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People with bipolar experience extreme mood changes from highs (mania or hypomania) to lows (depression).

Mania involves unusually happy or irritable mood, racing thoughts, and intense energy, causing difficulty in a person's life. It can be really distressing for the person experiencing it as well as the people supporting them.

If you are supporting someone who is having symptoms of mania or hypomania here are some ways to assist them (and yourself).

1. Recognise the symptoms of mania

Manic symptoms will be different from person to person, but things to look out for are:

• Increased confidence and inflated sense of importance
• Irritability
• Sleeping much less
• Talking very fast
• Making lots of plans and having lots of ideas
• Behaviour that is more reckless or less inhibited.

Hypomania has similar symptoms to mania, only they are less severe and disruptive to a person’s life.

Sometimes mania can involve symptoms of psychosis. This means a person is less in touch with reality. It might involve delusions, which are strong beliefs in something that isn’t true. Or, hallucinations, where people perceive something through their senses that isn’t there.

2. Let them know you're concerned

Someone may have an awareness of their symptoms or they may not. The experience of mania can be enjoyable and people may feel what is happening is positive.

So, how can you help?

Let the person you care about know your concerns. Give them an example of what you’ve noticed and how that makes you feel.

For example, ‘I’ve noticed you’re not sleeping much, I know you feel ok, but I’m worried about you.’

However, don’t get into arguments or debates. Express concern and encourage getting support, but if the conversation becomes unhelpful, it is ok to step away.

3. Encourage getting help early

If you notice someone having symptoms of mania, encourage them to get treatment as soon as possible. You can encourage them to contact any mental health professionals they are supported by. Offer to help them attend appointments or make phone calls if you feel comfortable.

If they are not linked to professional support and are willing to get help, talking to a GP is a good place to start.

4. Encourage rest and routine

Lack of sleep is a symptom of mania and can make symptoms worse. Encourage the person you support to rest and sleep where possible. They may also have medications that can help them to sleep.

Try encouraging regular routines around eating, taking any prescribed medication, resting, and sleeping. Helping them avoid substances like alcohol and illicit drugs is really important, as they can make symptoms much worse.

5. Think about safety

You might become very concerned about someone’s safety when they are manic. You might notice behaviour that could seriously impact their health, finances, or relationships.

You can try to work with them to reduce their exposure to risky situations. For example, by encouraging them to stay at home if they are vulnerable because of feeling hyper-sexual or invincible. 

These concerns can be complex and distressing, so don't carry them alone.

Talk to other people you trust or who support the person you care about. You can also call helplines like the SANE Helpline to discuss the situation.

If symptoms are not manageable at home and you are concerned about safety, you can contact crisis services. This could be calling the local hospital, psychiatric triage, or 000 if it is an emergency.

Remember to think about your own safety and wellbeing. It is important you remove yourself from situations that make you feel unsafe before helping the other person.

6. Work together

The best way to know how to support someone is to ask them. Asking ‘how can I help?’ shows that you respect their needs and preferences, even if you are not able to provide everything they ask for.

If someone’s symptoms are very severe, you may need to have this conversation when symptoms are more stable. Their preferences for support and treatment can become part of an agreed plan that is written down and shared with trusted health professionals.

A Wellness Recovery Action Plan has good questions for making this plan together.

People in Victoria can also complete an Advance Statement which has their preferences for treatment. If they become unwell enough to need compulsory treatment, this document needs to be considered by a treating practitioner.

7. Look after yourself

Supporting someone through mental health symptoms can be stressful, so remember to look after your own health. Make sure you have your own sleeping, eating and exercising routines, and do things that make you feel happy and connected.

Boundaries are important in any relationship, including when someone is going through mental health symptoms. If something is too much, it is important you do what you need to take care of yourself.

This could mean avoiding long conversations that are tiring for you, or not becoming too involved with a person’s projects or goals. It is okay to step away from discussions that become upsetting with kindness.

For example, ‘I know this is really on your mind, but I’m too stressed to think about it now. Let’s come back to it later.’

Mania can be a really challenging experience. Changes in thinking, mood, and behaviour can be hard for anyone to navigate. Remember to take care of yourself, reach out for help, and do what's manageable to help someone get through these symptoms safely.

At any point it’s okay to get extra help. The following services are available to provide information and support:

• Bipolar Caregivers
• SANE Helpline - 1800 187 263 (Monday to Friday 10am-10pm EST)
• Lifeline (24/7) - 13 11 14
• 000 in an emergency

And finally, be part of the discussion in our safe, anonymous forum community! Ask questions or help others by sharing how you’ve supported a loved one through mania on our Friends, Family & Carer’s Forum.