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Warning-sign checks

Bipolar disorder: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Call emergency services or go to an emergency department if there is an immediate risk of suicide, self-harm, or harm to someone else.

    Emergency help is also appropriate when severe confusion, violence, or loss of contact with reality makes the situation unsafe.

    Stay with the person if it is safe to do so, and reduce access to weapons or other lethal means while help is arranged.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Contact the treating clinician promptly if early warning signs appear.

    These may include sleeping less, becoming unusually energetic or irritable, spending more, talking rapidly, withdrawing from others, or developing persistent depressive symptoms.

    Early treatment may prevent symptoms from becoming more severe.

    Seek urgent professional help if there is rapidly worsening mania, psychosis, severe agitation, several nights with little or no sleep, dangerous impulsive behavior, or an inability to eat, drink, take medicine, or manage basic needs.

  3. 3

    Does any of this apply?

    Book an appointment

    Bipolar disorder usually requires long-term follow-up, including during periods of stable mood.

    Routine visits may review symptoms, sleep, functioning, side effects, substance use, physical health, and whether treatment still fits the person's goals.

    Recommended laboratory monitoring depends on the medicine being used.

Every sign above is quoted from the sofidex article on Bipolar disorder. If you are not sure, err upward — it is always reasonable to be checked.