According to the National Institute of Mental Health, more than 4 percent of all adults in America experience bipolar disorder at some time in their lives.1 While all of these people might share the same diagnosis, their symptoms might be radically different. For example, some people with bipolar disorder feel depressed much of the time. Others have episodes of mania as well as episodes of depression.
Manic episodes can be frightening, and families are often required to provide assistance to help their loved one move through manic days without any long-term harm.
Open discussions, both with the person who has the disorder and with the person’s health care team, are a key part of family support. Understanding more about manic episodes, how they begin and their symptoms can help families prepare an intervention before things spiral out of control.
Symptoms of Manic Episodes
A manic episode is typically associated with a feeling of happiness and power. People in the midst of an episode feel joyful and outgoing and are willing to talk to almost anyone about anything. They might take on a new project, like opening a business or traveling around the world. They might also believe their success is inevitable.
Impulsivity is also a part of a manic episode. As people feel happy and powerful they are more likely to:
- Spend a great deal of money
- Engage in physical acts with people they’ve just met
- Take out loans
- Invest in businesses
- Consume drugs or alcohol
People in the midst of mania also tend to be distractible, moving from one thought or project to another without completing anything. They’re struck by feelings of urgency, as though they must act now before the opportunity is gone.
Communication During Mania
Medical intervention is important when your loved one shows signs of the onset of a manic episode. Medication dosage adjustments might be required to bring the episode to an end, and therapeutic supervision might be necessary to keep someone from causing long-term harm during mania. But convincing your loved one to see the doctor can be difficult.
During mania, thoughts are scrambled and the needs of others fade into the background. People who feel mania are unable to focus on the thread of a conversation, and they may interrupt, argue or otherwise change the subject when family members want to talk. Their mental illness stands in the way of the type of conversation that takes place during a traditional intervention.
In addition, symptoms of mania can grow stronger if the person feels attacked or stressed. They’re unable to think clearly, and when they feel pressure, they might grow even more agitated and upset. Putting someone like this into a high-pressure conversation could result in disaster. That’s why one-on-one, non-threatening conversations might be a better approach during a manic episode.
The following steps can help:
- Suggest that a trip to the doctor is in order and offer to go along for the appointment.
- Bring up the issue repeatedly, but in short little bursts that are heavy on acceptance and understanding and light on blame or judgment.
- Talk on the go, if the person has a lot of energy, or in a quiet, non-stimulating room during a brief moment of peace.
Reducing Harm During Mania
While some people are able to see the wisdom in a call for care during a manic episode, some people are overwhelmed by feelings of power and don’t understand they might cause harm. The mania tells them that they’re powerful and great, and that might contradict with the family’s message of concern. That’s why those in the midst of a manic episode won’t get help at all.
It’s important for families to have emergency plans in place so their loved one stays safe until the mania passes. Some of these plans might include:
- Reduce triggers in the home by keeping televisions, radios and computers turned off
- Provide snacks that can be eaten on the go
- Spend time just listening to the person, helping to reduce a sense of isolation
- Discourage the beginning of new projects
- Refuse to argue or otherwise engage in harmful conversations
- Provide plenty of napping spots, so the person can sleep in short bursts
- Stay at home with the person until the mania passes
If these steps don’t help and your loved one’s behavior could result in some type of harm, involuntary hospitalization might be required. The DBSA suggests that this should be used as a last resort, only when the person absolutely will not get help and when harm is eminent. However, this could be a vital step some families must take when gentle persuasion and protection fall short.2
Compassionate Follow-Up for Mania
While formal interventions during manic episodes may not be appropriate, manic days often provide families with the details that make intervention powerful. That’s why keeping notes during a manic episode is vital. Families should write down everything, with as much detail as they can, so they can access those moments when their loved one is calm and a formal intervention can happen.
If an intervention doesn’t help it’s important for families to pay attention to their own mental well-being. Often caregivers who have poor stress control that care for people who struggle to follow their treatment programs tend to increase the chance that serious bipolar symptoms break free.3
Support groups and individual counseling can help to improve the health and overall well-being of the entire family unit.
Finding Help for Bipolar Intervention
Approaching a loved one with bipolar disorder during a manic episode can be overwhelming. Clinically trained interventionists with experience in treating people with this type of mental illness can help.
Our admissions coordinators can help you find a professional with the clinical mental health expertise that can help your family to heal. Call our helpline 24 hours a day at 844-675-1221.
Sources
1 “Bipolar Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, Nov. 2017.
2 “Hotline Information.” Bipolar Disorder Statistics – Depression and Bipolar Support Alliance. Accessed June 7, 2018.
3 “Bipolar Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, Nov. 2015.
Further Reading About Intervention for Manic Episodes
- A Symptoms Checklist
- Bipolar Disorder and Klonopin Abuse
- Bipolar II
- Bipolar-I
- Cyclothymic Disorder
- Intervention for Manic Episodes
- Isolation and Bipolar Disorder
- Mixed Bipolar Disorder
- Protecting Your Children by Finding Healing for Yourself
- Rapid-Cycling Bipolar Disorder
- Self-Absorption and Bipolar Disorder
- Stimulant Use
- Substance Abuse and the Risk of Suicidal Ideation
- The Costs of Bipolar Treatment Services
- Untreated Bipolar Disorder Can Lead to Increased Risk of Domestic Violence
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David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.
Reviewed by: Kim Chin and Marian Newton