From Kimberly Read & Marcia Purse,
Your Guide to Bipolar Disorder.
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About.com Health's Disease and Condition content is reviewed by Steven Gans, MD

by Kimberly Read

There are a number of warning signs of manic episodes, red flags as many call them, of which we should be aware. By learning these early indicators, red flags will go up before a loved one rockets into a manic spree, before you slide into depression, before a friend actually attempts suicide.

In this article, the first in a four-part series, we look at some of the common red flags for mania and hypomania. Part II looks at depression flags; Part III, the warning flags for Suicide; and Part IV, the early signs of childhood-onset bipolar disorder (COBPD).

These symptoms are organized into broad categories for easier reference; this list of symptoms is gathered from personal experience as well as the resources listed elsewhere on this page.

Increased energy

• Decreased sleep
  
• Little fatigue
  
• An increase in activities
  
• Restlessness

Speech Disruptions

• Rapid, pressured speech
  
• Incoherent speech (generally not present in hypomania)
  
• Clang associations: the association of words based on their sound
  (For example, my ex-husband once carried on for some time about vacancies, vagrancies and bacon seeds.)

Impaired Judgment

• Lack of insight
  
• Inappropriate humor
  
• Inappropriate behaviors
  
• Impulsive behaviors
  
• Financial extravagance
  
• Grandiose thinking

Increased or Decreased Sexuality

• May include inappropriate or sexual behavior

Changes in Thought Patterns

• Distractibility
  
• Creative thinking
  
• Flight of ideas
  
• Disorientation
  
• Disjointed thinking
  
• Racing thoughts

Changes in Mood

• Irritability
  
• Excitability
  
• Hostility
  
• Feelings of exhilaration

Changes in Perceptions

• Inflated self-esteem
  
• Hallucinations (not present in hypomania)
  
• Delusions (not present in hypomania)
  
• Paranoia (generally not severe in hypomania)
  
• Increased religious activities

Hypomania also differs from bipolar mania in that the symptoms are generally less severe so that they do not cause significant impairment of daily activities. There are no psychotic features present in hypomania.

More often than not, those who are close to us will notice our little red flags long before we will. If someone you love is waving flags, express concern. And if someone you love expresses concern, listen.

Related Terms:

• Pressured Speech
• Grandiosity
• Flight of Ideas
• Racing Thoughts