Guidance on Dealing With Bipolar Disorder

Last week I blogged about bipolar disorder and how triggering behaviors can affect relationships with others. I suggest you read that blog if you have not already done so. One reason is I discuss the symptoms and actions of Carrie Mathison, the main character in the hit streaming show, Homeland, and how her bipolar affects her actions and relationships. I recommend you watch the 8 seasons of the show, especially the first three years.

Symptoms of Bipolar Disorder

Worldwide, over 2.5% of the population will have either bipolar I or bipolar II during their lifetimes; 2.6% in the U.S. My guess is it's a lot higher because many people may not recognize the causes of the disorder or its potential seriousness, so it doesn't get treated.

According to the Mayo Clinic, “bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings. These include emotional high episodes also known as mania or hypomania, and lows, also known as depression. Hypomania is less extreme than mania.”

The Mayo Clinic points out that “episodes of mood swings from depression to mania may occur rarely or multiple times a year.” Each occurrence typically lasts for days, although some people have extended periods of emotional instability. Others may frequently have mood swings from depression to mania, and even depression and mania at the same time.

As you might expect, the actions taken when one is in a manic state can be serious and significantly affect one’s own wellbeing. For example, one’s judgment may be impaired, and decisions made impulsively, at a time when the symptoms of bipolar are not contained.

Skills to Deal With Bipolar

According to Alexandra Gold, Ph.D., writing in Psychology Today, there are skills that can be helpful to resist the urge to act on impulse when you are experiencing hypomania. These are discussed below.

Some people notice that they engage in more impulsive behaviors when they are experiencing symptoms of hypomania. These impulsive behaviors are actions that might feel good or desirable at the moment but that, in the long term, may have more negative consequences.

Examples of these types of behaviors include spending sprees, excessive substance use, and risky sexual activities. Some people also find that when they are experiencing hypomania, they also feel more irritable, which can make it harder to resist the impulse to get involved in confrontations with others, such as at work, that could have undesired lasting consequences. This is remarkably well depicted in the Homeland show by the lead actor, Carrie Mathison.

Advice From Psychology Today

Psychology Today provides useful guidance in how to resist acting on impulse during periods of hypomania.

The 48-Hour Rule: The 48-Hour Rule suggests you wait a minimum of two full days and have two full nights of sleep before making any major decision when you are in a hypomania state. Decisions could relate to anything at all, including significant purchases (new car) or major life changes (quitting your job). The 48-Hour Rule creates space (i.e., two days) between the urge to act and the action itself, ensuring that you are only making and acting on decisions after getting enough sleep. Many people with bipolar disorder experience sleep problems and sleeping fewer hours than normal is a common symptom of hypomania. In other words, the lack of sleep drives hypomania.

The Two-Person Feedback Rule: The Two-Person Feedback Rule suggests you check with two trusted people (among friends, family members, or loved ones) before making any big decision when you are experiencing hypomania. The goal of the Two-Person Feedback Rule is to ensure that you are considering and weighing the long-term risks associated with a given decision before acting on it. Sometimes, during hypomania, people may believe that their decision-making and thinking is better than the decision-making of others. This is certainly the case as depicted by the star in Homeland, Carrie Mathison.

Step away from the situation—literally: If you are in a situation where there is a temptation to act on an impulsive behavior or if you think it is likely that the situation could lead to some type of confrontation, try to leave the situation if you can. If you have reason to think that a specific situation could trigger impulsive behavior, think about the value of avoiding the situation entirely.

Check in on your thoughts: Hypomania can cause people to have hyperpositive thinking. This way of thinking leads people to overlook or minimize the risks of their behaviors and to overestimate positive outcomes that could result from their behaviors. Hyperpositive thinking can drive impulsive behaviors. Check in with yourself to catch hyperpositive thinking during episodes of hypomania. If you have an urge to engage in impulsive behavior, take a step back before engaging in that behavior and take stock of your thoughts. Ask yourself: “What are some of the risks that I might be overlooking with this thought?”

Limit access to items that could make it easier to act on impulse: Try to recall past episodes of hypomania and consider whether there were any items or factors that made it easier to act on impulse (i.e., access to substances, access to credit cards). It can be helpful to restrict your access to such items during periods of hypomania. When you are experiencing hypomania, it can be helpful to ask a trusted person to hold onto your credit cards to limit the risk of any uncontrolled spending.

This advice from Psychology Today is helpful, which is why I have included it in my blog. However, based on my experience it may be too late to follow because the action has already been taken. In other words, the action is immediate it, crowding out the steps mentioned above. I also find that involving others, other than one's spouse, may not be the best way to go because of a desire to keep the disorder on the downlow. Nevertheless, the overall advice is solid. I have especially found the 48-hour rule to be helpful, although the urge to act often overwhelms the ability to walk away from the decision for two days. For sure, I wouldn’t get a good night sleep during such occasions.

I hope my coverage of the literature on bipolar is helpful to those reading this blog and the previous one where I relate the disorder to the main character in Homeland.

 Feel free to share your thoughts by emailing me at: [email protected].

Posted by Steven Mintz, aka Ethics Sage, on March 12, 2025. You can sign up for his newsletter and learn more about his activities at: https://www.stevenmintzethics.com/.