Hypomania heading to mania or an episode with mixed features:

1. "Lay low", as I call it. When I'm becoming very hypomanic heading to manic it is a bad idea for me to be in public or get overly involved with certain types of stimulating projects. They often fuel the fire. Sometimes (especially in the past) I had/have little insight into a developing mania. Nowadays, I sometimes do. If I don't, then someone like hubby tells me. I'm getting better and better at spotting it early.

2. Then PRN Seroquel, if things worsen. Perhaps focusing on less stimulating projects (i.e. flower arranging or certain cooking/baking projects).

3. If all of the above fail and the episode seems to continue to worsen, I call my psychiatrist. He will then either advise me to take more of a base medication (usually Seroquel XR) or he will give me an emergency appointment.

Depression:

1. I try to make sure I don't just completely stop doing things. This is when I try to get active socially, to some degree, or start a doable "To Do" list. I also try to push myself to get out of the house at least a tiny bit and push myself to do something that is normally at least a little pleasurable (i.e. music, nature, or cooking).

2. If it worsens, I call my therapist. I try to work on challenging dysfunctional thinking.

3. If it worsens even more, I make sure my psychiatrist is aware of it. Sometimes he adjusts my medications. The adjustments can be up or down, depending on the type of depression (no energy vs. agitated).