Self-care for managing mania

Mania and hypomania are symptoms of bipolar disorder. Mania is the ‘high’ euphoric end of the mood scale, with hypomania similar but with less intensity.

If you think you’re experiencing mania, or symptoms are coming on, these strategies may help prevent or reduce the severity of an episode.

Monitoring mania or hypomania

Management of mania is a constant cycle of experiencing episodes, learning and adjusting coping strategies each time (also known as your wellness plan or self-care toolbox).

Triggers and symptoms are unique to each person, so pinpointing and learning what applies to you can be difficult. But, this work is beneficial as it will help you before or during an episode.

Use a mood diary

Keeping a mood diary, or Mood Chart, will help you understand your experience of mania or hypomania. Diaries help identify red flags and signs of an impending episode. Over time, you'll start to notice patterns and consequently when to take precautions.

Common triggers include:

• Drinking alcohol or abusing illegal drugs
• Staying up all night and skipping sleep
• Going off your regular diet and/or exercise program
• Stopping or skipping your medications
• Skipping medical appointments.

Ask others for a ‘reality check’

Often those around us are first to notice changes in behaviour. If you think your behaviour is becoming erratic, ask a trusted person if they have noticed any changes or warning signs.

Use this support network to your advantage. An external point of view can be extremely helpful in identifying warning signs. If they express concern, seek help.

Warning signs of mania and hypomania include:

• Extreme energy, restlessness, anger, impatience or irritability
• Overly good mood, inflated self-esteem, or grandiosity
• Fast, erratic talking and racing thoughts
• Inability to concentrate
• Decreased need for sleep
• Poor judgment
• Reckless spending
• High sex drive
• Alcohol or drug abuse.

What to do if you are experiencing mania or hypomania

Follow your wellness plan

If you are experiencing mania, now is the time to use a wellness plan, or if your symptoms are escalating a crisis plan (see below).

A wellness plan is a series of actions you take to prevent symptoms from progressing into an episode, or measures you put in place to limit the potential consequences. It can include the following steps:

Contact your health professional – The first and most important thing is to contact your mental health professionals. Consider increasing appointments, or moving them to an earlier time or day. Your doctor may recommend short-term changes to your medication to help reduce the severity of an episode.

Contact your support network – this includes trusted family and friends.

Continue with medication as prescribed – Use your phone alarm to remind you of your medication schedule. Avoid mixing medication with over the counter drugs. Whilst people experiencing mania commonly think they don’t need their medication, stopping suddenly can be dangerous.

Watch your finances – Try restricting your access to finances. Limit the cash in your wallet to enough for the day, but no extra. Place your credit cards somewhere difficult to access, give them to a trusted person, or don’t obtain one altogether.

Maintain your routine – People with bipolar disorder can get out of sync with the rhythms of life. Social rhythm theory is a therapeutic approach that acknowledges this and helps people maintain their sleep patterns, schedules and routines. 

Stay healthy – Eat healthy foods, avoid illegal substances, caffeine, foods high in sugar, alcohol. For more ideas, check out SANE’s Healthy living and Mindfulness factsheets.

Postpone big decisions – Wait until you can review them with your treatment team or a trusted loved one. Or, give yourself a day to reflect on the pros and cons of the decision you’re considering.

Avoid letting yourself feel high ‘a little longer’ – Whilst being high can feel great, remember, the higher you go, the harder the fall.

Avoid putting yourself in potentially triggering situations – These include new romances, unsafe sex, or conflict.

Use your self-care toolbox

After you have followed your wellness plan, contacted health professionals and family, and limited the potential consequences, it helps to try some self-care.

A self-care tool can be anything that helps you feel healthy and relaxed. Try to:

• Limit activities and tasks – If you can’t scale back, focus on the most important activities. Avoid spending more than six hours being active each day. Spend the rest of the time relaxing.
• Don’t exhaust yourself – Trying to tire yourself through exercise or stimulating activities doesn’t reduce energy, it increases it, feeding your mania.
• Avoid stimulating surroundings – Such as crowded parties, clubs and bars, malls, energising places, playing fast music and watching stimulating movies.
• Avoid stimulating foods and beverages - Avoid caffeine, soft drink, energy drinks and any vitamins or over-the-counter medication with caffeine.
• Avoid drugs and alcohol.
• Aim for at least 6 hours of sleep per night - If you have difficulty falling asleep try some of the SANE suggestions for good sleep hygiene.
• Try calming activities - Take a walk, yoga, breathe deeply, listen to relaxing music, talk to a calming friend, or have a quiet bath.

Create an emergency action plan

In crisis situations where your safety is a concern, you or your treating health professional may decide hospital admission is required. Having a plan for such times can provide a sense of self control and allows you to maintain some degree of responsibility for your treatment.

A plan may include:

• A list of emergency contacts – your doctor, close family or friends.
• A list of all your medications, including dosage information.
• Information about your other health problems.
• Treatment preferences – who you want to care for you, what treatments and medications do and do not work, what treatments you prefer not to have, who doctors are authorized to talk to.
• Personal information – access to house key, care of children/pets, management of bills, bank details, real estate agent.

Remember everyone's needs are different, so some of the apps, or suggestions in this blog may not work for you. But, if you reflect and keep learning from your experiences you'll start to instinctively know what helps when times get tough.

More to read . . . 

• SANE Guide to Bipolar disorder
• How to help in a crisis
• My Story: Bipolar disorder and self-care
• Busting the myths about bipolar disorder

For assistance . . .

• SANE Support Line – 1800 187 263
• Australian Psychological Society – 1800 333 497
• Carers Australia – 1800 242 636