- Mental Health
5 Signs You're Going into a Bipolar Episode
One of the main strategies psychiatrists and therapists
suggest for managing bipolar disorder is to keep a mood diary. A mood diary,
put simply, is a daily chart of your mood. It generally has whether you took
your medications that day, whether you felt mildly/severely elevated or
depressed, and whether you experienced any anxiety during the day. It’s a
helpful thing and you can find online ones for free.
When I first began keeping track of my moods, I quickly realized that I am utterly out of touch with how I’m feeling at any point in time. I was terrible at identifying anything other than “absolutely depressed” or “absolutely manic”. Since the main point is to identify whether you’re going into an episode, this was less than helpful.
So I turned to hard facts, physical symptoms which I could rely on to let me know whether I was going into an episode. They may not hold true for everybody, but it may put you on the right track to identifying your own objective ways of determining what state you’re in—or headed for.
1. Tense muscles
Some days, I’m hunched over a computer all day and end up with a back and neck ache. That’s fine and perfectly normal. When my muscles suddenly feel tight for no real reason, that’s when I start to worry. If I can’t pinpoint a direct cause (e.g., I’ve been driving all day, I’ve been sitting in the same position playing Minecraft for the last seven hours without ever changing position), then it’s a warning sign to look out for other signs.
When I’m manic, I feel less like I need to eat. I’ll skip meals and generally can’t sit still long enough to make anything or even eat it. When I’m depressed, I crave junk food—especially carbohydrates. Studies have shown that this is a real phenomenon. While I won’t bore you with the details, if you find yourself eating cupcakes nonstop, or if you find that even foods you love sound less appealing than cleaning out your closets, you may want to take a step back and assess yourself.
I’ve also heard the opposite is true, where some people while manic love to eat.
In any case, watch yourself for any drastic changes in your eating habits.
3. Caffeine, Nicotine, and Alcohol
These are three things that you should absolutely avoid when you’re bipolar. They’re also things that are sometimes the hardest to give up. Cut back on the coffee and cokes, stick to one beer or glass of wine when you’re out, and quit smoking.
That said, they can be useful tools for figuring out what mood you’re experiencing.
When I’m depressed, I guzzle caffeine to give me the energy burst to get through the day. A lot of people need a mug of coffee when they wake up to give them a short burst, but if you find yourself going through a twelve-pack of Coke a day, then you may be depressed.
Nicotine is one of the hardest to give up, but it’s also the easiest to identify. Approximately 90% of those with schizophrenia smoke, with people who have bipolar coming up at 70%. Nicotine has a calming effect, not just from the chemicals in it, but also the repetitive motion of smoking a cigarette. When I had my first manic episode, I went from being a pack-a-day smoker to two-packs-a-day.
Alcohol is more variable, but it’s naturally a depressant, so you may drink more when you’re manic.
Also, if you’re trying to cut back or quit any of these and find it especially hard—I know quitting smoking would have been nigh impossible while I was in the middle of a manic episode—then you may be in an episode or heading for one.
This one is the easiest to identify and most mood diaries even keep a log for you of how much you’ve slept each night. It can also be useful to identify when you’re sleeping. When I’m having a manic episode, I barely need any sleep at all. I would go for days without sleeping, then crash for three hours, and be up for another few days.
Depression is more variable; some people suffer from insomnia, while others have hypersomnia. I find when I’m in a depressive episode, I sleep more during the day and would have nightmares or troubles falling asleep during night.
Given recent evidence that mania can actually be triggered by a lack of sleep, it’s important to keep an eye on your sleep habits.
5. Friends and family
Even knowing all your physical signs and occasionally just tapping yourself on the head to ask yourself, “So, how’s it going?”, you may not be able to tell when something’s wrong. That’s when an outside observer comes in handy. It may be a close friend who knows about your diagnosis, or your girlfriend or boyfriend, but whoever it is, ask them to keep an eye on you and tell you if you’re acting weird.
I would caution that you pick someone who is level-headed and familiar with you. My mother has a disturbing tendency to take everything as a sign of either mania/depression and even when I protest that I’m not reaching for that cupcake because I’m depressed, I’m reaching for it because it’s red velvet, dangit!, she refuses to listen and insists that I’m having an episode.
Also, be sure that you do your part and take a deep breath and don’t get angry if the person tells you something’s up. It can be hard, especially if your emotions are labile, and you want to deny that anything’s wrong—remember that they’re telling you because you asked them to and because they care about you.
Even with medication, episodes can and will occur. By keeping aware of yourself and watching out for warning signs and triggers, you can plan ahead and keep those episodes from rocking your whole world upside down.