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Identify personal early warning signs for both depression and mania/hypomania, and create a stepped action plan for each mood polarity.
Bipolar disorder involves episodes in both directions — depression and mania/hypomania. Recognising the early signs of each polarity is the most powerful relapse prevention tool. This worksheet helps you map your personal warning signs for both poles, create separate action plans for each, and identify who can help you notice what you might miss yourself. Complete it collaboratively with your therapist and share with trusted supporters.
Introduce during the relapse prevention phase when the client is in a stable mood state. The action plan should be developed collaboratively, rehearsed, and shared with identified supporters. Review and update regularly.
Explain that most people with bipolar disorder develop personalised early warning signs before a full episode. Frame the action plan as an insurance policy — having a clear plan makes it easier to act quickly when warning signs appear, which can prevent or shorten episodes.
Create separate plans for (hypo)manic and depressive warning signs, as the response strategies differ. For clients who have difficulty recognising their own warning signs, involve a trusted family member or friend in the monitoring process. Include both self-management strategies and when to contact professionals.
Do not develop the action plan during an acute episode, as judgment and insight are impaired. If the client has poor insight into their illness even when stable, focus on building illness awareness and engagement before developing a prevention plan.
The most reliable early warning signs of mania are typically sleep changes (reduced sleep need without fatigue), increased goal-directed activity, and changes in spending or social behaviour. For depression, withdrawal, reduced activity, and sleep changes are common. Make the action plan concrete and accessible — laminated cards, phone notes, or shared documents.
Suitable for clients working with bipolar, early warning signs, relapse prevention, mania, depression, cbt, action plan, hypomania. This tool can be used as a standalone worksheet or as part of a structured homework plan.
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Track daily routine stability — wake time, meals, activity, social contact, and bedtime — as routine disruption is a key trigger for mood episodes.
Track daily mood on a depression-euthymia-hypomania/mania scale alongside sleep, medication, and key events.
A longitudinal formulation for bipolar disorder — mapping life events, episode patterns, and maintaining factors across time.
Identify and challenge positive beliefs about mania/hypomania that reduce motivation for relapse prevention — e.g. "I'm more creative when high."