Bipolar Relapse

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Bipolar Relapse

If any mental health condition could be categorized as a “roller coaster”, it would be bipolar disorder. Euphoric highs and crushing lows are a regular occurrence. People with bipolar don’t always know when they’ll have manic episodes, and because these episodes can be so destructive, they often fear their return. If you have bipolar, you may spend a lot of your time worrying about bipolar relapse. At Sun Behavioral Health Houston, we know how overwhelming that can be.

Bipolar disorder is manageable with things like therapy, medication, and healthy coping strategies. Because of this, it’s fairly normal to go months or even years without any mania or depressive episodes. Unfortunately, because of the nature of this disorder, they have a high likelihood of returning at one point or another. In fact, according to a study published by the National Library of Medicine, almost 90% of people with bipolar will experience a relapse in their lifetime.

What is a Bipolar Relapse?

Bipolar relapse is what happens when episodic mania or depression returns after a dormant period. For many, normalcy amidst bipolar disorder takes hard work and considerable effort. Bipolar relapse can be incredibly frustrating for people, and it can even cause feelings of guilt. You’ve spent so long fighting this disorder and figuring out what works and what doesn’t – only to be slammed with another episode.

You’ve done the work to ensure that you’re healthy and functioning. What did you do wrong? What could you have done differently? Could you have prevented it? Most of the time, the answer to this is a solid “no.” This is not anyone’s fault. It’s the nature of bipolar disorder, and you won’t always be able to avoid every instance of relapse.

When hit with a relapse, it’s important to remember that not all episodes are the same. You may not experience the same feelings you had last time. Just because you once experienced mania that lasted for 5 days straight doesn’t mean that’s what’s going to happen again. Being hit with a bipolar relapse does not mean you’re going to lose your job, your friends, or your house. There are tools you can use to ensure your safety and strength while you’re going through this.

Feeling hopeless or afraid of relapse is normal, but there are things you can do to prepare for (and sometimes even prevent) it.

What Are the Signs that a Bipolar Relapse is Coming?

Each person living with bipolar has something called a “relapse signature.” A relapse signature is a group of 4-6 signs, unique to each person, that appear before a relapse. They can usually indicate whether or not you’re about to have an episode of mania or depression. They’ll typically appear about 4 weeks before an episodic event. You may be aware of these signs already. In case you’re not, here are some of the common things that can predict a manic episode:

  • Staying out late
  • Heightened creativity
  • Excessive alcohol or drug use
  • Feeling more talkative
  • Increase in the flow of ideas
  • Reckless spending
  • Insomnia or sleeping less
  • Increased sex drive
  • Irritability
  • Feelings of invincibility
  • Increased energy, even with little to no sleep
  • Increased sensitivity to senses (smell, touch, sight, taste, etc.)

A relapse signature can also indicate signs of an impending depressive episode. These signs can include:

  • Slow speech and the slowing down of ideas
  • Isolation
  • Anxiety
  • Body aches or a decrease in pain tolerance
  • Senses seem muted or dull (colors aren’t as bright, smell isn’t sharp, etc.)
  • Little to no energy
  • Irritability
  • Difficulty with focus and concentration
  • Less talkative
  • Decrease in sex drive
  • Excessive alcohol or drug use
  • Restlessness
  • Loss of interest in things you usually love
  • Loss of motivation

When looking for signs of a relapse, it’s important to observe your behavior – not your feelings. Feelings come and go, but behavior is measurable. If you notice that you’re sleeping less or eating more (etc.), write it down. It could be an indication of an upcoming episode. Writing things down encourages you to notice what you normally wouldn’t. Recognizing these warning signs will help you identify your unique relapse signature.

Noticing the order in which these behaviors appear is also important. For example, for some people, this is the order of their signature:

  1. Decrease in appetite
  2. Decrease in sex drive
  3. Restlessness
  4. Heavy alcohol consumption

If they experience a decrease in appetite, they can say to themselves, “I haven’t been hungry lately. I need to look out for a decrease in my sex drive. This could be a sign of an impending episode.”

When you’re experiencing an episode of mania or depression, it can feel like you’re out of control. Recognizing your relapse signature allows you to take steps to minimize the episodic effects. This not only gives you an element of control, but it also prepares your family or friends for what’s coming so they can help.

Catching these early warning signs can also guide you to seek professional help before the episode begins. Seeking treatment can help you lessen the severity of the symptoms or even stave them off altogether. If you’re having trouble noticing these signs, keep a mood log, write down any change in your behaviors, or ask your friends and family to look out for your behaviors.

How to Manage a Bipolar Relapse

A relapse can still happen, even if you’ve done everything possible to stave it off. This doesn’t mean you’ve done anything wrong or that it’s your fault. This is the nature of bipolar disorder.

Fortunately, there are things you can do while experiencing an episode that can help. One of the most important things you can do is have a counselor or therapist you can talk to during your highs and lows. Therapy can provide powerful insights into the management of a bipolar relapse. You won’t just learn additional tips and tricks for getting through painful or uncomfortable times – you’ll have a knowledgeable person to talk you through them. This is an invaluable resource. Let’s look at some of the other things you can do during a relapse that can be helpful:

  • Take care of yourself. We’re always hearing about how important self-care is, but during a manic or depressive episode, it’s vital. Neglecting your needs will only worsen your symptoms. Make sure your basic needs are being met, and notice when you need a break. Practice self-compassion and don’t allow yourself to feel guilt if you can’t get everything done.
  • Exercise. Physical movement is a powerful way to regulate your moods. If you’re in the middle of a depressive episode, you may not want to get out of bed, let alone exercise. If this is the case, force yourself to take short walks throughout the day. You can also do simple exercises in your bedroom. 10 sit-ups here, 5 jumping jacks there – it adds up. Any kind of physical activity will be beneficial for you.
  • Be mindful of what you’re putting into your body. The temptation to use alcohol or other drugs during episodic events is powerful. Alcohol and other substances can magnify the symptoms of your episodes, making them stronger and unmanageable. It might feel good at the time, but the next day your body will be prone to anxiety, dehydration, and stomach problems. Alcohol and other substances can also interfere with any medication you’re on. Avoid using these substances and put healthier things into your body instead, like fruits, vegetables, seeds, and nuts.
  • Take your medication regularly – don’t skip doses. Bipolar medication works much better when it’s taken regularly. Taking medication as prescribed is one of the best things someone with bipolar can do for their moods. Skipping a day or even being a few hours late to take certain medications can dysregulate your mood.
  • Stick to your routine. Routines are important for anyone who suffers from a mental illness. A routine will give you a sense of safety and certainty, which is especially helpful when your moods are shifting. Include at least 8 hours of sleep into your daily routine, along with healthy eating and exercise. Carve out time for yourself and your hobbies.
  • Talk, talk, talk. You might be tired of discussing your bipolar disorder. You may even feel like a burden to your friends and family. Discussing the nature of your moods with people you trust will help. Friends and family can offer you the support you desperately need. If people know what you’re going through, they’re more willing to help with things you struggle with during an episode – like dishes, meals, or other tasks. Reach out, even when you feel like isolating yourself.

Treatment for Bipolar Disorder

If you haven’t already, it might be time to seek treatment for your bipolar disorder. Treatment can consist of things like individual therapy, recreational therapy, group therapy, or intensive outpatient programs. Many who have bipolar also find medication helpful. Finding the right provider for your bipolar treatment program is the next step. Wherever you decide to go for treatment, it’s important to look out for a few things in your provider:

  1. Are they compassionate? Will they listen to your concerns?
  2. Are they using evidence-based treatment methods?
  3. Do they have a knowledgeable staff that you trust?

You are not alone. Sun Behavioral Health Houston is available to listen 24 hours a day, 7 days a week. With our expert staff and our experience with treating bipolar disorder, we’re standing by ready to address your needs. For more information or to schedule a consultation, call us today at (713) 796-2273.

FAQs About Bipolar Relapse

What can trigger a bipolar relapse?

There are times when you’ll be able to recognize what’s triggering your relapses. High-stress situations, major life changes, or even excessive use of alcohol or other drugs can trigger a relapse. For many, relapses happen at random with no triggers.

How long does a bipolar relapse take?

Depending on the type of bipolar you’ve been diagnosed with, a manic or depressive episode can last anywhere from a couple of days to several weeks. Looking back at your episodic patterns from the past can help you determine the average length of your unique periods of mania and depression.

What causes a bipolar relapse?

There is typically no set cause for a bipolar relapse. There are things that can trigger or contribute to a relapse. It’s important to remember that experiencing a relapse does not mean you did something wrong.