For some people, sleep is the first sign that an episode is developing. They sleep fewer hours without feeling tired. Plans multiply, conversations become faster and confidence grows unusually strong. From the inside, it may feel like a burst of creativity and productivity. To others, it may be the beginning of hypomania or mania. [1]

During mania, judgement may change. A person might spend large sums of money, take on unrealistic projects or behave in ways that later have serious consequences. Severe episodes can include psychotic symptoms. Changes should therefore be understood in relation to the person’s usual behaviour and previous episodes. [2]

A regular sleep pattern and attention to early warning signs can support prevention, but they do not replace treatment. A plan agreed with a clinician, and sometimes with trusted relatives, may help everyone respond before symptoms become severe. [3]

References

1. NIMH. Bipolar disorder: mania, hypomania and depression.
2. NICE. Bipolar disorder: assessment and management. CG185.
3. Bond K, Anderson IM. Psychoeducation for relapse prevention in bipolar disorder: systematic review.

This information does not replace an individual medical assessment. Seek urgent assistance in an emergency.