression:
- I always feel like I need more sleep. I have more trouble sleeping and more nightmares.
- I cancel plans and appointments and don’t leave the house.
- Everything seems like a huge effort.
- Shower? Maybe. Makeup? No, thanks.
- I have more frequent migraines.
- I’m weepy. No dog adoption videos, please.
- I need a hug, but I also need you to go away.
- Overall, I’m in a bad mood, but I’ll probably feel bad about it later.
My early warning signs of hypomania or mania:
- I’m restless. I get twitchy.
- I have no doubt that I’m good at what I do.
- I get frustrated that others aren’t as good as I am.
- I interrupt in conversations when I would normally just listen.
- Suddenly it’s my idea to get together with friends.
- We should go on a trip. A trip sounds good, right?
- Just call me Chatty Cathy.
One way to figure out what your early signs are is to keep a symptom diary. You can use a regular journal or a chart specific to bipolar disorder. Once you’ve figured out what your early symptoms might be, you can keep a mood management plan to remind you of what helps and what doesn’t.
Image credit: flickr user steve p2008