I keep a close eye on my sleep patterns.  If I am sleeping regularly nine or ten hours and all of a sudden my sleep falls to seven hours a night my alarm is set off and I view my other behavior.  I do enlist the help of my wife when I do this (and this can be hard to do).  And sometimes my wife initiates this review.

Am I losing my temper more frequently?  Have I become agitated (like I am crawling out of my skin)?  What kind of music am I listening to?  Is it music to rev myself up?  How am I feeling when I listen to this music?  Am I becoming more euphoric?  Has there been a surge in self-confidence?  Am I talking more?

There are other signs.  One particular one I can’t ignore:  Am I becoming more anxious in public–maybe even a little paranoid?  All this self examination is set off by a change of sleep patterns. That is one sign I can’t ignore.

All this was taught to me by my doctor decades ago.  I have some control.  I will not go out of control. One of my meds will need to be increased and then some of these symptoms will subside.  I will start sleeping better in a few days.

When I realize I am undergoing another episode I call my med nurse who consults my doctor and they discuss what to do and the nurse gets back to me.  I am lucky:  the community mental health center I go to is very well run and I can rely on them.

I have gone through these episodes dozens of times.  I know now what to expect. I do not change my life abruptly when I am in this cycle although I recognize I might sleep a little less. I might make some adjustment like not going out in public as much if it is too difficult until this cycle ends. (They usually last four or five months.)

I know when this period is ended:  My sleep patterns become more normal. I will start sleeping more every night regularly.  And at that point I can go back to my normal dosage of the med I increased. My episode is done.