The relapse rate for bipolar disorder is high. Learning to recognize the early warning signs of a bipolar disorder relapse is an important skill. However, recognizing early warning signs of relapse is not easy for people with bipolar disorder, especially if they are sliding into a manic episode. With depressive episodes, patients often say they are on a “smooth slope,” slipping down a bit, not realizing the extent of their depression until they “hit bottom. Before the patient realizes the severity of the problem, there are often signs that are obvious to others, such as family members, co-workers or medical staff. Without considerable effort on the part of the patient, family and medical staff involved in the patient’s treatment, it is often too late to reverse the process.
The ability of the patient to become aware of reliable warning signs usually requires a lot of effort and requires repeated examination of the early warning signs for clues. This process is best started when the patient is made aware of the symptoms of a manic or depressive episode for the first time. We can help the patient recall symptoms about four areas: affective, behavioral, cognitive, and physical. If the patient is able to recognize the types of symptoms of these four aspects of the episode well, the focus can shift to identifying early warning signs and symptoms. We can have patients categorize symptoms in each area: pre-episode symptoms; symptoms that are clearly in the process of an episode; and symptoms that have already occurred or during a severe episode. Learning to categorize symptom progression in a staged approach can increase the patient’s attention to very early prodromal symptoms or behaviors.
In bipolar disorder, like other psychological disorders, patients will have changes in thinking, emotion, and behavior early in the onset or relapse, and timely action at an early stage can reduce the extent and duration of the episode. The disease is easy to relapse, therefore, patients should understand the precursors of relapse and learn to identify the early warning signals of relapse, which is very important for timely treatment.
The common early warning signals of relapsing mania are.
1.Temper grows, can’t control want to get angry because of small things;
2.Speaking faster than before, feeling that there are always a lot of things to say, the voice is also louder than before;
3, feel much better energy, as if there is no sleep, do not know how to get tired, want to contact with the opposite sex;
4.I feel that my brain has somehow become smarter;
5, the mood is very good, feel that everything around is beautiful, the previous troubles are gone, etc.
The common early warning signs of relapse depression are
1, depressed mood, depression;
2, change in sleep habits (often early awakening and excessive sleep.)
3.Lack of concentration;
4, reluctance to participate in daily social activities;
5.Lack of energy, easily fatigued;
6.Easy to get angry;
7.Loss of interest in things or activities that usually interest you, etc.
After early warning signs of bipolar disorder relapse are identified, active early intervention should be carried out to reduce the risk associated with relapse.
Strategies for intervention are.
1. Clarify previous medication use ;
2. Bring the patient for counseling and examination of mental status as soon as possible;
3. Increase attention and support to the patient.
Early warning signs are manifested as aura symptoms of disease recurrence. The aura symptoms themselves have adverse effects on the patient, and they also predict a relapse soon, which can increase the suffering of the patient and family. Therefore, patients should be followed up regularly to provide psychological support, reduce their anxiety, share their pain, and ensure that they receive appropriate and timely professional services, such as expert consultation and outpatient follow-up. At the same time, preparations should be made for relapse. In addition to making plans for high-risk events (e.g., job loss, loss of love, divorce, physical illness, etc.) and precursors to relapse, there should also be plans to prevent relapse. For example, the family and the patient agree that if a relapse occurs with destruction or injury, the family will take the person to the hospital. The most important thing is to keep track of the patient’s consistent condition so that if there is a change, action can be taken in time to prevent relapse.
If the patient does not receive long-term preventive medication, but only trusts the recognition of early warning signs of relapse and early intervention, then it is even more important to educate the patient about bipolar disorder as a disease with a high relapse rate, rather than a human flaw or character defect, etc.