How to Help Someone Going Through a Bipolar Manic Episode

Key takeaways:

• A manic episode is an elevated or irritable mood that continues for a week or more. It can appear with impulsivity, higher self-esteem, racing thoughts, and an inability to focus.
• It's important to stay calm and avoid conflict with a person in a manic episode. You can also help by minimizing stimulation, offering support, and encouraging good self-care.
• If a person experiencing a manic episode is unable to take care of themselves or is at risk of harming themselves or others, then they may require emergency hospitalization.

Table of contents

How to help

Tips for talking

Getting emergency help

Resources

FAQs

Bottom line

References

laflor/iStock via Getty Images PlusBipolar 1 disorderis a serious mental health condition that involves fluctuations in a person's mood and energy levels. People with this condition may shift between depression and mania or hypomania, which is an abnormally elevated or irritable mood.

During manic episodes, people may seem extremely happy or agitated and have a lot of energy. They may take risks, act impulsively, and require little or no sleep. Family and friends might feel like they're watching their loved one spin out of control.

Helping a person through a manic or hypomanic episode can be difficult. Your loved one may resist efforts to help them. In some cases, manic episodes can become so severe that a person requires emergency hospitalization.

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Read on to learn about the signs of a manic episode, what to say and do when someone is having an episode, and how to tell if a person needs emergency intervention.

How to support someone during a bipolar disorder manic episode

You can't stop a loved one from experiencing a manic episode. But there areactions you can taketo support them through it.

Know the symptoms of a manic episode

FeaturingMarc Lener, MD

Reviewed byAlexandra Schwarz, MD| April 30, 2023 The first step to supporting a loved one is recognizing the signs of a manic episode. During amanic episode, a person may seem extremely excited, agitated, or energetic. Symptoms can include:

• An elevated or irritable mood that lasts at least 1 week
• Sleeping less than usual or not at all
• Enhanced self-esteem
• Racing thoughts or ideas
• Appearing more talkative than usual and speaking very quickly
• Being easily distracted and unable to focus
• Engaging in risky or impulsive behavior
• An increase in goal-directed activity, such as taking on new projects
• Increased sexual activity
• Psychotic symptoms, such as disorganized thinking, hallucinations, and delusions

Minimize stimulation If possible, encourage them to stay in a quiet and relaxing environment - and to avoid stimulating and energetic activities. Try to keep them away from loud noises, bright lights, and big crowds. If the person has a lot of physical energy or restlessness, consider calm, low-impact activities like walking.

Avoid confrontation It's OK to talk honestly with someone who's in a manic episode, but don't bring up topics that could lead to conflict. Give them space for their feelings and experiences, and try to be as considerate and compassionate as possible (more tips on talking below).

Offer your support For some people, it can be tiring and isolating to experience a manic episode. Spend time with them as much as possible, and let them know that you're available for support. You can also offer to help them temporarily with complex tasks, like managing their finances or taking aleave of absencefrom work.

Encourage sleep when possible Sleep can be a challenge during a manic episode. Encourage the person to stick to a regular bedtime and to take short naps during the day if needed. You can create agood environment for sleepto help them rest more easily.

Encourage good self-care It can be hard for people experiencing mania to take care of themselves. Encourage them to pay attention to their basic self-care needs like eating, drinking enough water, and showering. It can also be helpful to offer foods that are simple and easy to eat, as it can be hard to sit still for a full meal.

Discourage drug and alcohol use Encourage your friend or family member to stay away from drug and alcohol use during a manic episode. Substance use can loosen inhibitions and worsen impulsiveness and mood changes. Drugs and alcohol can also interfere with sleep.

Encourage them to take their medication Manic episodes can be triggered by a person not taking medication they have been prescribed for bipolar disorder. If this is the case, encourage your loved one to talk to their primary care provider or mental health professional. Their healthcare team might instruct them to restart their medication or recommendadditional medicationto help reduce manic symptoms.

Encourage them to seek care A healthcare professional can guide you toward the best plan for treatment. If your loved one already has a therapist, primary care provider, or psychiatrist, start there.

If not, reach out to a healthcare professional to schedule a new patient appointment. Some people with bipolar disorder can be treated as an outpatient, while others may need to stay in the hospital.

Watch for signs that mania is ending Keep a lookout for symptoms that are improving, like:

• Better sleep
• More relaxed and balanced mood and behavior
• Clearer thinking

This can help you know what type of support to offer and whether your loved one needs additional treatment.

How do you talk to someone experiencing mania?

The best way to interact with someone experiencing a manic episode is to remain calm. When talking to someone who's manic, try to:

• Express empathy and compassion.Encourage your loved one to talk to you and make sure to listen to what they have to say. This can help them to feel comfortable and safe with you.
• Redirect their attention.If your loved one suggests doing something that's risky or seems extravagant, suggest that they hold off or do something else. For example, if they want to purchase a new car, encourage them to wait and offer an alternative activity.
• Suggest healthy activities you can do together.You can suggest taking a walk or any activity that's positive and won't overstimulate your loved one. Avoid activities that could lead to impulsivity, such as shopping or gambling. Also, stay away from drugs, alcohol, and caffeine.
• Avoid arguments, intense conversations, or challenging their thoughts. Confronting any irrational beliefs is unlikely to be effective. It may only agitate them more and create conflict.

During a manic episode, a person may say things that are hurtful. Try not to take it personally. Remember thatbipolar disorderis an illness. It's the illness that's causing your loved one to behave this way. Be sure to also take care of yourself and get support, since supporting a person through mania can be very difficult.

When should I seek emergency medical attention for someone in a manic episode?

In some cases, you may need to seek emergency help for a person experiencing a manic episode.

If your loved one isn't caring for their basic needs or is at risk of harming themselves or other people, seek help. Before calling for emergency help, you may want to encourage your loved one to voluntarily get help on their own. You can explain that you're worried about them and think they can benefit from professional assistance.

If the person refuses, then you should call for emergency help. In these cases, a person may be mandated to stay in treatment until professionals feel that they're stable and safe.

Who to call if a loved one in a manic episode requires emergency assistance If you think your loved one may need emergency assistance, you can call988to reach theSuicide and Crisis Lifeline. The lifeline is open 24/7 and can help you get emergency help. You can also call911, contact amobile crisis unit, or go to the emergency room.

If your loved one has a psychiatrist or therapist, you can also call that person directly. A mental health professional will only be able to speak to you if your loved one has given them permission. However, even without permission, healthcare professionals can receive information about your loved one.

Based on the information you share, the healthcare professional may decide to give you instructions. They may also determine that it's a serious enough emergency to breach confidentiality and discuss the situation more openly.

What happens to a person experiencing mania if the police are called? If the police are called while someone is experiencing a manic episode, the police should talk to the person to determine whether they should be taken to a hospital. If the police believe your loved one needs further evaluation, officers will transport them to the hospital, where your loved one will be evaluated by a mental health professional.

If a mental health professional determines that your loved one isn't caring for themselves or is otherwise at risk, they may place them on anemergency hold. This allows professionals to treat a person's symptoms and keep them safe until they're stable enough to be discharged from the hospital. Professionals will also work on connecting the person with treatment and resources outside the hospital. Laws oninvoluntary hospitalizationfor mental health disordersvary by state.

Keep in mind that there can be a risk in calling the police for a mental health emergency. An estimated20% of peoplekilled by police each year have a known mental illness. Before calling the police, contact a mobile crisis unit or take your loved one to the ER, if possible. Search online for "mobile crisis unit near me" to see what resources are available in your area.

If you do need to call the police, let the dispatcher and responding officers know that your loved one is experiencing a mental health crisis. You can also educate the police on helpful ways to interact with your loved one to reduce their agitation.

Mental health resources and support for bipolar disorder

There are many resources available for people with bipolar disorder and their loved ones.

For assistance finding mental health treatment, contactSAMHA's National Helplineat1-800-662-HELP (4357). The helpline is available 24/7 and can help you find treatment and local resources. You can also searchSAMSHA's Behavioral Health Treatment Services Locatorto find local providers.

The following organizations can help you learn more about bipolar disorder and find support:

• National Alliance on Mental Illness (NAMI):provideseducation on mental illness, as well as in-person and virtual support groups for people dealing with mental illness and their loved ones
• International Bipolar Foundation:offersinformation on bipolar disorderand ways to connect with others who have the condition
• Depression and Bipolar Support Alliance:provides information onmental health conditions and offers support groups and other opportunities to connect with peers
• American Psychiatric Association:provideseducation on bipolar disorderand a search tool tofind a psychiatrist

People with bipolar disorder can learn how to live with the condition and reduce its negative impact on their lives. If your loved one has bipolar disorder, remember that it's a chronic condition that requires ongoing treatment. Learning about bipolar disorder and showing your support can help your loved one manage their condition.

Frequently asked questions

What's the difference between hypomania and mania?expand_more Hypomania is another type of mood episode that can occur inbipolar disorders. A hypomanic episode has thesame symptomsas a manic episode. The difference is the symptoms are less severe and last for a shorter period of time.

How long do manic episodes last?expand_more

What brings someone out of a manic episode?expand_more

What makes a manic episode worse?expand_more

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" data-qa="ContentCalloutH2Title" The bottom line

Seeing someone you care about experience a manic episode can be scary and overwhelming. You may find yourself feeling angry or hurt by the things your loved one says or does during the episode. It's important to remember that it's their condition causing them to behave this way. This can help you to not take their actions personally.

When it comes to interacting with your loved one, try to remain calm, and avoid arguing with them. If your loved one's symptoms are so severe that they're not taking care of themselves or are at risk of harming themselves or others, call911or988, or go to the ER for emergency help.

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