What to Know About Coming Out of a Manic Episode

A manic episode occurs when a person who has bipolar disorder feels extremely active and energetic, often beyond their control, says Aimee Daramus, PsyD, a licensed clinical psychologist and author of “Understanding Bipolar Disorder.”

These are some of the characteristics of a manic episode:1

• Feeling either euphorically happy or irritable and disagreeable
• Having a high level of energy and being very active, to the point of feeling wired and doing multiple things at a time
• Having racing thoughts and ideas that are difficult to pin down
• Not needing much sleep and feeling energetic, despite not having slept much in days
• Talking a lot more than usual and very fast, making it difficult for others to keep up
• Behaving impulsively and recklessly. According to Dr. Daramus, this could involve partying too hard, spending too much money, driving too fast, making risky investments, behaving aggressively, or taking on ambitious or unrealistic new projects
• Having an increased appetite for food, alcohol, and other pleasures
• Having beliefs of grandiosity and feeling exceptionally confident, talented, powerful, important, and invincible
• Developing obsessions and pursuing them relentlessly, no matter how unviable they are
• Experiencing symptoms of psychosis such as hallucinations and delusions, and being unable to distinguish between what’s real and what isn’t
• Displaying restless behaviors, such as fidgeting and pacing
• Becoming a danger to yourself or the people around you

According to a 2021 study, manic episodes last approximately 3.5 months on average.2 For people who are not receiving treatment, a manic episode can last between three and six months. With effective treatment, the episode may end in under three months.

“Sometimes, if it’s caught early, a change in medication can stop a manic episode. If that doesn’t work, you just have to ride it out,” says Dr. Daramus.

Signs a Manic Episode Is Ending

These are some signs that a manic episode is ending, according to Dr. Daramus:

• Slowing down and feeling less urgent and pressured all the time
• Feeling more tired and getting more sleep
• Being able to think more clearly, even if your memories of the manic episode are fuzzy
• Making fewer impulsive decisions
• Feeling overwhelmed by all the projects you’ve taken on
• Feeling embarrassed about the way you behaved during the manic episode
• Feeling low and depressed

What Happens When a Manic Episode Ends

When a manic episode ends, you may be able to return to normal functioning, or you may experience a depressive episode, characterized by the following symptoms:

• Feeling low, sad, or anxious
• Feeling lethargic and slow
• Having difficulty making decisions
• Not being able to focus or remember things
• Sleeping too much or having an irregular sleep pattern
• Speaking slowly or feeling like there’s not much to say
• Losing interest in work, relationships, and activities
• Struggling with basic day-to-day activities
• Feeling hopeless and inadequate
• Having thoughts about death or suicide

Some people have irregular and unpredictable episodes of mania and depression, whereas others have a more regular pattern of mania followed by depression, or vice versa. People with bipolar disorder may cycle between these episodes slowly or rapidly, with or without a break period of normal functioning in between.

Coping With the End of a Manic Episode

These are some strategies that can be helpful as you’re coming out of a manic episode:

• See your healthcare provider: Dr. Daramus recommends seeing your healthcare provider immediately as they can prescribe medication or adjust the medication you’re taking. Your healthcare provider can also provide therapy and support as you deal with the aftermath of the manic episode or start experiencing a depressive episode.
• Take your medication consistently: Medication may be able to reduce the symptoms of mania, end the manic episode faster, help you regain normal functioning, prevent a depressive episode, and stabilize your mood.3 It’s important to take your medication regularly, exactly as prescribed by your healthcare provider. Inform your healthcare provider if you experience any side effects. Don’t stop taking the medication without discussing it with them, even if you’re feeling better.
• Opt for calming environments: Stimulating places and activities can trigger mania and prolong it. Avoid busy, loud, or brightly decorated places and opt for more relaxing and soothing places and activities instead.
• Build a healthy routine: It can sometimes be difficult to maintain a healthy routine when you’re in the midst of a manic episode—you might not sleep or get very little sleep for days at a time, according to Dr. Daramus. As the episode comes to an end, it can be helpful to start rebuilding your routine by maintaining consistent bedtimes and mealtimes and exercising regularly.
• Seek social support: Connect with friends and family members and let them know how you’re feeling and how they can help. You may have to repair some relationships that were damaged during the manic episode.
• Note down your symptoms: Maintain a journal in which you note down your mood and symptoms every day. This can help your healthcare provider better understand your condition and track any patterns in your episodes.
• Avoid substances: Avoid using substances such as alcohol, cannabis, or drugs, as they can interfere with medication and worsen the symptoms of bipolar disorder.

As a manic episode ends, you’ll start to feel less frenzied, be able to think more clearly, and get more sleep. You may have to face unpleasant consequences of your actions during the episode.

Therapy, medication, and social support are important factors that can help you cope with the end of a manic episode. They can help you resume normal functioning and potentially prevent further manic or depressive episodes.