5 Ways to help someone who is manic or rapid cycling

Before we get started, I want to help everyone understand why in my writing I use the terms “we” and “us”. The key reason for doing this is because stigmatization, judgment and the fear people have of people living with bipolar disorder can be very isolating and create a great deal of self-shame and self-fear. I use “we” and us” to remove stigma, judgment and fear in order to create belonging and acceptance. I also use “we” and “us” so it is very clear that I am writing about an experience that I belong to as well.

This blog is in response to someone asking for help to better be able to help her loved one who is struggling with rapid cycling…and I’m broadening this to include both rapid cycling and mania.

#1 Thing you can do to help the one you love is by taking really good care of yourself – emotionally, mentally, physically, your health etc.

It is incredibly hard to help someone who is experiencing mania or rapid cycling. The reason why hospitalization exists, besides being at harm to ourselves and others, is to slow us down. Hospitalization removes whatever supports mania and medically slows us down and forces our bodies and mind to stop running a million miles a minute and rest.  Being forced to slow down can feel like death or simply horrible.

The goal of this blog is to help intervene before hospitalization is needed.

This blog is about how to help someone you love slow down and gain some control during mania or mixed episodes without hospitalization. It is not easy.

A gem I have gained from my experience from experiencing mania is how powerful the mind-body connection really is. When my mind and emotions are going a million miles a minute there is no rational way to THINK myself out of this process. However, my body can only go so fast.  I learned that if I can slow down my body and gain awareness and control in my body that it has a profound affect on my mind.

What I hope to share are some tools that can be helpful to the ones you love that I have learned from experience and professional education that have been successful in slowing down mania or cycling and building awareness and control.

Help loved ones gain control of their mind through their bodies by:

  • Shifting our attention to our breath.

    When we focus on our breathing it brings our attention away from what is taking place around us and in our minds. Our attention goes directly to expanding and contracting our lungs.  Our attention goes to breathing as deeply into our bodies as we can and releasing our breath.

    By focusing on our breathing we experience control. Our awareness decides how deeply we breathe. We have the power to control our breath which can either slow down our body or speed it up.

    GOAL: Breathe deeply and slow down the breath which will regulate the rest of the body and the mind.

    How you can help:

    Don’t judge, label or say things like “You’re out of control. You’re manic. You’re crazy etc”

    Instead say something like, “I’m feeling scared/sad/down/lost/frustrated etc, will you hold my hand (or sit beside me) and breathe with me?”

    • Creating a safe place for us to contain ourselves

    When we feel out of control in our bodies, a long tight hug really helps.  There is something incredibly containing about a hug that is grounding for a person who feels out of control.

    The hug not only helps us stand, but it also helps us to emotionally center ourselves. We feel emotionally connected, present and a hug is an act of love.

    GOAL: Hug your loved one until they let go, don’t let them go. By hugging them they feel safe, wanted and loved. This containment creates self-control in both their body and mind.

    How you can help:

    Simply say, “I want to hug you, may I give you a hug?”

    • With your words

    When we are manic or rapid cycling we don’t respond well at all to words, we are not able to be rational…especially when sentences start with the word “You…”.

    GOAL: To not make us feel bad about ourselves, when we are manic or rapidly cycling and are out of control…we already feel bad about ourselves.

    How you can help:

    Make “I” statements. Start your sentences with the word “I”. For example, “I feel scared when…” “It concerns me when…” “It’s problematic for me when…” etc.

    • Giving us space.

    When you can’t express how you are feeling, it is incredibly frustrating when someone keeps asking you “What’s wrong?”, “How are you feeling?”, “Are you okay?” etc.

    GOAL: Give us space so we can ride out the emotional rollercoaster.

    How you can help:

    Help your loved one create a space when they are okay that feels safe to them. This space will be where they go when they experience an emotional rollercoaster.

    • Forgiveness

    Mania, depression and mixed episodes cause us to express ourselves and emotion in ways that are very hurtful.  We often feel ashamed of what we do and say. We are often not kind in how we treat the people we love during these times of incredibly emotional rollercoastering. We are so disappointed in ourselves and feel so much pain for how we treat those we love during an episode.  Forgiveness is a gift that we need to receive.

    GOAL: Help us heal and recover by forgiving us for the pain we cause.

    How you can help:

    If you remind your loved one that you know that how they are behaving is not who they are…that it is the mania or depression. Let them know that you love them and that the mania or depression is hurting you.

    Don’t let bipolar disorder be an excuse for bad behavior. Help your loved one see the difference. Therapy can be very useful to build this awareness.


    5 Ways to Gain Control During a Manic Episode

    In order to take  control of mania you first have to be able to recognize that you are experiencing mania.  Many people have a very difficult time doing this because the early and middle mania are pleasurable and productive.

    To recognize the early signs of mania please see my blog entitled, “Early Warning Signs of Mania: 6 Areas to Notice Mania on the Horizon”.

    Once you know the early warning signs and how to recognize mania, here are ways to intervene:

    1. Identify the Triggers.

    It is important to be able to identify what triggers your mania.  This will help you intervene because  will be able to identify what is fueling it.

    People often get triggered into mania by a combination of excitement, stress and sense of urgency.

    To develop your ability to identify triggers:

    • Notice what is taking place in your life and how you are responding to it near the onset of mania.
    • Notice your feelings about it.
    • Notice what thoughts keep you awake at night.
    • Notice what you feel a sense of urgency towards.

    Note: Not all manic episodes will have triggers. As the number of manic episodes increases the need for a trigger decreases. The more manic episodes you have the more hard-wired your brain becomes for mania.

    2. Identify what is fueling the mania.

    Fuel for mania are the actions that you take impulsively that tend to be goal-oriented that strengthen the mania.

    What you have a sense of urgency for or are behaving impulsively about is fuel for mania.

    3. Take the fuel away.

    Whatever manic actions you are doing. STOP. Stop doing the action. Put it away. Whatever it is, it can handle you not attending to it right now.

    Example: I get triggered into mania by excitement combined with a sense of urgency. In one hypomanic episode over 3 years ago (not full-blown mania) I built my first versions of my two very large websites all in five days.  That is unheard of productivity for “non-bipolar” people. I wasn’t sleeping, forgetting to eat and wasn’t able to see my clients at work because I had all the early mania symptoms and I could not stop building these websites.

    I had to take my computer AWAY. I had to stop building my websites and not allow myself to work on them until I was able to do so in a contained way.

    It wasn’t enough to just take the computer away, I had to replace it with something that my mind could focus on, yet would not cause me to feel a sense of urgency. Without replacing it, I would not be able to keep my impulses from causing me to grab my computer and keep intensely working.

    So I made art. I did a form of calming and centering art called “Mandalas” which is drawing or paining in a circle. I did contained art to contain me.

    Other things you can do to replace your goal-oriented behavior:

    • Spend time outside – walking, hiking, bike riding, exploring, swimming, etc
    • Work on jigsaw puzzles, suduko, crossword puzzles etc  These activities engage your brain in a way that contains it.
    • Spend time with friends outside of your home or watch a movie.
    • Cook food that you enjoy or explore new recipes or concoctions, but don’t cook for a banquet, just for yourself.
    • Make art, unless making art is fueling your mania.

    4. Sleep

    When you are manic, you must force yourself to sleep.  This is much easier to do when you take away your access to the trigger and fuel of your mania.

    Sleep will not be easy.

    Actions that promote sleep:

    • Deep breathing: inhale deeply into your belly slowly through your nose for about 5 seconds, hold your breath for 5 seconds, and exhale slowly for 5 seconds.  Do this as long as you can until you fall asleep.
    • Guided Visualization: There infinite ways to guide yourself, this is just one…imagine yourself being in a place that is beautiful, comforting and welcoming of you. Notice the colors, the sounds, and the smells. Notice who is there with you. Notice how you feel in your body and your mind being in this place that is so peaceful and welcoming of you. Let this carry you into a dream.
    • Light a candle (a safe candle in glass that cannot easily tip or break). Lay in bed and watch the flame and the light.
    • Complete darkness in your room. Have black out curtains. People living with bipolar disorder are extremely sensitive to light. Small amounts of light can prevent sleep (this does not include candle light, because of the properties of warmth and life in the flame)

    If these actions do not help you sleep, contact your doctor and discuss being on a sleep medication that is not addictive.

    5. Contact your Psychiatrist

    During an episode your psychiatrist will often make changes in the amount and balance of medication that you take to help stabilize you during this process.


    Early Warning Signs of Mania: 6 Areas to Notice Mania on the Horizon

    No single one of these qualities means that you are manic, but they mean that you could be vulnerable to mania.

    1. Notice your sleep.

    If you are not feeling tired, having difficulty falling or staying asleep, or your need for sleep is decreasing this is a very important warning sign that your body and mind are giving you to alert you that mania is on the horizon.

    Pay attention to is what is keeping you awake. If there is a repetitive thought playing like a tape recorder in your mind, if you can’t stop thinking about a goal that doesn’t have an external stressor, or nothing of importance is on your mind and you simply can’t sleep, mania may be on the horizon.

    This is different from having difficulty sleeping one night because you have an exam, deadline, or any external stressor.  However, if you are unable to sleep multiple nights due to external stressors it could very easily lead to mania.

    2. Notice your thoughts.

    If you notice that the speed of your thoughts are increasing, the number of thoughts you have at once are multiplying, your thoughts get jumbled or you have difficulty expressing your thoughts…mania may be on the horizon.

    3. Notice your drive towards goals.

    If you have a sense of urgency towards a goal, especially a goal that does not have a deadline or any external pressure, you may be experiencing the early signs of mania.

    4. Notice your energy.

    If you experience yourself as having more energy than usual. For instance, if you find yourself more exuberant than YOUR usual, you may be approaching an early sign of mania. This is especially true if you find that you cannot contain your energy appropriately to fit the situation you are in.

    5. Notice your impulses and drives.

    If you notice that you are more impulsive than usual – spending money, gambling, taking risks, sexually etc. If you are beginning to be driven by your impulses you may be in the clutch of mania.

    6. Notice your emotional sensitivity and emotional response. Also known as agitation.

    If you are experiencing levels of sensitivity or agitation that are greater than usual, keep a look out for mania on the horizon.

    However, if your response to an emotion causes you feel out of control, mania may be close. This does not mean that if you get angry and yell that you are manic. Nonetheless, if you find yourself feeling out of control of your emotions then you may be vulnerable to mania.