Sometimes, a gradual buildup of symptoms and slight changes preceding a mood episode is obvious only after the fact. Here’s what to watch out for.
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Managing a complex, brain-based mood disorder like bipolar requires self-awareness and a measure of caution about changes in emotions and thinking.
After all, it is easy to miss those all-important — but subtle and person-specific — “red flags” of an impending mood episode.
RELATED: How to Spot Bipolar Red Flags — and What to Do About them
At the same time, becoming fixated on monitoring moods and overanalyzing every “normal” change in thoughts or feelings can sap the joy out of everyday experiences and take you out of the present moment.
As with most things: it’s all about balance.
Given the very real risks associated with mania, bipolar depression, and mixed mood episodes, establishing or maintaining stability takes an everyday effort. Especially if you have already worked hard to face the fallout of past mood swings and restore damaged relationships.
So, what exactly should you be self-monitoring? And what changes merit your attention? Here are the top features of life to regularly assess:
1. Racing or Delayed Thoughts
With bipolar disorder, cognitive changes can be subtle or surprisingly sudden.
Hypomania and mania are often characterized by rapid or racing thoughts. If you feel like your internal chatter is circling out of control, your creative juices are flowing, or your mind is buzzing, make note of it and consider reaching out to your treatment providers.
Conversely, depressive episodes often entail a sense of delayed processing speed, as if your thoughts are “buffering.” You may experience increased difficulty putting your thoughts into words or following along with a lively conversation or television show.
Treatment providers regularly recommend mindfulness because being able to recognize changes in thinking habits can put you one step ahead of the next mood swing.
2. Changes in Motivation and Energy
Maybe you’re feeling slightly more sluggish and missing your morning workout routine is becoming a little more frequent. Or perhaps you’ve started taking on more projects at work or signed up for another recreational team or obligation.
These dips or upticks in energy and motivation may be understated, but, if you can track a subtle trend in changes to the norm, that is something to pay attention to and share with your support team. After all, a lack of energy can signal a downward shift to bipolar depression, and an abundance of stamina may indicate an upswing into hypomania or mania.
3. Appetite Adjustments
Oftentimes, when your appetite increases, it becomes noticeable after a while because you might say to yourself, “Wow, I’m really hungry,” all the time. But, when you gradually lose your appetite, it’s not as overt a warning.
We all know the feeling of not realizing we have skipped lunch, but we might not be as cognizant of gradually eating less during meals.
Keeping a food diary or log, whether on paper or through an app on your smartphone or laptop, can help you to recognize subtle changes in your eating habits. (Sometimes, hopping on the scale or snapping a selfie can prompt you to spot a change in your physical appearance.)
4. Memory Mishaps
Because they involve your memory, these subtle shifts can be difficult to recognize. Ask yourself this: Are tasks taking a little longer than they normally would to complete? Are you feeling frustrated more regularly?
- Perhaps it’s having to look at a recipe too many times or having to re-read the same passage in a book or article more often than is typical for you.
- Or maybe it’s not being able to recall the name of something in the middle of a conversation.
When these minor memory-based stumbles occur every once in a while, we don’t think anything of it, but if they are happening more than you like, it can become frustrating. So, if you start feeling agitated or annoyed with yourself, that might be a warning sign that a mood shift is on the horizon.
5. Sleep Disturbances
Bipolar sleep disruptions aren’t always overt, like suddenly sleeping through an alarm or not being able to sleep at all. There are often very subtle shifts in your internal biological clock that aren’t always noticeable at first — until they become a problem.
For instance, it is easy to overlook a trend of delaying bedtime by half an hour a few times a week or gradually waking up slightly later than scheduled.
Sleep shifts like these have a habit of creeping up on us. And, unless you keep a sleep journal or wear a smart device that tracks your shut-eye, slow changes in sleep routines may be missed until something more intense develops.
UPDATED: Revised November 5, 2021
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