What are the early signs that may help me predict a manic or depressive episode?
- Mania and depression often have triggers. In order to identify your triggers, reflect on past episodes and identify moments of stress, change, conflict, excitement, loss, opportunity, uncertainty, or anxiety that occured prior to the episode. These may be triggers of episodes.
- Identify fuels. Fuels are the behaviors, actions, feelings, impulses and thought processes that support and participate in mania and depression. By identifying these from past episodes you will be able to recognize them and respond to them before the fuels can be destructive.
- Notice how you are sleeping. Difficulty falling asleep, staying asleep, and waking up may be signs that you are vulnerable to mania or depression.
- Pay attention to how your thoughts are moving and if you feel a pressure to keep talking. If your thoughts are moving faster than normal, jumbling with each other or you find yourself having difficulty expressing yourself, this may be an early sign of mania.
- Notice how you are eating & grooming. If you are not remembering to eat and shower, this may be a sign of being vulnerable to mania or depression.
- Notice your sex drive. If your sex drive is significantly greater than it normally is or you are having difficulty containing your sexual impulses and desires this may be a sign of mania.
- Educate your support system with the information above and invite them to help you notice when you are vulnerable to an episode.
What is Mania?
To identify mania, professionals look at changes in a person's mood, behavior and thought processes. We then assess how they are effecting or disrupting a person's ability to work or succeed in school, manage their responsibilities, participate in social activities, and their relationships with others.
1.) Changes in Mood
People who are experiencing mania exhibit a mood that is significantly different from the mood that they would normally have. This mood lasts at least one week. This mood can be persistently elevated and expansive or irritable.
We identify this mood by interviewing the person as they're experiencing it or after. When it's possible, it helps to be able to talk with trusted people who've witnessed the mood in order to understand multiple perspectives of this different mood.
2.) Changes in Behavior
- Decreased need for sleep or sleeping for only a few hours per night
- More talkative than usual or a pressure to keep talking
- Increased goal activity or an obsession towards a goal that may or may not be realistic
- Taking greater risks in pleasurable activities which have more harmful or long term consequences. Example: spending money excessively, business risks, more sexual than usual or increased sex drive
3.) Changes in Thinking
- Inflated self-esteem or sense of grandiosity
- Flight of ideas that can be difficult to express or the subjective experience that thoughts are racing and possibly getting stuck or jumbled together making it difficult to communicate
- Distractibility or difficulty focusing on things beyond a desired goal
- The experience of delusions, hallucinations, and being out of touch with reality
In order to be diagnosed with mania a person would have to experience the change in mood for at least a week. During that time they would also experience 3 or more of the combined changes in behavior and thinking.
Example: Decreased need for sleep, inflated self-esteem or grandiosity, and taking greater risks in pleasurable activities.
What is the difference between mania and hypomania?
Hypomania is a form of mania in which a person experiences the symptoms of mania. However, the effect of the experience does not have the intensity to cause it to disrupt a person's ability to work or succeed in school, manage their responsibilities, participate in social activities, and their relationships with others.
What diagnoses a person with Bipolar Disorder?
Evidence of having one manic episode is all that is required to diagnose a person with Bipolar Disorder. If a person has never had a depressive episode they still would get the diagnosis of Bipolar Disorder.
What's the difference between Bipolar I. Disorder and Bipolar II. Disorder?
Bipolar I. Disorder is diagnosed when a person has had one full blown manic episode at some point in time. Full blown means that it significantly disrupted their life roles, relationships etc.
Bipolar II. Disorder is diagnosed when a person has only experienced hypomania, but has never experienced full blown mania, and has had at least one major depressive episode.
What is Cyclothymia?
Cyclothymia is a diagnosis that is given to someone when for a period of at least two years a person has experienced numerous periods of hypomania and numerous periods of depressive symptoms that are not disruptive enough in their life to be considered a major depressive episode.
What causes Bipolar Disorder?
We don't know.
There is evidence that Bipolar Disorder is genetic.
There is evidence that Bipolar Disorder is triggered and influenced by the environment, particularly how a person responds to life circumstances.
