Everyone's safety during an individual's acute manic episode

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Posted on: 28th May 2025

When a loved one is experiencing an acute manic episode, it can feel overwhelming, frightening, and confusing. Safety is the top priority — for your spouse and for you. Here’s what you can do, step by step:

IMMEDIATE ACTION: PRIORITIZE SAFETY

1. Assess for Danger

Ask yourself:

Are they agitated, reckless, or violent?

Are they talking about supernatural beliefs, paranoia, or grand plans that are unrealistic?

Are they not sleeping at all, not eating, or hallucinating?

Are they endangering themselves or others — e.g., driving unsafely, threatening behavior, trying to run away, etc.?

If yes to any of these, it may be a psychiatric emergency.

2. Call for Help (Don’t Go It Alone)

You may need to call a crisis team, mental health helpline, or even 911 (or your local emergency number) — but tell them it's a psychiatric crisis, not a crime.

When calling emergency services, say:

“My spouse has bipolar disorder and is in an acute manic episode. They are not violent, but they are out of control and may be a danger to themselves or others. We need medical psychiatric help, not law enforcement.”

If you're worried about how first responders will treat them:

Ask for a CIT-trained officer (Crisis Intervention Team)

Explain calmly that this is a mental health emergency

3. Avoid Arguing or Challenging Delusions

During mania, your spouse may not be grounded in reality. Trying to reason with or correct them often makes things worse.

Instead:

Stay calm and clear. Speak in short, simple sentences.

Don’t argue or say they’re being irrational, even if they are.

Don’t shame or blame. Mania is not a choice.

Set limits gently but firmly: “I can’t let you do that. Let’s sit and talk.”

4. Create a Calming Environment

If they're not yet out of control:

Reduce stimulation: dim lights, turn off the TV or music, avoid crowds

Keep them hydrated and fed — mania often leads to skipping meals

Try to keep them at home, in a safe space

5. Document Everything

Write down:

What they’re saying and doing

Any meds they are taking or skipping

How long the episode has lasted

Any signs of psychosis, risk, or erratic behavior

This helps doctors or crisis teams make fast, informed decisions.

6. Reach Their Doctor

Call their psychiatrist, case worker, or clinic if they have one

Ask if there's a crisis protocol or med adjustment you can follow

If they’ve been in the hospital before, ask if there’s a wellness or crisis plan on file

7. Secure the Environment

Remove access to weapons, car keys, credit cards, and dangerous meds

If you’re worried they’ll run away, lock doors or monitor exits (discreetly if possible)

8. Take Care of Yourself

You are not alone. Contact:

Lean on a friend or relative you trust

You can’t be their whole safety net — you need rest and help too

- NAMI Family Support (nami.org)
- Mental Health America
- Local family support groups

In Case of Hospitalization

Involuntary hospitalization (if they won’t go voluntarily) is difficult but sometimes necessary. Most states allow this if someone:

Poses a danger to themselves or others

Is unable to care for themselves due to mental illness

It’s painful, but many people stabilize more quickly with inpatient care, med adjustments, and professional support.

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