Bipolar disorder can escalate to crises, including severe manic episodes, depressive breakdowns, or suicidal ideation. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 1 in 3 people with bipolar disorder will attempt suicide in their lifetime. This guide empowers individuals and caregivers to act swiftly and safely during emergencies.
Recognizing Crisis Warning Signs
Mania/Hypomania Escalation
- Reckless behavior (e.g., maxing credit cards, unsafe sex).
- Paranoia, hallucinations, or aggressive outbursts.
- Refusal to sleep or eat for days.
Depressive Crisis
- Expressing suicidal thoughts or giving away possessions.
- Isolating completely, neglecting hygiene.
- Sudden calm after prolonged depression (may indicate a suicide plan).
Mixed Episodes
- Agitation, rapid speech, and hopelessness simultaneously.
- High energy paired with suicidal thoughts.
Immediate Steps During a Crisis
- Ensure Safety
- Remove access to weapons, medications, or other dangers.
- Stay calm and avoid confrontations during manic episodes.
- Contact Professionals
- 988 Suicide & Crisis Lifeline: Call/text 988 for 24/7 support.
- Crisis Text Line: Text “HOME” to 741741 (U.S./Canada).
- Emergency Services: Call 911 if harm is imminent (mention “mental health crisis”).
- Use a Crisis Plan
- Follow prearranged steps (e.g., contacting a psychiatrist, driving to the ER).
- Share the plan with trusted contacts (template here).
Post-Crisis: Recovery & Prevention
- Debrief with Care Team
- Adjust medications or therapy approaches to prevent recurrence.
- Hospitalization Options
- Inpatient Care: Short-term stabilization during severe episodes.
- Partial Hospitalization (PHP): Day programs for intensive therapy.
- Build a Relapse Prevention Plan
- Identify triggers (e.g., stress, sleep disruption).
- Schedule regular check-ins with a therapist.
Crisis Resources by Country
- U.S.: 988 Lifeline, SAMHSA Treatment Locator
- UK: Shout (text 85258), Mind Helpline
- Canada: Crisis Services Canada (1-833-456-4566)
- Australia: Lifeline (13 11 14)
FAQs About Bipolar Crises
Q: What should I do if someone refuses help during a manic episode?
A: Call a crisis line or mobile crisis team—they specialize in de-escalation.
Q: Can hospitalization make things worse?
A: Rarely—it’s designed for short-term safety. Always prioritize immediate risk.
Q: How do I create a crisis plan?
A: Collaborate with your therapist. Include emergency contacts, medications, and preferences (e.g., preferred hospitals).
Disclaimer
This content is for informational purposes only and is not a substitute for professional crisis intervention. Always seek emergency help during life-threatening situations.