A week of little to no sleep will cause me to become hypo-manic and then it will quickly turn into a full blown mania/psychosis episode. I saw my last one come on that I actually scheduled time from work via. disability leave and set up an appointment to check myself into the hospital. Unfortunately I went into a full blown episode two days before my check in date and didn't get to go to the hospital I wanted to...but work already knew I was out so no surprises there. Even though it didn't work out as planned, I'm glad I'm able to recognize my triggers.