The Onset of Mania and Depression: Spotting Early Warning Signs

What is Bipolar Disorder?

Bipolar disorder is a lifelong mental health condition characterized by alternating periods of extreme emotional highs, known as mania or hypomania, and lows, referred to as depression. These mood episodes are typically accompanied by significant changes in behaviour, energy levels, and daily functioning, which can severely impact a person’s relationships, career, and overall well-being.

Managing bipolar disorder involves recognizing early warning signs of these extreme mood shifts and working with mental health professionals to develop a comprehensive treatment plan. This plan often includes medication, therapy, other interventions, and learning to identify and respond to early warning signs. In addition, by understanding your unique “relapse signature,” you can take proactive steps to minimize the impact of bipolar disorder on your life.

It is important to note that managing bipolar disorder is an ongoing process. The journey toward stability and well-being typically involves a combination of professional support, self-awareness, and continuous learning.

Understanding the Timeline of a Mood Episode: The Prodrome

The timeline of a mood episode plays a crucial role in understanding how bipolar disorder impacts an individual’s mood. Before an episode of mania or depression, a person experiences a period called the prodrome, which consists of early signs and symptoms. The prodrome is divided into two stages: early prodrome and late prodrome. Recognizing these signs and symptoms is key to reducing or stopping symptoms before they develop into a full-blown episode.

Early Prodrome

The early prodrome is the initial stage, characterized by mild symptoms that can start up to four weeks before an episode of mania or depression. During this stage, you may notice subtle changes in your mood, behaviour, and thought patterns. These changes may not be obvious or significantly disruptive, but they serve as early warning signs that a mood episode is approaching.

Examples of early prodrome symptoms may include:

• Increased or decreased energy levels
• Mild irritability or moodiness
• Changes in sleep patterns (slightly more or less sleep than usual)
• Minor fluctuations in appetite or weight
• Subtle shifts in concentration or focus

Late Prodrome

The late prodrome stage is characterized by increasingly severe symptoms that can start days or hours before an episode of mania or depression. During this stage, the early warning signs become more pronounced and may be noticeable to others. Symptoms during the late prodrome are likely to interfere with your daily functioning and may serve as a more apparent indication that an impactful mood episode is imminent.

Examples of late prodrome symptoms may include:

• Significant changes in energy levels (feeling extremely energetic or lethargic)
• Marked irritability or mood swings
• Significant sleep disturbances (insomnia or hypersomnia)
• Noticeable changes in appetite or weight
• Difficulty concentrating or making decisions

Importance of Recognizing the Prodrome

Understanding the timeline of a mood episode and the concept of the prodrome is vital Recognizing the early warning signs of depression and mania allows you to take action before symptoms escalate. By seeking help and implementing coping strategies during the prodrome, you can potentially reduce the severity of a mood episode, improve overall well-being, and maintain a better quality of life.

It’s important to remember that the prodrome experience can vary from person to person, and each individual may have unique warning signs. Being familiar with your specific prodrome and working closely with your mental health professional can significantly help manage bipolar disorder and maintain stability.

Common Warning Signs: Mania

Mania is characterized by feelings of high energy, pressure, anxiety, and intensity. Early warning signs for mania involve shifts in mood, perception, thoughts, and behaviour. Some common early warning signs for mania include:

• More energetic
• Feeling “high” or “in another world”
• Easily distracted
• Senses seem sharper / colours more vivid
• Ideas flow quickly
• More talkative
• Suddenly feeling creative
• Irritability
• Spending money more freely
• Sleeping less
• Anxiety
• Feeling rested even with little sleep
• Increased sex drive
• Feeling especially strong or powerful
• Drinking or drug use
• An elevated feeling of importance

Common Warning Signs: Depression

Depression is characterized by feelings of sadness, low energy, or feeling slowed down. Early warning signs of depression involve changes in thoughts, feelings, behaviours, and physical symptoms. Some common early warning signs of depression include:

• Sadness
• Ideas feel slowed down
• Difficulty focusing
• Senses seem duller
• Less talkative
• Less interest in people and activities
• Less energetic
• Anxiety
• Worry
• Restlessness
• Aches and pains
• Drinking or drug use
• Irritability
• Social isolation
• Decreased sex drive
• Sleep problems (too much, too little, or disrupted)

Strategies for Spotting Early Warning Signs

Track Mood and Behavior

Establishing a baseline of your typical mood and behaviour is essential for noticing changes. Aim to complete a daily mood log to track mood, sleep, and other common warning signs. With consistency, you’ll improve at noticing warning signs.

Explore Previous Episodes

Reviewing past episodes can help you identify patterns and clues that you may have missed. Compare episodes and ask friends or family members for their observations.

The Relapse Signature

A relapse signature is a set of 4-6 warning signs, unique to each person, that consistently predict a manic or depressive episode. Learning to spot these patterns is crucial to catching future mood episodes early. A relapse signature isn’t just a list of warning signs—it’s also the order in which they appear and how they progress.

To learn your relapse signature, explore past episodes, write each warning sign on a notecard, put the cards in the order the symptoms appeared, and compare the episodes. Use this information to create a single progression order that is generally accurate.

Record, review regularly, and share your relapse signature with family members or close friends who can help. Regular check-ins with a mental health professional can also be used to monitor symptoms or changes related to the relapse signature.

Conclusion

It can be helpful to recognize the warning signs of a potential mood episode, as this can help you reduce its severity or even prevent it from happening altogether. By being aware of changes in your mood and behaviour, you can take steps to seek professional help, ensure your safety, and avoid situations that may lead to a relapse. By taking the time to track your moods, reflect on past episodes, and understand your unique warning signs, you’ll be better equipped to manage your bipolar disorder and live a balanced and healthy life. Remember, this process takes practice and patience, but with the right support and guidance, you can lead a more satisfying life.