I am more in tune with my mood at this point. When I first started the process 2 1/2 years ago I didn't know what was happening and when so I relied a lot on my T to help me figure out when enough was enough. Then in July of 2008 it clicked in me and I knew what my limits were. I went in to T the one day and just said, "it's time" and she knew that meant I needed inpatient care. Since that time I have realized when things were escalating and was able to see pdoc before I needed to be in the hospital. For me it was an experience thing. I learned over the course of a few years to recognize what symptoms in me (changes in sleep, inability to eat, irritability, skipping obligation, people telling me I'm acting different) mean that something is happening and I can see pdoc right away to get things figured out. I hope you can figure out things for you because it's way better to catch a cycle early than to have it blow up in your face. Take care!