Lemmings who have personal experience with bipolar disorder (self, family, or friends), how hopeless is the situation, really?
-
My son has been diagnosed with bipolar disorder. He's in his mid-twenties, so it's the average time for onset of bipolar disorder. No family history that we know of, but if it was just two generations back, it probably wouldn't have been talked about.
He had his first manic episode early in the year. He spent a brief time in in-patient treatment, followed by a period of out-patient treatment. During the out-patient treatment, his psychiatrist started to think the diagnosis was incorrect and she weaned him off his meds.
He has had another manic episode, and he's back in the in-patient facility. Luckily he was able to get back into the same place he was in before, so they aren't starting from zero. They started him back on different meds, and he's much better much faster than the first time.
His fiancee was talking to a friend and someone overheard. The person who overheard said her mother was bipolar and she had to take her to the hospital six times, and she told his fiancee that she should break up with him.
The only experts I've spoken to have been the doctors in the crisis center, and I don't know to what degree they are trying to sugar coat things to prevent us from giving up hope.
I'd rather know the reality.
If anyone has any personal experience they can share, I'd appreciate it. If anyone has any professional experience they can share, I'd appreciate that as well.
EDIT: Just wanted to add to this that we were able to visit him today, and he's doing very well.
Mental health counselor here.
The outcomes of treatment for bipolar disorder are unfortunately very variable. It depends on how severe your son’s symptoms are, how well he responds to the medications cocktail he’s being given, what that medication cocktail is, and how well he adheres to it.
The important thing is that your son controls what he can control, which is largely whether or not he takes his meds and how much he engages in therapy. Therapeutic skills involve insight/mindfulness work (i.e. how well your son can recognize his symptoms as they’re happening) and resource use (i.e. does he inform his therapist and/or psychiatrist when he notices he’s be king symptomatic). Mania often feels amazing to people experiencing it, so they’re often motivated against treating it when it occurs, and this is major barrier to treatment.
A big component is whether or not symptoms of psychosis are involved in either the mania or depression. Psychotic symptoms are: 1.) hallucinations (false sensory perceptions, like hearing voices, seeing things, smelling things, etc), 2.) delusions (false beliefs that don’t conform to “normal” societal beliefs, like “I am Jesus” or “God has a mission for me”), and 3.) paranoia (i.e. feeling people around you are hostile to you or are spying on you, etc). These can be experienced in either mood state, but are most often seen in manic states.
I would suggest getting in touch with an organization called NAMI (National Alliance for the Mentally Ill) as they have tons of resources for people struggling with mental illness and family members of mentally ill people.
-
My son has been diagnosed with bipolar disorder. He's in his mid-twenties, so it's the average time for onset of bipolar disorder. No family history that we know of, but if it was just two generations back, it probably wouldn't have been talked about.
He had his first manic episode early in the year. He spent a brief time in in-patient treatment, followed by a period of out-patient treatment. During the out-patient treatment, his psychiatrist started to think the diagnosis was incorrect and she weaned him off his meds.
He has had another manic episode, and he's back in the in-patient facility. Luckily he was able to get back into the same place he was in before, so they aren't starting from zero. They started him back on different meds, and he's much better much faster than the first time.
His fiancee was talking to a friend and someone overheard. The person who overheard said her mother was bipolar and she had to take her to the hospital six times, and she told his fiancee that she should break up with him.
The only experts I've spoken to have been the doctors in the crisis center, and I don't know to what degree they are trying to sugar coat things to prevent us from giving up hope.
I'd rather know the reality.
If anyone has any personal experience they can share, I'd appreciate it. If anyone has any professional experience they can share, I'd appreciate that as well.
EDIT: Just wanted to add to this that we were able to visit him today, and he's doing very well.
I'm an inpatient psych nurse. I see there are already 40 answers, so what are your specific ones for me?
-
My son has been diagnosed with bipolar disorder. He's in his mid-twenties, so it's the average time for onset of bipolar disorder. No family history that we know of, but if it was just two generations back, it probably wouldn't have been talked about.
He had his first manic episode early in the year. He spent a brief time in in-patient treatment, followed by a period of out-patient treatment. During the out-patient treatment, his psychiatrist started to think the diagnosis was incorrect and she weaned him off his meds.
He has had another manic episode, and he's back in the in-patient facility. Luckily he was able to get back into the same place he was in before, so they aren't starting from zero. They started him back on different meds, and he's much better much faster than the first time.
His fiancee was talking to a friend and someone overheard. The person who overheard said her mother was bipolar and she had to take her to the hospital six times, and she told his fiancee that she should break up with him.
The only experts I've spoken to have been the doctors in the crisis center, and I don't know to what degree they are trying to sugar coat things to prevent us from giving up hope.
I'd rather know the reality.
If anyone has any personal experience they can share, I'd appreciate it. If anyone has any professional experience they can share, I'd appreciate that as well.
EDIT: Just wanted to add to this that we were able to visit him today, and he's doing very well.
I've had a classmate who was bipolar. Super lovely girl, she would sometimes feel more sensible if the medication changed but I've never thought of her as needing to be treated with any special considerations when interacting socially. She got married and had kids and is still going well.
A close friend of my mother was married to a bipolar woman. She tried to kill him with a kitchen knife on one occasion, and in another, she effectively set the house on fire- they lost everything.
So, I don't really know what to say to you. My understanding is that your mileage may vary and by a lot. Personally I believe it's manageable in most cases with proper healthcare, and you probably already deal with several bipolar people day to day - you just don't notice it. But, I'm not an expert so take this with a pinch of salt.
-
My son has been diagnosed with bipolar disorder. He's in his mid-twenties, so it's the average time for onset of bipolar disorder. No family history that we know of, but if it was just two generations back, it probably wouldn't have been talked about.
He had his first manic episode early in the year. He spent a brief time in in-patient treatment, followed by a period of out-patient treatment. During the out-patient treatment, his psychiatrist started to think the diagnosis was incorrect and she weaned him off his meds.
He has had another manic episode, and he's back in the in-patient facility. Luckily he was able to get back into the same place he was in before, so they aren't starting from zero. They started him back on different meds, and he's much better much faster than the first time.
His fiancee was talking to a friend and someone overheard. The person who overheard said her mother was bipolar and she had to take her to the hospital six times, and she told his fiancee that she should break up with him.
The only experts I've spoken to have been the doctors in the crisis center, and I don't know to what degree they are trying to sugar coat things to prevent us from giving up hope.
I'd rather know the reality.
If anyone has any personal experience they can share, I'd appreciate it. If anyone has any professional experience they can share, I'd appreciate that as well.
EDIT: Just wanted to add to this that we were able to visit him today, and he's doing very well.
My personal experience is that when things start getting better, always question whether it is really getting better or is it just the manic phase. I have stopped taking medications twice when I started feeling better, only to crash a month or two later.
What worked for me was fixing the depression phase (the more concerning one in my case). I started working out and it killed my depression. And mania never came back. I am not taking medication since at least 2 years now.
Of course everyone is different but you have to try. I know it is very easy to succumb to hopelessness because everytime you get better, you get worse but it is manageable.
-
My son has been diagnosed with bipolar disorder. He's in his mid-twenties, so it's the average time for onset of bipolar disorder. No family history that we know of, but if it was just two generations back, it probably wouldn't have been talked about.
He had his first manic episode early in the year. He spent a brief time in in-patient treatment, followed by a period of out-patient treatment. During the out-patient treatment, his psychiatrist started to think the diagnosis was incorrect and she weaned him off his meds.
He has had another manic episode, and he's back in the in-patient facility. Luckily he was able to get back into the same place he was in before, so they aren't starting from zero. They started him back on different meds, and he's much better much faster than the first time.
His fiancee was talking to a friend and someone overheard. The person who overheard said her mother was bipolar and she had to take her to the hospital six times, and she told his fiancee that she should break up with him.
The only experts I've spoken to have been the doctors in the crisis center, and I don't know to what degree they are trying to sugar coat things to prevent us from giving up hope.
I'd rather know the reality.
If anyone has any personal experience they can share, I'd appreciate it. If anyone has any professional experience they can share, I'd appreciate that as well.
EDIT: Just wanted to add to this that we were able to visit him today, and he's doing very well.
wrote on last edited by [email protected]It depends on the person.
The first bipolar person I (knowingly) met was someone who transferred into my school when I was 12. This girl began to mercilessly bully me. It started with the “usual” things, like insults and shoving in the halls. But it ramped up. She destroyed my class projects. She beat the shit out of me to the point I lost a tooth. I had to get changed for gym in the gym teacher’s office, and she snuck a phone beneath the door to photograph me undressed.
Eventually, I couldn’t attend school anymore, and had to spend the final few years being homeschooled instead.
But, leaving school didn’t make her stop. It’s been sixteen years since I first met her, and it’s still continuing. She still harasses and stalks me, my partner and my family, both on and offline. This ranges from insults and threats sent via online platforms, to physical assaults or vandalized property/vehicles IRL, to one instance of SWATing.
She has spent time in jail for some of the things she’s done to us, but that hasn’t deterred her. Some of us are planning to leave the country soon (not because of her, it’s for other reasons) and one of the things we’re looking forward to is her no longer being able to get to us offline.
I’m aware that she is bipolar. Back when we were in school together, during the many meetings that involved her parents, that was something they always brought up. But (and I’m obviously not in a position to diagnose her) I have doubts that bipolar is the only thing that this person has.
Her parents also excused all of her abusive behaviors during those meetings at school, and continue to do so to this day, which I feel plays a far more significant role in her actions than the disorder itself does. They also said they were not medicating her with anything during those meetings, and were just using talk-therapy as the only form of treatment. I don’t know if she’s taking medication now or not.
So, it’s bipolar, mixed with some other disorder, mixed with absolutely terrible parenting where she never faced any consequences until she was already neck-deep in this cycle. I blame her parents for how she turned out long before I’d blame the disorder.
But, since you want all possible realities, I still wanted to mention her. I think she’s what can happen if something serious is left unaddressed, untreated, and the focus is on excuses instead of healing. To be honest, I feel bad for her in spite of all she’s done, because she needed help at an early age, didn’t get it, and so she’s continually gotten worse. No way is she a happy person like this, and she could have been with a proper intervention.
I also know that how she behaves isn’t how most people with bipolar behave. I’ve met several other people who’ve told me they have bipolar, and they’re very different. Both from her and from each other.
My closest friend with bipolar, from what I’ve experienced with them, mainly struggles from the depressive episodes, will zigzag between feeling worthless and feeling happy. This friend was hospitalized once for a suicide attempt before I met them.
This friend is taking medication and going to therapy, which both seem to help a lot. They said it took time to find the right medication and dosage though, and that certain things made them feel worse and behave in ways they didn’t want to. So, it’s something that needs to be handled carefully and monitored.
My friend only made the one suicide attempt, and has never tried to harm another person. They also have friends and family that would get them help if they expressed suicidal ideation again or displayed any other dangerous behaviors during an episode.
I think one of the biggest factors is just having a proper support system.
-
My son has been diagnosed with bipolar disorder. He's in his mid-twenties, so it's the average time for onset of bipolar disorder. No family history that we know of, but if it was just two generations back, it probably wouldn't have been talked about.
He had his first manic episode early in the year. He spent a brief time in in-patient treatment, followed by a period of out-patient treatment. During the out-patient treatment, his psychiatrist started to think the diagnosis was incorrect and she weaned him off his meds.
He has had another manic episode, and he's back in the in-patient facility. Luckily he was able to get back into the same place he was in before, so they aren't starting from zero. They started him back on different meds, and he's much better much faster than the first time.
His fiancee was talking to a friend and someone overheard. The person who overheard said her mother was bipolar and she had to take her to the hospital six times, and she told his fiancee that she should break up with him.
The only experts I've spoken to have been the doctors in the crisis center, and I don't know to what degree they are trying to sugar coat things to prevent us from giving up hope.
I'd rather know the reality.
If anyone has any personal experience they can share, I'd appreciate it. If anyone has any professional experience they can share, I'd appreciate that as well.
EDIT: Just wanted to add to this that we were able to visit him today, and he's doing very well.
I've got type II bipolar.
The depression side sucks, so I'm lucky the hypomania just manifests as boundless energy, racing thoughts, and an inability to sleep.
Going for a walk in the middle of the night actually feels quite nice.
The depression is much more manageable these days, CBT, some time with a therapist, and self exploration with psychedelics helped a lot I think. I still get the big downer episodes, in one at the moment and I hope it'll clear up in a few days.
What sucks is when a wave of paranoia or anxiety hits. As both those make coping much more exhausting.
But I'm alive, in my late 30s now, holding down a job, have a family, and often have people tell me that they think I'm a great parent.
So it's not the end for your son. Everyone's journey and path is different, and there'll be hard moments - but people are strong and we can find ways to push through and adapt.
-
My son has been diagnosed with bipolar disorder. He's in his mid-twenties, so it's the average time for onset of bipolar disorder. No family history that we know of, but if it was just two generations back, it probably wouldn't have been talked about.
He had his first manic episode early in the year. He spent a brief time in in-patient treatment, followed by a period of out-patient treatment. During the out-patient treatment, his psychiatrist started to think the diagnosis was incorrect and she weaned him off his meds.
He has had another manic episode, and he's back in the in-patient facility. Luckily he was able to get back into the same place he was in before, so they aren't starting from zero. They started him back on different meds, and he's much better much faster than the first time.
His fiancee was talking to a friend and someone overheard. The person who overheard said her mother was bipolar and she had to take her to the hospital six times, and she told his fiancee that she should break up with him.
The only experts I've spoken to have been the doctors in the crisis center, and I don't know to what degree they are trying to sugar coat things to prevent us from giving up hope.
I'd rather know the reality.
If anyone has any personal experience they can share, I'd appreciate it. If anyone has any professional experience they can share, I'd appreciate that as well.
EDIT: Just wanted to add to this that we were able to visit him today, and he's doing very well.
Type two here, with depression starting when I was 13. Was diagnosed at 21. Mostly struggled with depression and hypomania, and the rapid change between the two. Being diagnosed was maybe the best thing that happened to me. Everything fell into place. It took about 7 years to get the treatment just right, but the medication was mostly working after a year or two.
I've been to a lot of meetings, and I know a lot of bipolar people. The thing with bipolar is that when you get the medication right and you do the work, the disease is really manageable. But one of the most frustrating part of the disease is that many suffering from it are not taking their meds or not doing the work. And you can't force them to either. You can lead a horse to the water, etc. I have been really focused on getting better, but I see the appeal to just don't do it. One tends to see the disease through rose-tinted glasses. And it is work to just be "normal". So just saying fuck it and ride the nice initial waves of hypomania/mania can be really tempting. But there is nothing good coming out of that.
I highly recommend reading An Unquiet Mind by Kay Redfield Jamison (and her other books for that matter), she is an expert in bipolar. Both as a psychologist and as a bipolar person herself. Wishful Drinking by Carrie Fisher was also good. I think it is good to try to understand why bipolar people think and do as they do. I do recommend support groups too. Where I'm at there are group meetings 1-2 times a week. Relatives are welcome too. Sometimes there are meetups for relatives only too.
I wish you all the best, and just know that it is possible to live a full and great life as bipolar. There are medication and life-style changes that does wonders, the hard part is sticking with it.
-
My son has been diagnosed with bipolar disorder. He's in his mid-twenties, so it's the average time for onset of bipolar disorder. No family history that we know of, but if it was just two generations back, it probably wouldn't have been talked about.
He had his first manic episode early in the year. He spent a brief time in in-patient treatment, followed by a period of out-patient treatment. During the out-patient treatment, his psychiatrist started to think the diagnosis was incorrect and she weaned him off his meds.
He has had another manic episode, and he's back in the in-patient facility. Luckily he was able to get back into the same place he was in before, so they aren't starting from zero. They started him back on different meds, and he's much better much faster than the first time.
His fiancee was talking to a friend and someone overheard. The person who overheard said her mother was bipolar and she had to take her to the hospital six times, and she told his fiancee that she should break up with him.
The only experts I've spoken to have been the doctors in the crisis center, and I don't know to what degree they are trying to sugar coat things to prevent us from giving up hope.
I'd rather know the reality.
If anyone has any personal experience they can share, I'd appreciate it. If anyone has any professional experience they can share, I'd appreciate that as well.
EDIT: Just wanted to add to this that we were able to visit him today, and he's doing very well.
I was diagnosed with Bipolar type 1.
I also worked in mental health.
The early stages can be tough because the person diagnosed has not yet learned how to recognize and cope with the issues bipolar brings.
It's not hopeless. I finished university, started a stable career, bought a home, maintained some stable social relationships for decades, have a long term romantic partner. There were challenges along the way, but you generally get better at managing them as you go through more of them.
In addition to whatever recommendations the doctor makes , there are some things that every bipolar person can do to make things easier. If my illness is flaring up, I have a simple checklist.
If you notice a manic/depressive flare up, have you ...
Slept well?
Eaten a remotely healthy meal?
Done anything physical?
Done anything social?
Done anything productive?Yes, these things will help pretty much anyone if you do them regularly, but they're especially important for bipolar. They're also listed in order of importance.
-
My son has been diagnosed with bipolar disorder. He's in his mid-twenties, so it's the average time for onset of bipolar disorder. No family history that we know of, but if it was just two generations back, it probably wouldn't have been talked about.
He had his first manic episode early in the year. He spent a brief time in in-patient treatment, followed by a period of out-patient treatment. During the out-patient treatment, his psychiatrist started to think the diagnosis was incorrect and she weaned him off his meds.
He has had another manic episode, and he's back in the in-patient facility. Luckily he was able to get back into the same place he was in before, so they aren't starting from zero. They started him back on different meds, and he's much better much faster than the first time.
His fiancee was talking to a friend and someone overheard. The person who overheard said her mother was bipolar and she had to take her to the hospital six times, and she told his fiancee that she should break up with him.
The only experts I've spoken to have been the doctors in the crisis center, and I don't know to what degree they are trying to sugar coat things to prevent us from giving up hope.
I'd rather know the reality.
If anyone has any personal experience they can share, I'd appreciate it. If anyone has any professional experience they can share, I'd appreciate that as well.
EDIT: Just wanted to add to this that we were able to visit him today, and he's doing very well.
Now that my brother has found the right medication, his life is actually going really well.
-
I was diagnosed with Bipolar type 1.
I also worked in mental health.
The early stages can be tough because the person diagnosed has not yet learned how to recognize and cope with the issues bipolar brings.
It's not hopeless. I finished university, started a stable career, bought a home, maintained some stable social relationships for decades, have a long term romantic partner. There were challenges along the way, but you generally get better at managing them as you go through more of them.
In addition to whatever recommendations the doctor makes , there are some things that every bipolar person can do to make things easier. If my illness is flaring up, I have a simple checklist.
If you notice a manic/depressive flare up, have you ...
Slept well?
Eaten a remotely healthy meal?
Done anything physical?
Done anything social?
Done anything productive?Yes, these things will help pretty much anyone if you do them regularly, but they're especially important for bipolar. They're also listed in order of importance.
Thanks for your reply.
There were definitely signs leading up to this. As I've mentioned, we were a bit too hopeful that the diagnosis was wrong, so we deluded ourselves into thinking it wasn't happening. Which is strangely comforting because now that we have no basis for believing the diagnosis was wrong, we WILL pay closer attention.
The biggest sign was he wasn't sleeping. That would be bad for anyone, but he never has trouble sleeping.
-
It depends on the person.
The first bipolar person I (knowingly) met was someone who transferred into my school when I was 12. This girl began to mercilessly bully me. It started with the “usual” things, like insults and shoving in the halls. But it ramped up. She destroyed my class projects. She beat the shit out of me to the point I lost a tooth. I had to get changed for gym in the gym teacher’s office, and she snuck a phone beneath the door to photograph me undressed.
Eventually, I couldn’t attend school anymore, and had to spend the final few years being homeschooled instead.
But, leaving school didn’t make her stop. It’s been sixteen years since I first met her, and it’s still continuing. She still harasses and stalks me, my partner and my family, both on and offline. This ranges from insults and threats sent via online platforms, to physical assaults or vandalized property/vehicles IRL, to one instance of SWATing.
She has spent time in jail for some of the things she’s done to us, but that hasn’t deterred her. Some of us are planning to leave the country soon (not because of her, it’s for other reasons) and one of the things we’re looking forward to is her no longer being able to get to us offline.
I’m aware that she is bipolar. Back when we were in school together, during the many meetings that involved her parents, that was something they always brought up. But (and I’m obviously not in a position to diagnose her) I have doubts that bipolar is the only thing that this person has.
Her parents also excused all of her abusive behaviors during those meetings at school, and continue to do so to this day, which I feel plays a far more significant role in her actions than the disorder itself does. They also said they were not medicating her with anything during those meetings, and were just using talk-therapy as the only form of treatment. I don’t know if she’s taking medication now or not.
So, it’s bipolar, mixed with some other disorder, mixed with absolutely terrible parenting where she never faced any consequences until she was already neck-deep in this cycle. I blame her parents for how she turned out long before I’d blame the disorder.
But, since you want all possible realities, I still wanted to mention her. I think she’s what can happen if something serious is left unaddressed, untreated, and the focus is on excuses instead of healing. To be honest, I feel bad for her in spite of all she’s done, because she needed help at an early age, didn’t get it, and so she’s continually gotten worse. No way is she a happy person like this, and she could have been with a proper intervention.
I also know that how she behaves isn’t how most people with bipolar behave. I’ve met several other people who’ve told me they have bipolar, and they’re very different. Both from her and from each other.
My closest friend with bipolar, from what I’ve experienced with them, mainly struggles from the depressive episodes, will zigzag between feeling worthless and feeling happy. This friend was hospitalized once for a suicide attempt before I met them.
This friend is taking medication and going to therapy, which both seem to help a lot. They said it took time to find the right medication and dosage though, and that certain things made them feel worse and behave in ways they didn’t want to. So, it’s something that needs to be handled carefully and monitored.
My friend only made the one suicide attempt, and has never tried to harm another person. They also have friends and family that would get them help if they expressed suicidal ideation again or displayed any other dangerous behaviors during an episode.
I think one of the biggest factors is just having a proper support system.
Thank you for your response!
That sounds absolutely terrible for you as well as her.
The one thing everyone agrees on with my son is that he would never hurt anyone else. We're all only concerned that he could hurt himself.
-
I've had a classmate who was bipolar. Super lovely girl, she would sometimes feel more sensible if the medication changed but I've never thought of her as needing to be treated with any special considerations when interacting socially. She got married and had kids and is still going well.
A close friend of my mother was married to a bipolar woman. She tried to kill him with a kitchen knife on one occasion, and in another, she effectively set the house on fire- they lost everything.
So, I don't really know what to say to you. My understanding is that your mileage may vary and by a lot. Personally I believe it's manageable in most cases with proper healthcare, and you probably already deal with several bipolar people day to day - you just don't notice it. But, I'm not an expert so take this with a pinch of salt.
Thank you for sharing your experience. I appreciate the information.
-
Mental health counselor here.
The outcomes of treatment for bipolar disorder are unfortunately very variable. It depends on how severe your son’s symptoms are, how well he responds to the medications cocktail he’s being given, what that medication cocktail is, and how well he adheres to it.
The important thing is that your son controls what he can control, which is largely whether or not he takes his meds and how much he engages in therapy. Therapeutic skills involve insight/mindfulness work (i.e. how well your son can recognize his symptoms as they’re happening) and resource use (i.e. does he inform his therapist and/or psychiatrist when he notices he’s be king symptomatic). Mania often feels amazing to people experiencing it, so they’re often motivated against treating it when it occurs, and this is major barrier to treatment.
A big component is whether or not symptoms of psychosis are involved in either the mania or depression. Psychotic symptoms are: 1.) hallucinations (false sensory perceptions, like hearing voices, seeing things, smelling things, etc), 2.) delusions (false beliefs that don’t conform to “normal” societal beliefs, like “I am Jesus” or “God has a mission for me”), and 3.) paranoia (i.e. feeling people around you are hostile to you or are spying on you, etc). These can be experienced in either mood state, but are most often seen in manic states.
I would suggest getting in touch with an organization called NAMI (National Alliance for the Mentally Ill) as they have tons of resources for people struggling with mental illness and family members of mentally ill people.
There were hallucinations in the first episode, and definitely some grandiose ideas in both the first and second episodes.
I have some concerns, because some aspects of his care after the first episode were neglected because he was felt he was experiencing too much anxiety to deal with it. That left him without any therapy, and because the psychiatrist had weaned him off the meds, he was unmedicated.
I don't believe he would have stopped the meds without the psychiatrist saying he should. However, we do need to make sure he has ongoing care, therapy, and group meetings.
-
Thanks for your reply.
There were definitely signs leading up to this. As I've mentioned, we were a bit too hopeful that the diagnosis was wrong, so we deluded ourselves into thinking it wasn't happening. Which is strangely comforting because now that we have no basis for believing the diagnosis was wrong, we WILL pay closer attention.
The biggest sign was he wasn't sleeping. That would be bad for anyone, but he never has trouble sleeping.
Especially for type 1 bipolar, lack of sleep can trigger mania. It's also very hard to sleep while manic, which can make the problem worse.
Sleep hygiene and sleep tracking were very helpful for me personally. Tracking helps predict manic phases, and tracking helps see how effective different things are for getting good sleep. Sleep hygiene is a good place to start in terms of trying to find what works well for sleeping better.
