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Identify and challenge positive beliefs about mania/hypomania that reduce motivation for relapse prevention — e.g. "I'm more creative when high."
Many people with bipolar disorder hold positive beliefs about their elevated states: "I'm more productive," "I'm the real me when high," "The creativity is worth the crash." These beliefs reduce adherence to medication and early intervention. This worksheet helps you examine them honestly.
Use when the client has identified beliefs that positively appraise (hypo)manic states, which may reduce motivation for treatment adherence and early intervention. Common pro-mania beliefs include 'I'm more creative when high' and 'I need mania to be productive.'
Acknowledge that (hypo)manic states can genuinely feel positive and productive. Frame the worksheet as a balanced examination of both the benefits the client perceives and the costs they may have experienced. Avoid dismissing the positive aspects — work with ambivalence collaboratively.
For clients with strong pro-mania beliefs, motivational interviewing techniques may be more effective than direct cognitive challenging. For those who have experienced primarily hypomanic rather than manic episodes, the perceived cost-benefit ratio may genuinely be different.
Do not use during a hypomanic or manic episode when the client is likely to endorse pro-mania beliefs more strongly and lack insight. This work requires the reflective capacity available during euthymic states. Avoid being perceived as trying to 'take away' positive experiences.
The most effective approach is often to help the client see that medication and early intervention protect the desirable aspects of hypomania by preventing escalation into mania with its destructive consequences. Examine specific past episodes: what started as productive often ended in damaged relationships, financial problems, or hospitalisation.
Suitable for clients working with bipolar, pro-mania beliefs, cbt, hypomania, medication adherence, relapse prevention. This tool can be used as a standalone worksheet or as part of a structured homework plan.
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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.
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.