Bipolar Disorder And Relapse

Even if you take your medication consistently there is no guarantee that it will prevent a bipolar episode.

Relapses will happen.

This doesn’t mean that you must resign yourself to embarrassing and unpleasant hospital stays for the rest of your life. There’s hope.

If you can learn how to identify those early warning signs, it is possible to limit, and in some cases, prevent a manic or depressive episode.

Remember, everyone’s triggers are different.


Bipolar Relapse Triggers

It is estimated that at least 75 percent of people diagnosed with Bipolar Disorder will experience repeated episodes throughout their lives.  This means that they will experience manic highs and depression, even when following their treatment plan.1

When a relapse occurs, and you believe you have been doing everything right it can be devastating. The feeling of failure can be almost unbearable, and this alone can bring on depression.

Along with taking your meds every day, you need to know what your triggers are if you want to prevent frequent relapses.

Some of the common bipolar episode triggers – include:


  • Not getting enough sleep every night (e.g., less than 6 hours, although the total number of hours needed can vary from person to person)
  • Not having a daily schedule/routine
  • Alcohol use
  • Illicit drugs use
  • Major life events (e.g wedding, new baby, death in the family, illness)
  • Other stressful life events or changes in daily routine (e.g. starting a new job, moving, job loss, a vacation)

I’ve found that too much caffeine can trigger a relapse, but this isn’t necessarily true for everyone.

While you can’t avoid every situation that might trigger a relapse, knowing what they are ahead of time can help you be prepared.


Warning Signs for Bipolar Relapse

The signs of a bipolar relapse aren’t always easy for you to recognize, especially for mania. Often it’s your close friends and family that notice the change in your behavior, before it becomes a full blown manic episode. This is one of the reasons why it is important to have at least one or two people close to you on your support team.2

If you can catch the warning signs early enough, it might be possible to minimize or prevent the oncoming episode. Some common early signs that might indicate the onset of mania can include:

  • Sleeping less than usual (and feeling rested/not feeling tired or lethargic)
  • Rapid speech
  • Excess energy
  • Distracted/irritable
  • Racing thoughts
  • Making rash decisions/poor judgement
  • Exhibiting risky behaviors

The symptoms that could signal that start of bipolar depression often include:


  • Loss of interest in activities
  • Lack of energy
  • Constantly tired
  • Anxiety
  • Various body aches
  • Neglecting to take care of yourself (e.g., abandoning hygiene)
  • Feeling sad or having sad thoughts

You might also notice that you don’t want to spend time with friends and family. Concentrating on any task might also be difficult.

The Journal of Psychiatric Practice published a review that found your risk for a bipolar episode relapse is highest if you still experience some symptoms despite your medications. Talk to your doctor if this applies to you. It could be a sign that your treatment plan needs to be adjusted.


How to Learn Your Early Bipolar Relapse Signs

You won’t learn all the warning signs that signal a bipolar relapse the first time it happens. It will take time, patience and effort. It’s also worth it in the end. Here are a few tips on how to limit the severity of the episode and possibly prevent future ones from occurring.

  1. Know what type of Bipolar Disorder you have.

There are differences between Bipolar Disorder I and Bipolar Disorder II. The treatments are not the same, and this is important.

  1. Think about your previous manic and depressive episodes.


It’s often unpleasant to think about, but recalling past episodes and the accompanying symptoms can help prevent the next one. Try to remember when your early symptoms first appeared and when the episode was “the most severe”. Also ask yourself, when you hit the “point of no return”.

  1. Create a “mood chart”.

Even though it might seem silly, a daily mood chart can be an invaluable tool in preventing relapses. It can also aid in recovery, though you will always be “bipolar”. If you don’t want the embarrassment of a paper chart lying around, there are several apps and charts available online. I also use my chart to keep track of my daily meds. This way I can see which ones are working and when I need to talk to my doctor.

  1. Have coping skills.

This should already be a part of your treatment plan. Everyone has their own unique way of dealing with stressful situations. It is up to you and your physician to create your own. Coping skills also include being aware of your feelings and behaviors. This way you’ll notice when something is wrong before it turns into depression or mania.

  1. Support is crucial.


Bipolar Disorder is not an illness that you can manage alone. You need support. Let a few close friends and family members know that you are bipolar, and ask them to let you know if they see a change in your behavior or mood. If you are alone, there are support groups. Your primary care provider, local yellow pages and even a quick internet search can link you with ones in your area.

  1. Know the difference between normal and Bipolar.

This can be tough. Even when you’re not in the middle of an episode, you won’t always feel or behave the same. You’ll still get overly excited at times, feel irritable and even lose your temper. Everyone does. While you don’t want to panic every time your mood changes, it’s also important not to ignore it. There are 3 things you can ask yourself when this occurs that can make it easier to tell if these are early warning signs.

  1. Do your feelings and behavior match the situation?
  2. Is your reaction characteristic of your regular behavior?
  3. Are these feelings or behaviors consistent throughout the day?

If you answered “no” to any or all of these questions, it could be an early warning that your bipolar symptoms are returning.


Getting Past Bipolar Disorder Relapses

Nobody is perfect and relapses will probably happen. It is a part of being bipolar, but it doesn’t have to control your life.

Take your medications as prescribed. Try to limit the amount of stress in your life. Know your triggers and how to spot the symptoms warning of a relapse. Don’t forget to use your support system. Being bipolar is nothing to be ashamed of. If you follow these guidelines as best as you can, it is possible to limit the severity of the relapse and possibly stop it before it starts.

As always, talk to your primary care provider anytime you feel like your bipolar treatment plan is no longer effective.