Dealing with a manic episode can cause intense distress. However, planning and treatment can help a person cope with and manage symptoms of mania.
Mania is a symptom of various mental health conditions, including bipolar disorder.
An individual’s thoughts and behaviors can change drastically during a manic episode. Mania may cause a person to feel unusually energetic, euphoric, or irritable. Mania can also lead to hallucinations or delusions.
While in a manic state, a person may be more likely to engage in impulsive or high risk behaviors. In some cases, a person may require hospitalization during a manic episode to prevent them from hurting themselves or others.
This article looks at the warning signs of a manic episode and provides tips on coping.
A person may not recognize that they are experiencing a manic episode while it is occurring or may feel unable or unwilling to address the symptoms of mania while they are experiencing them.
Planning can allow people to put coping strategies in place in advance.
Contact a mental health professional
If a person feels like they may be beginning to have a manic episode, they should contact a mental health professional such as a psychiatrist or a psychiatric nurse. These professionals can talk people through their symptoms and help them enact coping mechanisms.
A person who does not have a mental health professional they regularly consult can reach out to a mental health crisis service such as the National Alliance on Mental Illness (NAMI).
People can call the NAMI helpline at 800-950-62264 or text “Helpline” to 62640.
Individuals with severe symptoms who need emergency medical treatment should call 911 or go to their nearest emergency room.
Suicide prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
Use a self-management plan that includes self-care practices
A person may find it helpful to put together a self-management plan so they know what steps to take if they start to become manic.
Steps may vary between individuals but can include measures such as:
- avoiding stimulating, noisy, or busy environments
- avoiding situations that could lead to impulsive or high risk behaviors, such as online shopping or social gatherings with alcohol
- postponing major life decisions
The self-management plan may also involve practicing self-care. A person may wish to try doing the following during a manic episode:
- Managing sleep: It can be challenging to sleep during a manic episode. However, managing sleep can help keep a person’s mood stable or shorten a manic episode. A person can try:
- establishing a sleep routine
- keeping a sleep diary
- avoiding screens 2 hours before bed
- Eating a healthy diet and engaging in exercise: Maintaining regular meal schedules and taking part in gentle physical activity can help with managing stress or anxiety during a manic episode.
- Practicing relaxation techniques: A person can try breathing exercises, relaxation techniques, or mindful meditation to help reduce stress and anxiety. This can also help with sleep.
Reach out for support
A person may be able to discuss their symptoms with a trusted friend or family member. If they have experienced mania before, they may also wish to explain what a manic episode may look like to those around them.
Friends and family
Loved ones may also offer emotional support and help keep a person safe during a manic episode. In some cases, this may involve contacting a mental health professional or crisis service.
While a person feels well, it can be helpful to prepare for events they may not feel equipped to deal with during a manic episode.
A manic episode may last
An episode of hypomania may last at least 4 days. Hypomania is similar to mania but typically produces less severe symptoms and does not usually affect a person’s social or professional functioning.
Managing feelings after an episode
A 2017 study notes that during a manic episode, people often find it challenging to recognize that they may be behaving in ways that are out of character.
While in a state of mania, an elevated mood and a lack of insight can make it difficult for someone to understand that some of their actions may have negative consequences.
Most of the people interviewed in the study expressed feelings of shame and regret related to certain behaviors that occurred during a previous manic episode. The study suggests people may also feel exhausted after an episode, when they may have to deal with consequences related to these behaviors.
Psychotherapy can help a person cope with these feelings and learn ways of managing their responses to thoughts and behaviors. It is important to note that mania is a state of mind that occurs due to a mental health condition, and these conditions should not create shame.
Talking through the experience of a manic episode with a mental health professional can help a person process their feelings, learn from their experiences, and plan for possible future episodes.
According to NAMI, a person who experiences manic episodes may benefit from creating a crisis plan that includes a wellness recovery action plan and psychiatric advance directives.
A wellness recovery action plan
This plan includes important information that family, friends, and healthcare professionals may need during a crisis.
It may list:
- contact details of relevant mental health professionals
- contact details of friends and family members
- notes on the person’s diagnosis, current medications, and medical history
- information about previous manic episodes, psychosis, or suicide attempts, if applicable
- known triggers of manic episodes
- information about methods that have helped a person recover during past episodes
- notes on any issues with substance use, if applicable
- crisis line contact details, such as The National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
A psychiatric advance directive
A psychiatric advance directive (PAD) is a legal document that allows a person to act on another person’s behalf if they are ill or unable to make decisions about their treatment.
The PAD details the person’s preferences for treatment. This ensures that if the person is unable to make decisions at a later stage due to their mental health, their treatment goes ahead according to the decisions they made while they were well.
Recognizing the warning signs of an oncoming manic episode may help a person prepare and seek support.
These signs can differ between individuals, and it may take time for someone to identify their particular warning signs. It may be helpful for a person to simply note that their thoughts and behaviors are starting to change.
Early signs
In the lead-up to a manic episode, a person may experience the following:
- feeling unable to focus
- feeling unusually confident
- struggling to sleep
- becoming hyperfocused or obsessive about certain topics or activities
- abandoning self-care routines and behaviors
- feeling hypersensitive to stimuli, such as sounds and smells
- talking over people and feeling unable to listen to others
- starting to behave in impulsive ways, such as reckless spending
During an episode
Manic episodes can last for
A person may experience:
- racing thoughts
- rapid speech
- elation or irritability
- impulsivity
- grandiosity, or feeling unusually powerful, talented, or important
- increased talkativeness about many different topics
- feeling as if they require less sleep than usual
- having an excessive appetite for pleasurable activities, such as sex, food, or alcohol
- anxiety and restlessness, which can cause unintentional movements
- an expansive mood, which can cause a person to act grandiose, self-important, excessively friendly, or overly enthusiastic
Mania can often also lead to features of psychosis, such as delusions and hallucinations.
People may experience paranoia and be unable to differentiate between the symptoms of psychosis and reality.
A person may be able to reduce the risk of a manic episode by learning what triggers their mania and implementing strategies that help avoid these triggers.
Triggers may include:
- stress or problems in daily life, such as financial or work issues
- physical illness
- sleep disturbances
Strategies and routines to reduce stress and improve physical health could help,
- exercising regularly
- maintaining a regular sleep schedule
- practicing stress reduction techniques
- attending regular therapy or counseling appointments
- taking medication that a doctor has prescribed
- avoiding excessive intakes of caffeine and alcohol
Loved ones of those who experience manic episodes can help by:
- offering empathy and assistance but giving the person space when they need it
- learning to recognize signs of a manic episode
- taking part in planning for future manic episodes or crises
During an episode, they can try:
- remaining calm and avoiding confrontation or arguments
- using active listening, such as repeating back and confirming what their loved one has said
- helping to make the surrounding environment quiet and peaceful
- trying to help the person redirect their impulses, such as suggesting they wait to make purchases or important decisions
If necessary, they may need to contact mental health or emergency services.
At certain points, some people with mental health disorders may not recognize they need help. This is called anosognosia.
Learning about anosognosia and working with mental health professionals can allow a person to help their loved one identify times when they may need additional treatment or support.
Mental health resources
Visit our dedicated hub for more research-backed information and resources on mental health and well-being.
A person may not recognize that they are experiencing a manic episode when it occurs.
For this reason, making plans and decisions in advance while they feel well can help with managing mania. This may involve planning strategies for possible crises, such as a wellness recovery action plan.
Psychotherapy, medication, stress reduction, and maintaining good physical health can help a person cope with and reduce the risk of manic episodes.