Bipolar Manic Episode – How to Manage

What is a Bipolar Manic Episode?

A bipolar manic episode is a brain condition that is classified in extreme and unusual shifts in moods, energy, and motivation.  It’s often referred to as “highs” and “lows.”  According to Mayoclinic.org, there are four types of bipolar disorder:

• Bipolar I disorder. You’ve had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).
• Bipolar II disorder. You’ve had at least one major depressive episode and at least one hypomanic episode, but you’ve never had a manic episode
• Cyclothymic disorder. You’ve had at least two years — or one year in children and teenagers — of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression).
• Other types. These include, for example, bipolar and related disorders induced by certain drugs or alcohol or due to a medical condition, such as Cushing’s disease, multiple sclerosis or stroke.

When I refer to a “bipolar manic episode”, I am referring to having these symptoms:

• Abnormally upbeat, jumpy or wired
• Increased activity, energy or agitation
• Exaggerated sense of well-being and self-confidence (euphoria)
• Decreased need for sleep
• Unusual talkativeness
• Racing thoughts
• Distractibility
• Poor decision-making — for example, going on buying sprees, taking sexual risks or making foolish investments

My Story

When I was four years ago, I was diagnosed with ADHD.  I was put on stimulant medication to help with the challenges I had with focusing and anxiety.  The medication helped, but I still experienced extreme highs and lows.  In 2012, I was diagnosed with bipolar II, which described my symptoms.  I began a journey of starting new medications to regulate my mood.

In 2019, my psychiatrist finally said, “we have tried just about every medication there is to manage the bipolar manic episodes that you experience.”  He helped me understand that there is no perfection with medications.  I learned that I have to learn to navigate the highs and lows as they came.  During the last seven years, here are the “DO’s” and “DON’T’s” of what I’ve learned to do to manage bipolar manic episodes:

The “DO” of bipolar manic episodes:

1.) Keep a normal schedule

Eat Good Food

• According to many sources, including “Do Carbs Make You Crazy” by Emily Deans MD, research indicates that people who have bipolar manic episodes benefit from eating at least three meals a day, consisting of complex carbohydrates and high protein. This helps stabilize blood sugar levels, which can result in more steady moods.  Foods and Nutrients for Mania and Depression has a great list of other foods for bipolar manic episodes.  If you need to make changes to your diet, do it when you are not in an episode.  Attempting to make sudden changes during a manic episode could make the manic episode worse.

Take Your Medication

• If for any reason you feel like you no longer need medications, keep taking them!  The only person who should ever endorse this is your psychiatrist. I remind myself that I am under the authority of my psychiatrist and he is the expert, not me.  Skipping medication or opting to not take medication at all is the #1 cause of bipolar manic episodes which can be life-threatening.

Have Quiet Time

• As a Christian, my quiet time consists of journaling and reading scripture. I’m a big fan of the BookFactory Journals when I write by hand, or I’ll use an electronic journal called Evernote.  I use the Youversion bible app to read scripture, which also has the option to read scripture out loud when my mind can’t process the words I’m reading.  As an alternative to this, I will also listen to a podcast or read a simple devotional that requires less effort than journaling or reading scripture.  No matter what you do to have quiet time, the important thing to remember is not to strive for the duration, but strive for consistency during the bipolar manic episodes.

Connect with Others

• One of the most important things you can do when you are having a bipolar manic episode is to connect with others.  I have a few close people in my inner circle that I will send text messages to, asking for prayer and support.  The most important person you can tell about your struggles is your spouse or significant other.  It’s also important to stay in touch with anyone who you are seeing professionally, such as a counselor or medical doctor.  My personal rule of thumb for managing a bipolar manic episode is to wait 48-72 hours before reaching out for professional help.  Often, I may just be having a bad day instead of having a full-blown manic episode.  For me, my bad days rarely last more than 24 hours.  You know yourself best, so you have to be the judge of what your normal is.  If you are experiencing any kind of suicidal thoughts, you should immediately reach out for professional help.

2.) Use Healthy Distractions (Stay Busy)

Go to Work

• Assuming that work isn’t the cause of your episode, work can be a great way to stay busy and keep your mind off of how you feel. It allows you to feel productive and still accomplish something in the middle of an episode.

Exercise

• Aerobic exercise is one of the best prescriptions for someone with bipolar. This includes walking, jogging, jump roping, etc. – anything that elevates your heart rate for an extended period of time. Unfortunately, there are not many documented studies with how exercise helps specifically with bipolar manic episodes.  However, medical experts are discovering that exercise does promote neurogenesis, which is a game-changer for anyone struggling with mental illness.
• In the study “Effects of Exercise and Physical Activity on Anxiety”, it concludes “there is strong evidence from animal studies that exercise and regular activity positively impacts the pathophysiological processes of anxiety. Numerous studies and meta-analyses show that exercise is also associated with reduced anxiety in clinical settings. Similar to the heterogenic nature of the anxiety, no single mechanism sufficiently accounts for the anxiolytic nature of exercise. Physical activity positively impacts a number of biological, as well as psychological, mechanisms. The role of exercise in the enhancement of neurogenesis in humans has drawn significant attention in recent years and its implications for anxiety disorders are an exciting area of investigation.”

Movies

• Nothing beats just sitting down and watching a good movie. When I’m in a bipolar manic episode, I enjoy watching a movie or something on TV.  I’m very careful what I allow into my mind, so I watch movies that are relaxing and family-friendly.  A movie that has a lot of violence or inappropriate scenes could be a trigger for me, so I choose not to watch those kinds of movies.  I use pluggedin and IMDB to check movies before watching them.

Serve Others

• This has been the hardest one for me to master during a bipolar manic episode, but it’s probably the most effective one on this list. One of the best distractions you can ever use is thinking about serving other people instead of your pain and suffering.  Practically, I will often clean up things around the house or do things to help my wife.  I am also able to do this at work since I work one on one with clients.

Recall Past Victories

• Having been journaling for over ten years, one of my favorite things to do is go back in history. I’ve experienced countless bipolar manic episodes, and almost every single one of them has been journaled about.  When I’m in the middle of another bipolar manic episode, I often forget about every victory that I’ve ever had.  It’s incredibly helpful to look back see that I got through what seemed like an impossible episode.  I remind myself that if I got through it then, I can get through it now.

Preach to Yourself

• If we are honest, we all do this a lot! We are constantly preaching to ourselves in the form of positive or negative feedback.  When I’m in the middle of a bipolar manic episode, I am very intentional about preaching to myself out loud.  I will often aggressively recite scripture out loud or declare who God is in the midst of my circumstances.  “God’s Words” list below is very personal, but these are things that God has personally spoken to me, and I often recite them out loud.  I encourage you to do the same.

God’s Words

• I do not change even when your moods change. Jesus Christ is the same yesterday and today and forever. Hebrews 13:8
• I speak in the highs and the lows “And when he brings out his own sheep, he goes before them; and the sheep follow him, for they know his voice.” John 10:4
• I am still on the throne when you are suffering. Micaiah said, “Therefore, hear the word of the LORD. I saw the LORD sitting on His throne, and all the host of heaven standing by Him on His right and on His left. 1 Kings 22:19
• I see your pain and I’m walking with you through it. “The eyes of the Lord are everywhere, keeping watch on the wicked and the good” (Proverbs 15:3)
• I know how you feel.  I’ve experienced the exact same pain that you have and worse. “You keep track of all my sorrows. You have collected all my tears in your bottle. You have recorded each one n your book” Psalm 56:8
• Your highs do not define you. Your lows do not define you. You are defined by who I say you are. Therefore, if anyone is in Christ, he is a new creation. The old has passed away; behold, the new has come. 2 Corinthians 5:17
• I promise to use every single high and low for the good. And we know that in all things God works for the good of those who love him, who[a] have been called according to his purpose. Romans 8:28
• I allow all suffering to take place for a greater purpose. Some of this will be revealed to you on Earth … other parts will only make sense in eternity.  “Your sorrow shall be turned to joy” John 16:20

The DO NOT of bipolar manic episodes:

Add to your plate

• When you are experiencing a bipolar manic episode, it’s important that you lower your level of commitments or try to maintain your current level of commitments. It’s normally best to not add anything to your plate when you’re in the middle of a bipolar manic episode.  Instead, you should wait until there is some level of stability before taking on more things.  The more you take on, the more stress and higher chances of a bipolar manic episode relapse

Get in heated discussions

• We all believe that we are inherently right. The problem is that when we are in a bipolar manic episode, we can become aggressive to make sure that everyone else knows we are right.  Some of my greatest mistakes in business have come from when I was in the middle of a bipolar manic episode and I said something that was out of character for me or responded in a way that I would never do.  I have burnt several bridges from this, but I’ve also learned that when I’m in an episode, it’s best to delay responding to emails or people that can trigger my emotions in an unhealthy way.

Make big decisions

• In the middle of a bipolar manic episode, our ability to rationally think or process information is hindered, because our brain is also fighting for a state of equilibrium. Big decisions should never be made in a bipolar manic episode.  For me, that means I won’t make any financial decisions over a certain dollar amount if I’m in a bipolar manic episode.  I also will not make any commitments that require large amounts of my time, such as new projects or ventures.

Self-medicate

• Before I surrendered to Christ in 2009, my background consists of years of self-medicating in a way that was incredibly harmful to myself and others. I’ve found that many people who self-medicate as I did are either undiagnosed with some kind of mental illness or they are in denial.  I have several people who I know personally who refuse to see a doctor, even though they have every symptom of someone who is mentally ill.  Instead, they live their lives in extreme highs or lows, often hurting themselves or others.  In 2016, a close friend died as a result of self-medicating.

Social Media

• In an article titled “Using lots of social media sites raises depression risk”, they share results from a national survey. “In 2014, Primack and his colleagues sampled 1,787 young adults, ages 19 through 32, using an established depression assessment tool and questionnaires to determine social media use. The questionnaires asked about the 11 most popular social media platforms at the time: Facebook, YouTube, Twitter, Google Plus, Instagram, Snapchat, Reddit, Tumblr, Pinterest, Vine and LinkedIn. Participants who used seven to 11 platforms had 3.1 times the odds of reporting higher levels of depressive symptoms than their counterparts who used zero to two platforms. Those who used the most platforms had 3.3 times the odds of high levels of anxiety symptoms than their peers who used the least number of platforms. The researchers controlled for other factors that may contribute to depression and anxiety, including race, gender, relationship status, household income, education and total time spent on social media

In Conclusion

Life isn’t fair.  You didn’t ask for bipolar disorder, and it isn’t easy.  No matter what you believe, the is a purpose in your pain and suffering.  My pain and suffering led me on a path to starting Special Strong in 2016.  Now, I get to serve others who struggle in similar ways that I do.  It doesn’t make life easier, but it gives my pain purpose.  Instead of allowing the pain to bring me down, it gets used to help others.  I hope that this article can serve as an encouragement to you, knowing that you are not the only one suffering.  You can still experience Heaven on Earth.  You will find a purpose for your pain.  Jesus paid the ultimate price of pain so we could live today.  Jesus knew his purpose for His pain. Always remember that even in the suffering, GOD IS ENOUGH.

The thief comes only to steal and kill and destroy. I came that they may have life and have it abundantly. John 10:10

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