Signs of bipolar depression relapse

The Signs and Triggers of a Bipolar Relapse—What Can You Do? – BrightQuest Treatment Centers

September 21, 2018, Laurel NowakBrightQuest Treatment Centers

As complex and overwhelming as bipolar disorder can be, it’s possible to develop a well-rounded plan to manage the ups and downs so they aren’t so debilitating. If you are able to recognize the early warning signs before a bipolar relapse, you may be able to minimize its impact. Likewise, you can keep an eye out for triggers and, most importantly, stick to a comprehensive treatment plan for the best possible outcomes.

First of all, it’s important to know that a bipolar relapse does not mean that someone has done something wrong or messed up. Bipolar disorder is an overwhelming illness, and it can be unpredictable and difficult to manage. A person who suffers from bipolar disorder needs reliable support, a comprehensive treatment plan, and a way to stay on top of that treatment. But, even still, relapse happens.

It’s hard to characterize a relapse of bipolar disorder in general terms because it can look and feel different for everyone. But there are ways you can look out for signs of a bipolar relapse and also manage triggers to better prevent distress. In fact, treatment serves to empower people with bipolar disorder to develop greater awareness of their transitional symptoms, especially with a host of social and professional support and effective options for therapeutic recovery.

As we have discussed, the mental and emotional experience of bipolar disorder can be challenging and even destabilizing. In fact, in order to observe an oncoming bipolar relapse, it’s a good idea to be on the lookout for behavioral signs rather than telling thoughts and feelings. This is because behavioral signs of a bipolar relapse are tangible and easier to observe. Signs of a hypomanic episode, on the other hand, may actually lead one to believe the opposite—that they are doing well and feeling altogether better. Whereas a depressive episode can be so overwhelming, and the emotional experience can feel completely defeating. But, again, the specific nature of these disordered mood experiences are different for everyone.

When we look at behaviors, they tend to be representative of the disordered thoughts and feelings. But they are more concrete, more measurable. By developing mindfulness and empowered perspective people living with bipolar disorder do not need to be completely blindsided by a relapse. When someone spots a warning sign, they can turn to their treatment toolbox and reach for a coping strategy or for the professional support that can ease their distress and perhaps prevent an extreme mood episode.

The signs that we will be looking for are called “prodromal”—rather than “syndromal,” which refers to the symptoms of the bipolar mood episode itself. So, during the prodromal phase, you can look for the following early warning signs.

Early Signs of Bipolar Depression

  • Procrastination or failure to complete things—even simple daily tasks—likely due to a lack of motivation
  • Expressing more negative opinions and sentiments
  • Changes in eating habits
  • Withdrawal from socialization and a tendency toward isolation
  • Withdrawal from things and activities a person is normally interested in
  • Visibly diminished energy; slower actions, movements, and speech
  • The tendency to sleep more than usual
  • Easily distracted, unable to concentrate, or more often forgetting things

Early Signs of Bipolar Mania

  • A visible resurgence of energy and euphoria that don’t seem like they are a direct reflection of the events and conditions around them
  • Quicker speech that seems to flow continuously and from various directions
  • Irritability or restlessness
  • An obvious boost in one’s self-confidence—evident in their speech or their actions
  • A short attention span; easily distracted
  • Emotional reactions that seem out of proportion with the real-world events and experiences
  • The tendency to sleep less than usual
  • Behaviors that seem impulsive or risky
  • Psychotic symptoms, such as delusional thinking or hallucinations

Because the signs and symptoms are unique to each person, it’s important to measure changes in behavior with the person’s own average tendencies rather than with a seemingly objective baseline.

Begin Your Recovery Journey Today.

Managing Bipolar Disorder, Treatment, and Triggers to Prevent Relapse

It’s important to also be aware of the other side of bipolar transitions: the triggers that can provoke mood episodes. With professional guidance, an individual can get to know the range of their particular triggers. But some common triggering situations include:

  • A lack of adequate sleep
  • Sedentary habits
  • Stress from any number of responsibilities, events, or relationships
  • A lack of daily routine
  • A lack of regular self-care
  • Social isolation
  • The transitions of seasons
  • The use of substances
  • Specific thought patterns
  • Extreme sensory inputs, such as bright lights or powerful noises or crowds

As part of a comprehensive treatment program, a person develops coping mechanisms for when their triggers arise. Among other strategies, their care plan may include medications, good sleep hygiene, wholesome nutrition, supportive relationships and groups, and daily routines, including exercise and other positive activities. With solid connections to clinicians, family, and friends, they also have others who can be alert to potential triggers or changes in their behavior that may signal an oncoming mood episode.

One of the most likely reasons that someone experiences a bipolar disorder relapse is that their treatment plan is interrupted. They might stop taking their medications—perhaps even because an approaching hypomanic episode leaves them feeling on top of the world or because an approaching depressive episode has them feeling defeated and hopeless. They might miss therapy appointments, which can compromise their ability to cope, as well as their ability to see warning signs clearly. As such, the most important safeguard against bipolar relapse is to have a solid, familiar, well-supported program of treatment and care—and to adhere to the therapeutic paths and to maintain the invaluable system of support. No one has to endure bipolar disorder on their own. And their possibilities for optimal quality of life are infinitely better with the right help from knowledgeable experts.

BrightQuest offers comprehensive residential treatment for people struggling with mental health disorders. We also treat co-occurring substance use disorders. Contact us to learn more about our innovative program and how we can help you or your loved one start your journey toward recovery.

SAMHSA’s National Helpline | SAMHSA

Your browser is not supported

Switch to Chrome, Edge, Firefox or Safari

Main page content

  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

  • Suggested Resources

    What Is Substance Abuse Treatment? A Booklet for Families
    Created for family members of people with alcohol abuse or drug abuse problems. Answers questions about substance abuse, its symptoms, different types of treatment, and recovery. Addresses concerns of children of parents with substance use/abuse problems.

    It's Not Your Fault (NACoA) (PDF | 12 KB)
    Assures teens with parents who abuse alcohol or drugs that, "It's not your fault!" and that they are not alone. Encourages teens to seek emotional support from other adults, school counselors, and youth support groups such as Alateen, and provides a resource list.

    After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
    Aids family members in coping with the aftermath of a relative's suicide attempt. Describes the emergency department treatment process, lists questions to ask about follow-up treatment, and describes how to reduce risk and ensure safety at home.

    Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction
    Explores the role of family therapy in recovery from mental illness or substance abuse. Explains how family therapy sessions are run and who conducts them, describes a typical session, and provides information on its effectiveness in recovery.

    For additional resources, please visit the SAMHSA Store.

Last Updated: 08/30/2022

Bipolar Disorder | Symptoms, complications, diagnosis and treatment

Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). Episodes of mood swings may occur infrequently or several times a year.

When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When the mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, alertness, judgment, behavior, and the ability to think clearly. nine0003

Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medication and psychological counseling (psychotherapy).


There are several types of bipolar and related disorders. They may include mania, hypomania, and depression. The symptoms can lead to unpredictable changes in mood and behavior, leading to significant stress and difficulty in life. nine0003

  • Bipolar disorder I. You have had at least one manic episode, which may be preceded or accompanied by hypomanic or major depressive episodes. In some cases, mania can cause a break with reality (psychosis).
  • Bipolar disorder II. You have had at least one major depressive episode and at least one hypomanic episode, but never had a manic episode.
  • nine0015 Cyclothymic disorder. You have had at least two years - or one year in children and adolescents - many periods of hypomanic symptoms and periods of depressive symptoms (though less severe than major depression).
  • Other types. These include, for example, bipolar and related disorders caused by certain drugs or alcohol, or due to health conditions such as Cushing's disease, multiple sclerosis, or stroke. nine0018

Bipolar II is not a milder form of Bipolar I but is a separate diagnosis. Although bipolar I manic episodes can be severe and dangerous, people with bipolar II can be depressed for longer periods of time, which can cause significant impairment.

Although bipolar disorder can occur at any age, it is usually diagnosed in adolescence or early twenties. Symptoms can vary from person to person, and symptoms can change over time. nine0003

Mania and hypomania

Mania and hypomania are two different types of episodes, but they share the same symptoms. Mania is more pronounced than hypomania and causes more noticeable problems at work, school, and social activities, as well as relationship difficulties. Mania can also cause a break with reality (psychosis) and require hospitalization.

Both a manic episode and a hypomanic episode include three or more of these symptoms:

  • Abnormally optimistic or nervous
  • Increased activity, energy or excitement
  • Exaggerated sense of well-being and self-confidence (euphoria)
  • Reduced need for sleep
  • Unusual talkativeness
  • Distractibility
  • Poor decision-making - for example, in speculation, in sexual encounters or in irrational investments

Major depressive episode

Major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in daily activities such as work, school, social activities, or relationships. Episode includes five or more of these symptoms:

  • Depressed mood, such as feeling sad, empty, hopeless, or tearful (in children and adolescents, depressed mood may manifest as irritability)
  • Marked loss of interest or feeling of displeasure in all (or nearly all) activities
  • Significant weight loss with no diet, weight gain, or decreased or increased appetite (in children, failure to gain weight as expected may be a sign of depression)
  • Either insomnia or sleeping too much
  • Either anxiety or slow behavior
  • Fatigue or loss of energy
  • nine0015 Feelings of worthlessness or excessive or inappropriate guilt
  • Decreased ability to think or concentrate, or indecisiveness
  • Thinking, planning or attempting suicide

Other features of bipolar disorder

Signs and symptoms of bipolar I and bipolar II disorder may include other signs such as anxiety disorder, melancholia, psychosis, or others. The timing of symptoms may include diagnostic markers such as mixed or fast cycling. In addition, bipolar symptoms may occur during pregnancy or with the change of seasons. nine0003

When to see a doctor

Despite extreme moods, people with bipolar disorder often do not realize how much their emotional instability disrupts their lives and the lives of their loved ones and do not receive the necessary treatment.

And if you are like people with bipolar disorder, you can enjoy feelings of euphoria and be more productive. However, this euphoria is always accompanied by an emotional disaster that can leave you depressed and possibly in financial, legal, or other bad relationships. nine0003

If you have symptoms of depression or mania, see your doctor or mental health professional. Bipolar disorder does not improve on its own. Getting mental health treatment with a history of bipolar disorder can help control your symptoms.

Bipolar disorder - causes and signs, diagnosis and treatment

Bipolar disorder is a psychopathological disease that manifests itself with sudden changes in mood, alternating episodes of mania and depression. Relapses last weeks and months. Manic-depressive psychosis, as the disease was previously called, if left untreated, can destroy a career, family relationships, and in especially severe cases, lead to suicide. nine0003

The pathological condition occurs with the same frequency in both sexes, the peak falls on the most active age of 15-25 years. Episodes respond well to medication and psychotherapy.

Bipolar personality disorder: symptoms and signs

Mental illness occurs with the change of 2 affective states - depression and mania, which in many manifestations are opposite to each other. The clinical picture depends on the phase of the course:

Phase Stages Symptoms Phase highlights
Manic includes 5 stages Hypomanic Increased emotional mood Emotional instability
Sleep problems
Vigor physical and psychological
Severe mania Continuous Jokes Aggressive-irritable mood or euphoric mood
Outbursts of anger
Sleep duration 4 hours
Lots of nonsense ideas
Manic frenzy Incomprehensible speech Sleep disorders - reduced need and duration
Lots of jerky movements
Motor calming Physical and mental activity is reduced
Reactive Return to normal
Depression proceeds in 4 stages Initial Depression, bad mood Oppressed, depressed mood
By the evening the condition improves
Sleep disorders
Growing depression Increased anxiety Decreased or absent appetite
Mood deterioration
Decreased appetite, performance
Severe depression Severe anxiety Thoughts about the meaninglessness of life, feeling of uselessness
Suicidal thoughts
Reactive Symptoms subside and go away

Causes of bipolar disorder

The disease affects 1. 5 to 2.4% of the population. Scientists consider the connection of the disease with such provoking factors:

  • genetic predisposition;
  • head injury;
  • hormonal imbalance;
  • traumatic life events - severe stress, loss.

Motivation for treatment

24/7 emergency care

Top specialists

Quality assurance

Diagnosis of bipolar disorder

Modern flexible diagnostics at the Profi-Detox clinic is the first decisive step on the way to full recovery. With any treatment, specialists begin with a careful thoughtful study of the symptomatic picture, a careful questioning of the patient, and, if necessary, his relatives.

At this stage, the ability of professionals to ask the right questions and make decisions about the choice of tactics is indispensable. For such cases, experienced doctors work in the clinic: a psychiatrist, a neuropathologist, a psychologist, an endocrinologist, a therapist. nine0003

To rule out organic pathology, the clinic conducts:

  • laboratory tests;
  • instrumental diagnostics;
  • diagnostic imaging.

Free consultation

+38 (067) 126 04 04

How is bipolar disorder treated?

Patients with bipolar disorder require mandatory medical attention. Since in its absence, an attack of mania or depression can drag on for up to a year or more. In "Profi-Detox" preference is given to proven, modern methods. nine0003

The combination of drug therapy with psychotherapeutic and physiological effects is the most effective. Fortunately, bipolar disorder responds well to treatment, and patients return to a productive life within 1-3 months.

In our clinic, the doctor works with the patient individually and chooses specific regimens, timing of medication and dosage. As a rule, the course may include:

  • mood stabilizers;
  • antidepressants;
  • nine0015 antipsychotics;
  • anticonvulsants.

Patient transfer

We arrive at the address within 45 - 60 minutes.

Free consultation

Call and ask any question.

Learn more