Bipolar Early Warning Signs & Action Plan
A bipolar relapse prevention worksheet listing personal early signs of elevation and depression, a three-stage action plan for self and supporters, and key contacts.
1-page fillable PDF · US Letter (prints on A4) · Relapse prevention
- Approach / concern
- Bipolar & Mood
- Technique
- Relapse prevention
- Format
- Fillable PDF, 1 page (US Letter / A4)
- Access
- Pro and Advanced plans (3-day free trial)
- For
- Licensed clinicians to use with clients
- Updated
- October 2026
Key facts
What is the Bipolar Early Warning Signs & Action Plan?
Early warning signs (prodromes) are subtle changes in sleep, energy, thinking and behaviour that often precede manic or depressive episodes. Identifying personal prodromes and planning responses is a core component of bipolar psychoeducation.
Why it works
Teaching people with bipolar disorder to identify early symptoms and seek treatment reduced manic relapses and improved functioning in a randomized trial (Perry et al., 1999). Canadian guidelines recommend psychoeducation and relapse-prevention planning (Yatham et al., 2018).
When to use it
- Bipolar I and II disorder
- After a recent mood episode
- Medication changes
- Involving family in care planning
How to use it in session
- Review past episodes to identify early signs.
- Involve trusted supporters with consent.
- Plan actions at each stage.
- Share with the care team.
- Review after any episode.
Clinician tips
- Reduced need for sleep is a common early sign of mania.
- Supporters often notice signs before the client does.
- Pair with daily mood charting.
Worked example
Sharing with clients
Members can download the PDF to print or email, or copy a private client link from the download box. Your client opens the link and downloads the worksheet on any device. No client account is needed, and nothing your client writes is stored on TherapyAid.
Frequently asked questions
What are common early signs of mania?
Needing less sleep, racing thoughts, increased energy, talkativeness, irritability and impulsive spending are common, but signs are personal.
Should family see this plan?
With consent, sharing the plan with trusted supporters can greatly improve early detection.
References
Perry, A., Tarrier, N., Morriss, R., McCarthy, E., & Limb, K. (1999). Randomised controlled trial of efficacy of teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment. BMJ, 318(7177), 149-153.
Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Bond, D. J., Frey, B. N., et al. (2018). Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disorders, 20(2), 97-170.
This worksheet is an educational tool for use by, or under the guidance of, a licensed or registered mental-health professional. It is not a diagnostic instrument or a substitute for clinical judgement. If a client is in crisis in Canada, call or text 9-8-8 or call 9-1-1.
