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Red Flags: Warning Signs of Mania
From Kimberly Read & Marcia Purse,
Your Guide to Bipolar Disorder.
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Bipolar Basics
by Kimberly Read

How often have we heard it said? How often have we said it? "If only I had known ... If only there had been some warning ... If only I had seen it coming ... If ... If ... If!"

Don't the tragedy and regret of these statements just make you want to whip out your hanky and have a good cry?! I have to admit this is exactly what I did following my ex-husband's suicide attempt and diagnosis of Bipolar Disorder. I what-ifed myself into tears repeatedly.

As my ex-husband was able to verbalize his feelings and regain some emotional control, he shared that he felt the same way. We discussed this at length, and with the help of a psychologist, we tried to focus our energy on looking forward rather than back.

I soon discovered there are a number of warning signs, red flags as many call them, of which we should be aware.

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By learning these early indicators, red flags should go up well before a loved-one rockets into a manic spree, well before you slide into the murky depths of depression, well before a friend actually attempts suicide.
In this article, the first in a four-part series, we look at some of the common red flags for mania and hypomania. Part II looks at depression flags; Part III, the warning flags for Suicide; and Part IV, the early signs of Childhood Onset Bipolar Disorder (COBPD).

I have attempted to organize these symptoms into broad categories for easier reference. I have gathered this list of symptoms from personal experience as well as the resources listed in the sidebar.

Increased Energy
Decreased Sleep

Little Fatigue

An Increase in Activities

Restlessness
Speech Disruptions
Rapid, Pressured Speech

Incoherent Speech (generally not present in hypomania)

Clang Associations: the association of words based on their sound
(For example, my ex-husband once carried on for some time about vacancies, vagrancies and bacon seeds.)
Impaired Judgment
Lack of Insight

Inappropriate Humor

Inappropriate Behaviors

Impulsive Behaviors

Financial Extravagance

Grandiose Thinking
Increased or Decreased Sexuality
May include inappropriate or sexual behavior
Changes in Thought Patterns
Distractibility

Creative Thinking

Flight of Ideas

Disorientation

Disjointed Thinking

Racing Thoughts
Changes in Mood
Irritability

Excitability

Hostility

Feelings of Exhilaration
Changes in Perceptions
Inflated Self-Esteem

Hallucinations (not present in hypomania)

Delusions (not present in hypomania)

Paranoia (generally not severe in hypomania)

Increased Religious Activities
Hypomania also differs from bipolar mania in that the symptoms are generally less severe so that they do not cause significant impairment of daily activities. There are no psychotic features present in hypomania.
In closing, I want to remind each of us that more often than not, those who are close to us will notice our little red flags long before we will. If someone you love is waving flags, express concern! If someone you love expresses concern, listen!

Updated: September 29, 2006