Even with treatment, the average person with bipolar disorder still has 4 episodes in the first 10 years of the illness. Without treatment, most people will have episodes more often. That’s why it is important that you learn to recognize changes in your mood.

If you feel your symptoms are returning and you need help, don’t be embarrassed or afraid to ask for it. If you tell your doctor how you’re feeling, he or she can work with you to prevent your mood swing from becoming a full-blown episode.

Types of episodes
There are 3 types of bipolar episodes. Periods of high moods (or “mania”) are called manic episodes. During times of low moods, a person feels unexplained sadness or hopelessness. These periods are called depressive episodes. Some people also have mixed episodes. This is when a person feels both manic and depressed at the same time.

“When I got a credit card bill for $5,000, I realized I’d had another manic episode.”

—Amelia

Signs of mixed episodes
In a mixed episode of bipolar disorder, you may feel manic and depressive symptoms at the same time. For example, you may feel both irritated and sad.

“There was a week when my moods were so unpredictable. Up, down, up, and down all in the course of a day. My friends avoided me during that period because they didn’t know which 'Amelia' they’d get next.”

—Amelia

Keep a daily diary
It’s important to share the patterns of your symptoms with your doctor. Download the daily diary (PDF). Use it to record your symptoms. And to keep track of your medicine and events that affect your mood. Bring it to your appointments. It can help you and your doctor understand your condition.

Pocket response plan
An early response plan can help you recognize mood swings. And it can also help you remember who to call if you need help. To create your own, download the early response plan (PDF) and fill it out. Keep it with you, so you always have it when you need it.

Getting help in emergencies
People with bipolar disorder—and their friends and family—should know that there are times when medical attention is needed right away. This may mean calling your doctor, calling 911, or going to the emergency room. Signs that emergency help is needed include: thoughts of suicide, thoughts of self-harm, or violent behavior.

“I recommend that patients talk with their families about what to do in case of a severe episode. Discuss things like when to call for help, who to call, and which treatments you’re comfortable with and why.”

—Dr. Suarez^†

Crisis plan
It’s important to have a plan that guides your family and friends regarding what to do in the event of an emergency. Download the crisis plan (PDF) and fill it out, so you and your family will be prepared in advance if you need help.

Next: Getting a correct diagnosis