It’s that time of the year again – spring. Our interest in life literally springs up, our moods and love life improve and many patients with bipolar disorder begin to experience their first signs of hypomania.

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Call it a seasonal effect, blame it on light or the forthcoming changes in our social routines, spring appears to be a period that every bipolar and their family should keep an eye on.

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So what better time than now to write about our bipolar fleas – the early warning signs of manic and depressive relapses?

I recently had an incident with my lovely dogess Iano – a beautiful and proud royal boxer. We went to my sister’s country house and Iano as usual enjoyed her time there. This time, however, before our departure I noticed some insects running over her body. A sickly dog had been around our house and somehow he managed to pass quite a handful of fleas to her. She usually keeps herself so clean that it had never occurred to me that fleas could take over her perfect body.

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I tried to remove her fleas one by one but the more I was staying there the more fleas kept on coming to her. So I put her in my car and drove her quickly down my flat – far away from any infected areas. On our way there we bought some anti-flea shampoo from a pharmacy and made plans about how to disinfect her.

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Iano was beginning to get irritated by the fleas but she was still happy enough on her way back. I eventually managed to remove all her fleas (one by one), and to isolate her for a good few hours in a disinfected bathroom. The next day she was taken to our vet for a routine check-up, and I kept an eye on her for possible infections for the next week or so.

She is better than ever now, and I think she even liked all the attention that she got that day.

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During the entire incident, I couldn’t help thinking how similar fleas are to the bipolar symptoms that come just before manic and depressive relapses. For whatever reason, they just start cropping up on you, and if you don’t pay attention or your significant other does not pick them up, then what will usually happen is that they will start growing up on you. They will also start multiplying.

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They like having company. It’s very unlikely that you will have only one symptom. The more you delay doing something about them, the worse they will get. You will eventually relapse and the consequences along with your available treatment options are likely to be far more painful than if you had been proactive about the whole situation.

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Getting into the rush of doing something quickly may not be the easiest or the most pleasant thing to do. It may not even be the right time for you or your family. But if you wish to prevent your forthcoming relapse – it’s always the right time. Self-management definitely works – early on.

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There are things that you can do just by yourself to take notice of your early warning signs and to calm them down, but getting help from your family and your treatment providers are important steps to consider, and when necessary, to take. Yes, you may not want to worry your family or your therapists with every mood change or every bad or very good day that you have, but keeping them in mind and getting to them quickly is important.

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I couldn’t help thinking about the pain my dear Iano would have suffered if those bloody fleas had started to grow on her. And I am so happy to see that she got through the whole ordeal almost unscratched, that I wish for every bipolar patient to keep well and to keep well by acting quickly and by having the right people and resources in place to help manage their early warning signs before they relapse.

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I won’t get into the science of the bipolar early warning signs in this article. As a matter of fact, we know quite a lot about your bipolar fleas but I would like to run a little survey with you to see what changes you notice in your behavior, thinking, or mood prior to any manic or depressive relapses (use this form here).

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Try to describe them in your own words – there is no need to use any psychiatric lingo. Then we can see whether we are in agreement with the literature, and I will write a bit more on what we know about the early warnings signs of bipolar disorder. I am also looking forward to your comments in our comments section.

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Until our next blog post enjoy your spring life and keep an eye out for any bipolar fleas.

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Bipolarly yours,

Dr. Yanni Malliaris

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