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For those who are living with bipolar disorder, depression or mania can seem to take over without warning. But, if we learn to recognize our early warning signs and "mood triggers," we can more effectively manage the symptoms that can cause problems in our lives.

Mood triggers are outside influences that can have significant positive or negative effects on our moods. A problem at work or having coffee with a friend can each trigger mood changes.

Triggers that may initiate depression or mania can include:

• A night of insomnia
• Family or marital conflicts
• Financial problems
• Use of alcohol or drugs

David J. Miklowitz, PhD, in The Bipolar Survival Guide, says that at the height of a manic episode, a person with bipolar disorder usually doesn't recognize anything out of the ordinary about their behavior. It's helpful to rely on those close to you to help you recognize signs of mania, such as irritability, insomnia, elevated mood, or depression, such as lack of interest in activities or lacking energy.

Dr. Miklowitz advises that you identify your early warning signs of an oncoming manic episode or depression and then create a plan for prevention measures.

What to do if you think you're becoming manic

Clue: Feeling tired from a restless night
Action: Try to catch up on your sleep as soon as possible.

Clue: Getting behind on your medication
Action: Get back on a regimen as quickly as possible.

Clue: Experiencing signs such as unrealistic thinking and speech, racing thoughts and feeling exceptionally productive
Actions: Avoid over-stimulating places or events.

Clue: Feeling exceptionally confident
Action: Avoid making major life decisions, such as those involving marriage, divorce, buying or selling a home or quitting your job.

Clue: Feeling preoccupied with money
Action: Stay away from the mall and the bank, and have someone you trust hold your credit cards for awhile. Postpone making any major purchases.

What to do if you think you're becoming depressed

Clues:

• Feeling sad, hopeless, tired, slowed down, numb or unmotivated
• Feeling symptoms of a mixed state, which might include irritability and anxiety
• Experiencing insomnia
• Having self/critical thoughts
• Sleeping too much or too little
• Craving carbohydrates

Actions:

• Try to stay active.
• Put an extra effort into doing the things that are going to make us feel better.
• Get some exercise.
• Maintain a regular sleep/wake cycle.
• Balance pleasurable activities with work.
• Eat a healthy diet with more protein and fewer carbohydrates.
• Use these techniques to manage your negative thinking.
• Stay in touch with people who make you feel good.

Use a mood chart to take control
Keeping a mood chart can help you track day-to-day changes in your emotions. It can help you identify when you might need an adjustment in medication, recognize what activities are resulting in improved moods, reveal a pattern of sleep problems or alert you to life problems causing mood shifts that you might want to discuss with your doctor or therapist.

You can find several types of mood charts online, but you can create your own to suit your needs. It might look something like this.

A tool for managing bipolar disorder can be found at Working Toward Wellness, a workbook prepared by Depression Bipolar Support Alliance (DBSA).

Related articles
Faces of mania
Mixed mania
What is hypomania?
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David J. Miklowitz PhD; (2002) The Bipolar Disorder Survival Guide: What You and Your Family Need to Know, Guilford Press

Page updated August 1, 2010