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Bipolar · An escalating high

Their mood is high and things are escalating

Focus on what has changed, keep the conversation manageable and bring in professional help when it is needed.

Ask for an urgent assessmentIf you think this could be mania, ask for an urgent mental health assessment. Contact their mental health team if they have one, or use the urgent help for their UK nation. You do not need to wait until things become unsafe. Stay calm and use any plan agreed when they were well while you seek help.

[1]

Look for changes from their usual pattern

Possible signs of a high mood include having lots of energy, needing less sleep, talking quickly, feeling overconfident, being impulsive or spending unusually large amounts of money. Someone may also become irritable or experience hallucinations or unusual beliefs.

One change on its own does not tell you what is happening. Compare it with the person's usual pattern and any warning signs they have identified themselves.[2]

What you can do now

  1. Use short, calm sentences. Deal with one practical point at a time.
  2. Name what you have noticed. Describe sleep, spending, risk-taking or changes in speech without trying to win an argument about a diagnosis.
  3. Use the agreed plan. If they previously asked you to contact someone or help with money during a high, follow that agreement.
  4. Ask for an urgent assessment if you suspect mania. You can seek advice even if they refuse; do not try to force them into an assessment yourself. Professionals must consider consent and any legal exceptions. Describe the changes to their team, if known, or use the urgent-help route. Say if you cannot safely provide the support they need.[3]

Money and commitments

Use any money safeguards they agreed while well. If there is no agreement, ask their care team for advice about the immediate concern. Planning ahead explains options to agree together.

If no plan exists, avoid taking control of accounts, cards or property on your own. Ask their care team for help and use independent debt or legal advice where needed.[4]

If they seem paranoid or are hearing or seeing things

Use the psychosis conversation guidance: acknowledge the fear, do not argue about the belief and do not pretend that you share it.

What to say in the moment
Related help
How to talk without escalating thingsProfessional supportPlan ahead together
Sources and how this guide was written

  1. Opening advice

    NICE recommends urgent specialist assessment when mania is suspected. NHS urgent-help guidance and Bipolar UK support and crisis signposting.

    Back to the advice

  2. Look for changes from their usual pattern

    NHS bipolar information, Mind's supporter guidance and Bipolar UK signs and symptoms.

    Back to the advice

  3. What you can do now

    Mind: supporting someone with bipolar and Bipolar UK: supporting someone.

    Back to the advice

  4. Money and commitments

    Bipolar UK: bipolar and money and Mind: make a plan for difficult times.

    Back to the advice

Last full source check: 26 August 2026

Consent and seeking advice wording checked: 7 October 2026. Sources and explanation.

Later checks: Mania escalation advice checked: 30 September 2026.

Independent information, not a medical or crisis service. This guidance has not been clinically reviewed. How we use sources.

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