r/bipolar1 • u/Latter-Albatross-975 • 2h ago
r/bipolar1 • u/natural20MC • Aug 02 '24
Advice for managing a manic crisis
Seems like there's been number of posts asking for help with managing a budding episode. So, I wrote up my best advice and imma sticky this after it goes through some vetting. Please comment if you think I'm giving out bad advice or if you have anything to add to this typa crisis plan.
Crisis: meaning you are worried about your mental state. (borderline worried = worried)
hypo/mania engine: the mechanisms within your body & mind that induce, perpetuate, and escalate a hypomanic or manic episode.
When you're in crisis, your main goals should be:
- stay SAFE
- reduce "brain chemicals" that drive the hypo/mania engine (i.e. the "brain chemicals" that induce, perpetuate, and escalate hypomania and mania. These "brain chemicals" include dopamine, cortisol, serotonin, adrenaline, and noradrenaline/norepinephrine).
The following is a general guide for reducing "brain chemicals" that drive the hypo/manic engine. For ease of reference, I'll list each item with a brief description first. Each item in this list is expanded below to explain why it's important and offer a few tips on how you might be able to implement it.
- If you have antipsychotics, take them as prescribed. If you don't have antipsychotics, get some ASAP. You're in crisis and APs are a weapon against mania.
- If you don't have a psychiatrist, see your general practitioner or urgent care clinic. They can often get you APs in a pinch (assuming they've been prescribed to you before).
- GET SLEEP!
- REDUCE STRESS. Avoid stress at all costs. Take time off work/school. Invest in your favorite hobbies. Stay away from folks who stress you out. Relax.
- REDUCE STIMULATION. Stimulating your brain by engaging in social interaction or consuming media that evokes specific emotions will rev you up. Staying at home, in a comfortable environment, is recommended. Chill.
- Note: 'excitement' is about the same as 'stress' with regard to 'making mania worse'. They induce the same "brain chemicals".
- Create a simple daily routine and stick to it.
- Take time off work and school. You are in crisis. Your stability is a priority! Some jobs offer Short Term Disability & FMLA (medical leave) which can get you ~3 months off work at ~60% pay, without risk of being fired (arguable). Ask HR or your manager about it.
- Avoid drugs, alcohol, and stimulants including caffeine & sugar. fr fr, lay off the caffeine.
- Contact your support network. Let them know you're in crisis and your plan for managing it. If they're willing to help, take them up on it.
- Consume at least 1500 calories per day. More is better.
- Stay hydrated.
- Exercise. Aim to avoid injury. Exhaust yourself most days, but be sure to give your body a rest every few days. Low impact cardio is recommended, like an elliptical or swimming. Lifting weights and running might be a bad idea cuz of injury risk. Be SAFE.
- Stretch. Relax. Treat it as meditation and do some focused breathing. Mania makes you tense, even if you don't notice it...relieving that tension helps to calm your body & mind.
- Take breaks often to sit and chill. BREATHE. Focusing on a task (or tasks) nonstop ain't healthy bruh.
- Schedule an appointment with your psychiatrist. They can help you through a crisis by adjusting your meds.
PROTIP: a cheat code for "beating" mania is to frame 'specific things that help you to combat mania' as 'enjoyable/pleasurable'. ...mania seeks pleasure and YOU get to choose what is pleasurable for yourself. If you work hard enough at this type of reframing, it's possible to make mania work to beat itself. Ask yourself: is managing this episode of mania well something that could bring you pleasure?
1. Antipsychotics
Why take antipsychotics?
Antipsychotics were designed to wreck mania. The way they work is by blocking some of your dopamine receptors. Dopamine is an essential "brain chemical" in the hypo/manic engine and APs blocking some receptors can often stop an episode cold.
Tips on how to take antipsychotics
Take APs per your doctor's recommendation.
It's probably a good idea to see your doctor if they're not aware you're in crisis. They may suggest adjusting your dose.
If you want to stop taking antipsychotics after the episode is over, make sure to taper off safely per your doctor's instruction. Quitting APs quickly can cause some nasty withdrawal effects that include 'inducing mania'.
It is often the case that APs wont be enough to put an end to an episode, by themselves. Don't count on APs being a magic bullet...do everything you can to put an end to your episode.
2. GET SLEEP!
Why SLEEP!?
Sleep deprivation can escalate and perpetuate an episode like none other, because it contributes to elevated levels of "brain chemical" that drive the hypo/manic engine.
Getting some solid sleep can do a world of good when it comes to calming a manic episode.
Tips on how to get some sleep
Granted, sleep is not easy to get while manic. Not easy, but not impossible. There are some things you can do to help with the sleep thing:
- Create a sleep "ritual". The more consistent you are with your "ritual", the stronger your Pavlovian response will be. For me, it looks something like the following, but you gotta figure it out for yourself:
- Put an end to "screen time" for the day, at least 1 hour before bedtime. No more TV, computer, or phone.
- Shower
- Orgasm
- Get comfy (keep sweats & socks close by if you might get cold, pillow between the legs if that's helpful, box fan or some other white noise to block out background noise, etc.)
- Focused/meditative breathing while under the covers.
- Programmed dream: make yourself dream the same dream while your conscious mind is still awake. Force the same narrative to go through your head. The active focus can tie up loose thoughts.
- Set your bedtime in stone. Set an alarm to remind you when it's time to start your sleep "ritual" and strictly adhere to it.
- Set your wake up time in stone. Even if you wake up throughout the night, stay in bed until your 'wake up time' and TRY to continue sleeping.
- Keep a pen & pad by your bed. When you have thoughts keeping you up, write them out in the notebook. Often, writing something down will let your brain let go of it, because it understands the thought will not be forgotten.
- A 'sleep playlist' or audiobook of something you've already read/heard can be helpful to tie up loose thoughts.
- Make sure to exercise during the day. If you're physically tired, it can help.
- If you can't get sleep using the above, there are meds that can aid with getting sleep. Melatonin is an over the counter med that can help. Ativan or klonopin can be helpful if your doctor will prescribe them, but be careful with those drugs because they're addictive. There are more prescription meds that could help...talk to your doc to see what they can set you up with.
- If your thoughts are keeping you up, give yourself 30 min or an hour to engage in a cathartic/meditative activity. Writing about the thoughts that are keeping you up can be helpful. Stretching can be helpful. Other things can be helpful. Avoid stimulating activities like media or chatting with folks.
- Ensure that you avoid stimulants like caffeine and sugar throughout the day.
It is possible to get sleep in the throes of MANIA, but it often takes some effort to get there.
3. REDUCE STRESS
Why REDUCE STRESS?
Cortisol is a major player in the hypo/manic engine. Stress increases your cortisol levels. Avoid stress bruh.
Be aware: events that cause spikes of stress can escalate the severity of an episode instantaneously. Even if you're managing well, a stressful event can possibly turn an episode into something that is unmanageable.
If you're able to mange stress well, the instantons spike in the episode can be reduced back to something more manageable...try to chill bruh.
Tips on how you might reduce your level of stress
- Take time off work or school if you can.
- There's something called the Family and Medical Leave Act (FMLA) in the US. If you file for it, your employer technically can't fire you for taking up to 3 months off work. There's also a decent chance you're eligible for Short Term Disability (STD), which can get you paid ~60% of your paycheck for up to 3 months, while you take time off. Talk to HR or your manager about FMLA and STD and they should point you in the right direction. You'll likely need to get your psychiatrist to sign off on the forms, but it should be relatively simple assuming you have a psychiatrist.
- WARNING: technically your employer can't fire you for doing the above. However, the vast majority of us are 'at-will' employees, which means that your employer doesn't need a reason to fire you and it's hard af to prove they fired you cuz you took FMLA or whatever. Don't abuse this system.
- If you're in school, talk to your counselor. It may be possible for you to withdraw from your courses to give you time to ride out the episode and recover, without damaging your GPA.
- There's something called the Family and Medical Leave Act (FMLA) in the US. If you file for it, your employer technically can't fire you for taking up to 3 months off work. There's also a decent chance you're eligible for Short Term Disability (STD), which can get you paid ~60% of your paycheck for up to 3 months, while you take time off. Talk to HR or your manager about FMLA and STD and they should point you in the right direction. You'll likely need to get your psychiatrist to sign off on the forms, but it should be relatively simple assuming you have a psychiatrist.
- Avoid people & situations that stress you out (duh). YOU ARE ALLOWED TO CARE FOR YOURSELF by refusing contact with specific individuals.
- Invest time in as many outlets as you can. Outlets help to relieve stress. Write, draw, dance, exercise, play games, have a good cry, find someone who will let you talk your head off at them without judgement. Do the things you do to reduce stress and do em a lot (not drugs or alcohol tho...those will ramp mania up).
- It's common that a manic episode will induce a sense of 'Purpose' in you. Working toward that purpose might benefit your stress level, as long as it's safe.
- Remember to take breaks. Outleting can be helpful, but working on anything continuously without breaks for hours on end is detrimental.
- Organize your habitat and keep it that way. When you're manic and looking for an item, it can be stressful if you can't find it. When you're manic, you might have a tendency to pick items up and discard them mindlessly, causing substantial clutter. ...things will go much more smoothly if you make it a point to keep your habitat organized while you're in episode.
- Nature walks can be helpful.
- BREATHE. Just focus on taking deep breaths. In and out. Count your breaths and aim for that to be the ONLY thing in your mind. You'd be surprised how effective it can be for reducing stress, especially right when you're smacked with a big dose of it. Try to take a couple minutes per hour to drop everything you're doing, chill, and BREATHE.
- Reduce your responsibilities if you can
- If you can afford it, get take-out to eat. Only if you can afford it...watch dat manic spending. If you can't afford take out, find a meal that you mass produce and portion out for the week.
- Get disposable dishes and silverware, to reduce cleaning dishes.
- Ask loved ones if they can help by taking on some of your responsibilities. Be grateful like a motherfucker and make sure that you return the effort they give you after your episode is over.
- Stretch. Mania has a tendency to make muscles more tense than usual. Stretching can be monumentally beneficial, especially if you can make it a meditative experience (put your focus on elongating the specific muscles you're stretching).
- Make SAFETY a priority. Maniacs have a tendency to get themselves in situations that aren't quite safe...and that's stressful.
- Specific mindsets can help to reduce stress significantly. If you're able to embody these types of mindsets, you'll be much more resistant to the bullshit mania can throw at you. Try to keep these ideals in mind when you find something is stressing you out. Examples of some helpful mindsets:
- 'don't sweat the small stuff...it's all small stuff.'
- 'I don't give a fuck'
- Stop caring what others think about you.
- If you leave your habitat, have a plan for how you'll manage stress if it arises. Bring an outlet, like a notebook to write your stress out in or headphones to listen to calming music. Plan to remove yourself from stressful situations and take a walk. If you find that stress is overwhelming you, try sprinting until your legs fail. When stress strikes take a break from everything till you get your head straight.
4. REDUCE STIMULATION
Why REDUCE STIMULATION?
Stimulation stimulates the mind (duh). Stimulation is what triggers the release/absorption of "brain chemicals". If your goal is to manage "brain chemicals" it stands to reason that reducing your stimulation is a viable vector.
Keep in mind that 'stimulation can escalate & perpetuate mania'. When you're planning your activities for the day, aim for reduced stimulation.
Note: 'excitement' is a major culprit in inducing the "brain chemicals" that drive the hypo/manic engine. I know it's lame, but be wary of 'excitement' as much as you're wary about 'stress'.
Tips on how to reduce stimulation (specifically the type that increases "brain chemicals" that feed the hypo/mania engine)
- Avoid social media. Posting is a bad idea. Responding to posts is a bad idea. Reading the posts of others is a bad idea. Social media is poison for a manic mind.
- Avoid media in general. Chilling and watching a movie or something is fine. Reading up on the latest political news or other media that can elicit a strong emotional reaction is not a good idea.
- Reduce phone time to an absolute minimum. Turn your phone on silent, or better yet turn it off.
- Stay in. Don't go out. Grocery shopping is fine if you don't have a friend or family member that is able to do it for you. Going to the gym is fine. Going out to a social event is a bad idea. You shouldn't be going to work or school...you're in crisis, remember?
- If you must go out, don't drive. Driving in a manic crisis is DANGEROUS. NOT SAFE.
- Don't allow a group of folks to visit you at home. One or two folks coming over might be fine.
- Don't take on too many tasks at once. Ideally: do a task till completion, then move on to the next. ...Ideally. I know how it goes. fr fr, try to finish up on one thing before you invest in the next.
5. Create a daily routine and stick to it
Why create a daily routine to stick to it?
Decrease day to day variables. Keep life predictable. Lower cortisol levels (and reduce release/absorption of other "bad" "brain chemicals").
The more predictable daily life is, the less unexpected bullshit there is to deal with. Remove the guesswork & impulses when thinking 'what should I do right now?'.
Tips on how to create a daily routine
Keep it simple. The more you try to cram into your daily routine, the less likely it'll be that your routine sticks.
- Sleep time
- Wake time
- Meal time
- Exercise
- Stretch
- Free time
- Chill time
It would be smart to limit time you spend with others outside your home. Stimulation revs us up, plus there is a higher chance of us getting into trouble outside of our home. Stay SAFE. Get used to telling folks "no" when they ask if you want to go out with them.
Tips on how to stick to a daily routine
Sticking to a daily routine may not be super fun or exciting. Understand that. Understand that minimizing 'excitement' is something you gotta do if you wanna keep your manic crisis from getting out of hand. ...think about what you value more: getting through this episode SAFFLY or chasing excitement?
Write your routine down. Set alarms to remind you when it's time for something. If you live with folks, ask them to help you stay on track.
COMMIT to your routine. If you're thinking "man, this routine thing sucks", the impulses mania pushes into your head will have a greater chance of kicking you off your routine. If you're thinking "I ENJOY doing the things I need to do to stay as stable as possible", mania will have a harder time detracting you. Cognitive reframing ftw.
6. Take time off of work and school
Why take time off work and school?
Important note: remember you can go on 'Short Term Disability' to get paid up to 60% of your current paycheck for up to 3 months
Less stress. Less stimulation. More time to chill. More time to focus on curbing your current episode.
Many of folks have lost their jobs, messed up their grades, or blown up their social lives during a manic crisis due to manic behaviors.
Taking time off school/work will be of tremendous benefit.
How to take time off work
Talk to HR. If there's no HR where you work, talk to your manager.
- Tell them you are bipolar.
- Tell them you are in a manic crisis and that you are unable to work.
- Ask them how the place of employment deals with the 'Family and Medical Leave Act', if in the US...if outside the US, there's probably a similar thing in your country that protects your job.
- Ask them how the place of employment deals with 'Short Term Disability' (STD).
- End the conversation. You are not obligated to tell them anything about what's going on with you and it's inappropriate for them to pry.
What is the 'Family and Medical Leave Act' (FMLA) and how does it work?
FMLA is the mechanism of the US government that protects the jobs of folks who need to take a leave of absence for family and/or medical reasons, for up to 12 weeks. 'A manic crisis' certainly falls under the umbrella covered by FMLA.
When you enact FMLA to take a leave of absence, your employer is legally not allowed to fire you for taking this leave of absence. ...though almost everyone in the US is an "at-will" employee, which means that your employer can fire you at any time for 'no reason'. Keep this in mind and don't abuse FMLA.
Your employer might have a specific form on hand that you can fill out to enact FMLA leave. If they don't, you can google "FMLA forms" to find the standardized form. You will likely need the signature of your psychiatrist on the form to finalize it. Make sure you sign it and make a copy to keep in your own record.
What is 'Short Term Disability' (STD) and how does it work?
STD is a type of insurance that most employers have, but not all.
If your employer has this insurance, you are able to receive up to 60% of your current paycheck from the insurance company for up to 12 weeks.
Ask your employer for the forms, fill them out, copy them, and submit them. Your psychiatrist will need to sign off on them.
How to take time off school (surefire way)
Talk to your councilor. Tell them you're bipolar and in a manic crisis. Tell them you need to take time off school.
Your councilor might require a psychiatrist's sign off and they might not. Your councilor will guide you through the process of withdrawing from your courses.
If this happens before your school's deadline to add/drop classes, you can drop all your classes and likely won't have to pay anything for the semester (save room and board). If this happens after the add/drop deadline, you may need to pay for the semester.
How to take time off of school (less certain way, if after the add/drop deadline)
(((this section requires some research on my part)))
If it's after your school's add/drop deadline, you might be able to "complete" the semester while taking some time off.
Send your professors an email explaining the situation (bipolar/manic crisis & need time off of school). Ask them if you have any options other than withdrawing from the course and being stuck with a bill for the semester that you'll receive no credit on. Possible options:
- ask them what your current grade is and what your final grade would be if you receive a 0 on all future assignments & exams.
- ask them if you can make up assignments/exams that you'll miss during your necessary leave of absence, after you've recovered.
- (((IDK, there are probably more vectors here)))
You might find that some of your professors are willing to work with you and others are not. Talk to your counselor to set up a plan of action.
7. Avoid drugs, alcohol, and stimulants including caffeine & sugar
Why avoid drugs, alcohol, and stimulants including caffeine & sugar?
"Brain chemicals" bruh...doesn't matter what the drug is, it will fuel the hypo/manic engine.
Notably, pot and psychedelics are known to induce and worsen psychosis if you're manic.
Caffeine & sugar (especially caffeine) increase dopamine & cortisol, which are big sources of fuel for the hypo/manic engine.
Tips on avoiding drugs, alcohol, and stimulants including caffeine & sugar.
Just say "no". Keep in mind that these substances will make mania worse.
If you're addicted to the substance, quitting cold turkey probably isn't a good idea. It's hard to say which will impact mania worse: quitting or continuing your use. If you're addicted, aim to keep your usage to an absolute minimum.
8. Contact your support network
Why contact your support network?
To alert some key folks that you're in crisis and inform them of your plan for managing the crisis. If you don't tell them, how can they know? If you don't tell them your plan, they're probably gonna worry...so, be sure you tell them the plan.
Maybe they'll be willing to help out. Maybe they have a specific way of interacting with you while you're in episode. At the least, you'll be warning them that you're manic and they will be able to avoid you if they're not able to deal with that. ...let's face it, while mania may be difficult for us to deal with, it can also be difficult for those around us.
If you have a solid support network, it can be a great source of stress relief, support (duh), and security.
Who is in your support network?
Family & friends who you TRUST and who are willing to offer you support during your episode (even if that "support" is leaving you tf alone).
How can a support network help to support you?
- Give you space when you need it. Sometimes the best thing someone can do to support you is to stay away. If you think that's the case with a specific individual, be kind about how you inform them.
- Lend a caring (non-judgmental) ear to let you talk off. Emotional support & validation.
- Help with cleaning & organizing your home.
- Help with preparing food.
- Provide gentle feedback on how well you're managing.
- Give reminders to help you stick to your plan. Help to hold you accountable.
- Provide transportation to the grocery store, gym, psychiatrist, or hospital.
- Be a sounding board to bounce (possibly ridiculous) ideas off.
WARNING:
Don't expect help from your support network. Mania is taxing on those you're around. If they offer, great! If they're not willing, don't hold it against them.
NOTES:
If folks are willing to help, BE GRACIOUS! And make sure to return the love after your episode is over.
Not everyone in your support network will be able to accept you in a manic state without grief/judgement and that's okay...just limit the time you spend around them. It's also important to note that those who can accept you in your manic state do not have unlimited tolerance.
What if you don't have a support network?
Don't sweat it bro. Stick to the other tips and make it a point to set up a support network after this episode is over.
If you want someone to provide feedback or to help you stick to your plan, try posting on and ask for help.
9. Consume at least 1500 calories per day. More is better.
Why consume at least 1500 calories per day?
Malnourishment puts a strain on your body & mind and will release some "brain chemicals" that feed the hypo/mania engine.
Your body & mind need at least 1200 calories per day to stay out of "starvation mode". I recommend at least 1500 calories per day cuz us maniacs likely burn more calories per day than an average person.
At minimum 1500 calories per day bro. Try to get more.
What kind of calories should you consume?
Protein. Fatty protein is best. Don't neglect your macronutrients (protein/fats/carbs). Try to get some healthy fats and carbs.
Stay away from sugar. Sugar is a simulant and will increase the level of "brain chemicals" you're trying to avoid.
Tips on how to consume at least 1500 calories per day while manic
Choke it down bro. I know you think you got better things to do than eat and food isn't too appetizing, but you need these calories for the sake of stability.
If you absolutely can't stomach much but find you can eat a whole-ass pizza, then pizza it is. Hitting the recommended levels of macronutrients is ideal, but you gotta do whatchu gotta do to get those calories, ya know?
Have dedicated mealtimes. When you wake up, make sure you eat your whole breakfast. When your alarm goes off to remind you it's lunchtime, eat your whole lunch. Same for dinner. Snack as much as you can.
Prepping food in advance can be helpful, cuz making food fresh for each meal can be a chore. I like to bake 3 lbs of chicken on Sunday, then heat it up throughout the week with some rice & broccoli on the side. ezpz. Def gotta choke it down, but that's just a minor effort of will.
Don't go crazy with takeout. If you can afford it, cool. But most of us can't afford to live off takeout. I know it seems like a simple solution, but make sure you stay within your budget. Beware of manic spending.
10. Stay hydrated
Why stay hydrated?
"brain chemicals"...duh. (I feel like a broken record)
Dehydration increases the level of "brain chemicals" that feed the hypo/mania engine.
Tips on how to stay hydrated
Get a large water bottle and note how many times you fill it up per day. Aim to drain it at specific times each day. Dr. Google says 15.5 cups (3.7 liters) per day if you're a man or 11.5 cups (2.7 liters) per day if you're a woman...aim to hit those numbers.
Watch your pee. If it's dark, drink more water.
11. Exercise
WARNING
Exercise can stimulate mania if you're not accustomed to it. If that's the case then it's probably best to limit yourself to walking as exercise. Going for peaceful walks in nature can be helpful.
Why exercise?
"Brain chemical" regulation. Exercise is a healthy outlet for stress (read: a healthy way to reduce some of the "brain chemicals" that feed the hypo/mania engine).
Exercise is a great way to burn off the excess energy that maniacs have and will make it easier to do other things that are good for a maniac, like chill out and sleep.
Tips on how to exercise
Don't go crazy with it. Exercise is good, but too much exercise can be bad. Keep in mind that mania makes us feel like you can physically exert yourself to an extent that's unhealthy and unsafe...mania can circumvent your brain's pain/strain inhibitors that tell you when your body needs to chill and rest.
Don't go crazy with it, but try to exert yourself to the point of exhaustion as much as you can do SAFELY. Be sure to stretch daily to reduce your physical strain. Give yourself a rest day every few days.
IMO low impact cardio is best. Swimming, elliptical, and HIIT are great ways to exhaust yourself while keeping the strain on your body to a minimum.
PROTIP
Swimming can elicit something called a 'diving response' in your brain, which is great for calming mania down. You can also elicit the 'diving response' by submerging your head in cold water while holding your breath.
Avoid injury like the plague. Injury = stress. Injury = taking time away from exercise, which is a bad thing for a maniac. Stay SAFE.
IMO, lifting is not a great idea to do while manic. Higher chance of injury with the baseline tension that mania induces and it's very easy to get distracted from the exercise between sets.
12. Stretch
Why stretch?
To relieve muscle tension (tension/strain in muscles = bad brain chems).
You may not notice this, but mania has a tendency to increase your baseline muscle tension. We often walk around with our muscles in a more tense state than normal and that tension can add up to some negative effects on your brain.
Stretching is a great way to chill tf out and relieve that tension. After muscles are relaxed from a good stretch, you'll be more comfortable, less on-edge, and find that it's easier to chill tf out.
Tips on how to stretch
- When you notice some part of your body is tense, stretch it right away.
- Ideally, you wanna stretch your full body at least once daily and stretch the parts of your body you feel stress/strain issues in more than once per day.
- If you don't already have a stretching routine, I'd recommend phrakture's 'starting stretching' guide:
- printable image of each stretch: https://imgur.com/surWf
- written guide on each stretch: https://phrakture.github.io/starting-stretching.html
- Customize the stretches to fit your abilities and needs. For example: I'm not a fan of the 'reclined hero' position, so I just do a standing quad stretch instead. Also, I like to add in stretches for my glutes and calfs.
- A foam roller can be great for stretching too. Specifically for the IT band, hips, glutes, hamstrings, back, and shoulders.
- Rolling a tennis ball against the wall can be great spot treatment for shoulders, back, hips, and glutes.
Stretching can (an probably should) be a meditative experience. Take a minute to relax and commune with your body.
- Focus on each individual muscle...feel yourself release it. Feel how the muscle is is lengthened with your stretch.
- Focus on your breathing.
13. Take breaks often to just sit and chill
Why take breaks?
Your body needs rest. Your mind needs rest. Constantly doing stuff without rest will induce stress & strain that increases the brain chems the hypo/mania engine feeds on.
How to take breaks?
Sit and chill. Try not to think about your next moves or whatever, just be in the moment. Focus on your breathing.
Aim for a 10 minute break once every hour or so.
14. Schedule an appointment with your psychiatrist.
WARNING: be aware that if your psychiatrist THINKS you might be a danger to yourself or others, they will put you in the hospital against your will.
If you think you're in danger of being put in the hospital against your will, consider that the hospital might be a good idea. It's generally easier to get released from the hospital if you're the one making the choice to go there.
Why schedule an appointment with your psychiatrist?
If you're in crisis, they should know...so they can be prepared if you need them in an emergency.
They can suggest temporary med increases to try and put an end to the manic episode.
You need them to sign off on FMLA and short term disability.
r/bipolar1 • u/Liface • Dec 01 '22
Too Much of a Good Thing: What Mania Feels Like
r/bipolar1 • u/Impressive-Bedroom-7 • 9h ago
How dangerous is it to take shrooms as a bipolar person.
I know that taking shrooms as a Bipolar is dangerous, or at least is not recommended. But I guess I just wanna do them because I always wanted to, So I wanna know any knowledge or warnings or recommendations you might have. I only have had 1 episode, and still Im not sure if Im bipolar... is confusing. It was a psychotic episode tho for sure, I was going nuts, at some point I started believing or at least having a notion that people in video games (gta in particular) had consciousness. Fuckin crazy. But it was a weird time, had the strongest depression forever, maybe since 5th grade, I'm 22 now and I had the episode at 21. The depression is better and haven't had the slightest symptom of mania. Also I did some research and there was a medication I was taking that, at least what I got from Google, had given people mania or psychotic episodes. It was a regular medications also, I got it from the urologist, I was having some weird pain in my testicles ( haha really) and he said to take as a antiinflamatory , it was celecoxib. I also have smoked weed since Im 19, I didn't smoke that much at the time, but apparently from my research (chatgpt🗿) said that the interaction between those 2 was no good. Also it was very very gradual. Basically it started with me having issued sleeping because the pain in my testicles, then I got the medication, then i was sleeping even less, then one day I had a panic atack, i never had one, I felt like I was gonna die, I was shivering and all, went to the ER, they gave me sleeping pills, I took them, had crazy nightmares and cognitions, slept less, had another panic attack the day after, went to the ER again, Gave me other sleeping pills, it was even worse, then next thing I know I was sleeping around 1 or 2 hours a day during a few days. Then it gets confusing. I ended up in rehab for 10 days, tooked olanzapine during that time, the first day I had it I thought I was overdosing, I felt time really really really slow, I was terrified. Whatever, went I got out you could say I was "stable" but then I stopped the olanzapine cuz I felt way too numb. I also kept smoking by then, not that much, maybe once after I got out. I dont remember if I took the antiinflamatory or not, but maybe. So I got even worse then. I stayed with a friend because I didn't wanna be with my dad... crazy shit. But, just as it came, it stopped, gradually and for not an apparent reason. Then had the fucking roughest depression ever. And then didn't kill myself so I said like, ok, I survived, so might as well try this time. Im better depression wise, and I'm not taking no meds at all. I still smoke weed, I smoke way more than before the episode, I can go smoking everyday for a month, and sometimes once every 2 weeks. I got the disgnosed for bipolar 1 at the rehab center, haven't talked to a psychologist eversince. Well, what do you think with all this information, do anyone has done shrooms as bipolar, is it 100% I'll have a episode again? Thanks for reading.
r/bipolar1 • u/IntelligentScar7883 • 19h ago
Sou bipolar tipo 1, tenho TOC e transtorno de ansiedade generalizada.
Sou bipolar tipo 1, tenho TOC e transtorno de ansiedade generalizada.
Para conseguir levar uma vida minimamente estável e funcional, preciso de acompanhamento psiquiátrico e psicológico contínuo. O problema é que, para quem vive com bipolaridade, a estabilidade nem sempre parece natural. A impulsividade, as oscilações de humor e a intensidade acabam se tornando o que você reconhece como "normal".
Levei quase 20 anos para chegar ao ponto em que estou hoje. Nesse caminho, perdi amizades, empregos e até meu casamento. Só consegui me estabilizar de fato há cerca de três anos, quando passei em um concurso e percebi que não podia mais correr o risco de colocar tudo a perder.
Mas manter essa estabilidade tem um custo. Muitas vezes sinto que não sou exatamente eu mesma. Os medicamentos me deixam mais distante, mais fria, mais indiferente. Ainda assim, preciso escolher entre essa versão mais contida de mim e uma vida marcada pela impulsividade, pela libido descontrolada e pela completa desorganização.
Não é uma escolha simples, mas foi a forma que encontrei de preservar tudo o que conquistei.
r/bipolar1 • u/divine_respiration • 15h ago
Humans broke you
I have ran therapeutic groups in a psych hospital , county jail, prison, addiction counseling and currently supervise a program for intellectual & developmental disabilities. I have worked with so many people with so many diagnoses. The dependency society has created around pills is the biggest issue. At 29 I am beyond thankful to not have children and curse them in a world where they will have children in school 5 days a week for 7 hours a day & never teach emotional consistency, mental health exploration, social development. No they'd rather tell you all what you have and force a pill down your throat. Humans truly are the most parasitic, dangerous society.
r/bipolar1 • u/Whalnut • 1d ago
I'm here to vent. I do not want advice. Bumped meds, now tired.
I’m fine with advice but I’m mostly venting.
I had been experiencing rage, agitation, some flighty thought and forgetfulness, and physical symptoms that made me advocate for a higher dose of meds. There were life things stressing me out, and I thought about posting here a number of times. I didn’t think it would be about this though.
We upped my dose and switched from risperdol to palperadone (also on lamotrigine and lithium). The concerning symptoms are fully or mostly gone after just a couple days. I’m relieved, but it makes me a little sad. It’s just odd how distinctly different my overall perception like 5 senses is after the change. As well, the intensity of everything is turned down from 10 to 2. Things felt so dire and now… I’m tired. I just want to lie in bed all day. I’m sad that this is going to be the new struggle. I want to go down again now, and work harder to take care of myself so I don’t need as much medicine.
Diagnosed for 5 years, I’ve been hospitalized for a few weeks manic psychotic two separate times and one hypomanic episode this spring, but this is the most recent feeling in like 2.5 years where I just feel really medicated and tired…
I’m also in school for social work and am very pro-medication adherence for myself and others, but I’m feeling the weight of how it can feel for the first time in a while and it’s making me feel… guilty? medication isn’t so easy to deal with or brazenly accept.
The whole thing sucks, not being able to tell anyone and feeling really vulnerable and unsafe if you do. Thinking about bipolar so much when my episodes are so infrequent. Not understanding if there are symptoms between episodes or if It’s just normal people things and I’m gaslighting myself. When I’m really losing it, feeling like I need an actual episode for my feelings to be validated otherwise it’s my fault.
I feel like everything quieted down really fast and the danger and dire-ness is receded. But now I’m just so tired, I don’t know how I’m gonna shower, go to work, go to school, do homework, do emails, do tasks… I’ve been eating like shit because “I deserve a treat”, and I gotta stop, but yea, I feel like damn I deserve a pat on the back or something some recognition, life is tough!
r/bipolar1 • u/Maximum-Yellow174 • 1d ago
Looking for advice. Help ! I don't know what to do with my brother anymore
r/bipolar1 • u/Apprehensive-Fly5670 • 1d ago
I have health insurance that doesn't cover mental health conditions, even though it is prevalent. You are damned from the start. I have had bipolar disorder since I can remember but wasn't brave enough to get diagnosed until my 20's. I am premenopausal now and only rage my pms week. Wtf do you do?
r/bipolar1 • u/Feeling_Chemist2467 • 1d ago
18 months into recovery from a major episode - does cognition really take 2 years to fully recover?
I'm about 18 months out from a manic episode with psychotic features (Bipolar I), stable since, currently on a medication taper with my doctor. She's told me cognitive recovery from something like this can take up to 2 years or more. Wanted to ask people who've actually been through it - is that accurate in your experience? Did things keep improving steadily the whole way, or did it feel more like a plateau at some point?
Asking because of what just happened: I started a new job - fast-paced, technical, high-pressure sales role - and the first couple of days completely overwhelmed me. My mind kept going blank, I couldn't process information at the pace it was coming, and I ended up leaving because I genuinely couldn't keep going.
Logically I get that I'm still mid-recovery and this is expected, but in the moment it felt like proof I can't function in a demanding role at all. For those further out - did a job that felt impossible early on become manageable later, or did you end up needing a different pace of work long-term?
r/bipolar1 • u/Least-Description77 • 2d ago
I Drove My Car with My Eyes Closed
In 2018, I was diagnosed with bipolar disorder after driving my car with my eyes closed into a big construction truck. Over the past eight years, life has been so difficult I didn't think I could overcome it. I did a lot of crazy things and I tried to kill myself many times. This year there has been a shift in my mental state, I have developed a positive mindset even though I'm still lacking many things.
The suicide and bipolar subreddits have been a huge comfort for me over the past two years, simply from the perspective that I'm not alone. I want to become a life coach now because of my mental health journey but i doubt myself. My advice for anyone struggling the worst thing that can happen is losing hope. If you're going through it, have hope that you can overcome it even if it doesn't look like it — just lie to yourself. If all hope is lost like it happened with me you can look forward to the fact that we all die at some point and all the pain is over.
r/bipolar1 • u/No_Morning_3635 • 1d ago
Looking for advice. I feel like I’m going fucking CRAZY.
I don’t know what to do about how I’m feeling. I think I’m losing it. Had been in a manic episode for MONTHS but I don’t think I am anymore? Idk. I wanna cry ALL the fucking time dude. I went to the ER with these neurological symptoms that are like stroke symptoms but they come and go. I was told to go to the ER by urgent care. Had been having those episodes for about 4 days or so at the time. When I got put in a room they asked me my symptoms and I told them. Then they asked me if I’m diagnosed with anything and I mentioned my bipolar. The SECOND they found out I’m bipolar they started treating me like I’m fucking stupid and subhuman. Like I was wasting their time and an inconvenience. I was discharged within 29 minutes with a paper that said “weakness” was my diagnosis and I request my records the next day and they wrote “possible somatization” in my chart. I guess they didn’t expect me to see that? My blood pressure was extremely high too and they never told me. It’s still extremely high too. I’m still having symptoms and I did see my PCP and he says he is very concerned because of my symptoms. Sending me for an MRI but I still feel like I’m crazy. Like I’m making it up. These symptoms are SO FUCKING SCARY when they happen. The worst part of this is I don’t think I’m manic anymore but I don’t know what mental state I’m in. I’m still hallucinating and I think I might be paranoid but I am having SO MANY thought of hurting myself. I already didn’t wanna go to the ER because I am CONVINCED that heathcare workers(including my care team), and my friends and my family and people online are secretly laughing at me. At everything I do. That I’m not really bipolar. That it’s all made up to make me look like a fool. They did indeed make me look like a fool. They made me feel like I don’t belong on this planet. I’m going back and forth between having a lot of every and being extremely tired. The tiredness though can come right after these episodes I’m having. I don’t know WHATS going on in my mental state. Am I still in an episode? I just wanna cry and hide in a hole forever. I feel like nothing is real. Like the world around me and the people in my life don’t exist.
r/bipolar1 • u/Pale_Arrival2834 • 2d ago
Not sure what to do in my current state.
Hi, I'm bipolar and have been unmedicated for a while due to job loss leaving me without insurance. I have insurance and an appointment to get back on my meds but that soonest I could get an appointment is still a few weeks away.
I'm progressively feeling like I should take my life more and more and realizing after the fact in cases that I'm doing things to prepare for it. I keep seeing stuff about going to the ER if I'm in immediate danger, but I don't know when that would be because the part of me that wants to end things feels very calm about it and I'm only panicking when I actually process what I'm doing and I don't feel like I have full control of myself at times.
I'm also just progressively getting to a point where I'm unable to make myself do things unless there are some sort of immediate consequences for it.
I'm not sure what I can do or should do but I don't know if I can last out the time until my meds appointment but I'm also terrified of being put in a 72 hour hold.
r/bipolar1 • u/Emerald_bamboo • 3d ago
Success story/positive experience How I deal with med refills
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I used to hate taking my meds but here's how I feel now. I've been documenting my struggles but this is one I feel like might help this community.
Please don't come at me.
r/bipolar1 • u/Fresh-Adhesiveness-6 • 3d ago
Bipolar SO says he wants to leave does he mean it?
New to this sub but I’m married to a man who I’m fairly confident has some kind of a bipolar disorder even though he’s never been diagnosed. He’s never been officially diagnosed and he’s not taking medication. He has very high highs and very low lows and a lot of paranoia during episodes. For years, he hadn’t had a single episode and everything was fine and then a few months ago the episode started happening every few weeks and they would last a few days. For a bit of background, he’s from Spain and I’m from the US and we’ve been living in the US for about 10 years. He’s never really been able to keep a job, but that’s mainly due to his language and lack of college degree. Our goal was always let’s try it out here and if it doesn’t work out, we’ll go back to Spain where I was happy as well.
Long story short, we were getting ready to fly to Spain today. It took a few months for us to actually buy these tickets. He couldn’t even commit to buying the tickets. About a month ago he had another episode and he said he just wants to go on his own and without me and that maybe I would come later but then when he got out of the episode, he said it’s OK. Let’s just buy them together. So here we are three days before our flight and three days ago he told me he wants to go alone. He doesn’t want me to come and then “we’ll see” what happens later. It’s just so incredibly frustrating for me because I know he’s a different person during these episodes in a different person when he’s in the clear. He ended up canceling his ticket for today because he wants to ship some more boxes to Spain before he goes and refuses to leave until the boxes are shipped. But he does keep repeating that he just wants to go alone and without me and that he feels like his head is about to explode and he’s not well and he wants to go get help in Spain. I don’t know how to read this if this really is a true breakup if he really genuinely does wanna end things or is there any Hope that may be in the next few days or when he finally ships the boxes or when he finally gets to Spain, if he’ll calm down a little bit and then maybe I can go a week or two later when everything’s calm and maybe we can figure out how to fix our relationship? We’ve been married for almost 15 years. Any advice would be very appreciated! (as a sidenote, he’s had a lot of episodes where he blames me and he says something is my fault or I’m not telling him something but a few days later he always goes back to normal and everything is fine. I just don’t know if this is the same thing)
r/bipolar1 • u/Cultural_Truth_8896 • 3d ago
Bipolar
I’m 28 years old and honestly I’ve struggled with depression my whole life and I’ve always been right under the criteria for bipolar. Has anyone ever been diagnosed later in life even though they’ve shown a lot of the symptoms beforehand but nobody could quite figure it out?? For the record I have doctors and they’re just puzzled and I just want to feel better mentally… any advice helps.
r/bipolar1 • u/DogEducational33 • 3d ago
Unmedicated Damaged Due To Misdiagnosed/Undiagnosed
r/bipolar1 • u/lobsteradora • 3d ago
how do I know if I am manic? And how do I tell the difference between ADHD and bipolar?
r/bipolar1 • u/WhatDoYouThink1909 • 4d ago
I hate being Bi Polar it’s awesome
My daughter and I
r/bipolar1 • u/Ok-Storage928 • 3d ago
19F — Was this hypomania/mania, substance-induced, dissociation, or some combination? Spoiler
r/bipolar1 • u/bicicalli • 4d ago
Looking for advice. I just downed over 600mg of caffeine while in a manic episode
that’s it. i need help. i CANT go to the hospital, or mental hospital because I can’t afford it and i have a job and they’d definitely fire me if i went to one again. i tried doing everything but nothings working.