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Last year, my bipolar left me hospitalized for the standard 72 hour review and release. It was my first hospitalization because of this disease, and the whole process was very enlightening.

Hospitalization statistics are most often associated with episodes of depression and not acute mania. Mental health professionals focus on those numbers, tends to cause the need for hospitalization during manic episodes to be overlooked. So influential are these one side of bipolar numbers, I was nearly refused admittance under a voluntary 5150. Only after several hours of observation in the ER, was it accepted that I was in fact a danger to myself and others, without having thoughts of suicide.

Acute mania can lead to destructive behaviors resulting in injury, or death not only for the individual, but for those around them. Though this level of acute mania is uncommon, it is important to recognize at what point an episode becomes dangerous. Accurately determining a need for hospitalization requires all individuals involved to have strong lines of communication established before an episode requires professional intervention.

Acute mania can be identified through levels of aggressiveness, sleep patterns, activity, and destructive behaviors such as sexual exploits, or driving at excessive speeds. However, it is important to note, these identifying factors do not automatically mean a need for hospitalization. They are simply indicators that can help identify a shift taking place in the effects of the disease.

My standard personality is fairly aggressive, and when coupled with my size, people who don't know me well, have a tendency to be fearful of me. I also tend to drive a bit fast, am very animated when I speak passionately, and am willing to take above "normal" risks in order to achieve a goal. Though these are all characteristics of mania, not a single one means required hospitalization; at least for me.

Knowing when hospitalization is needed begins before acute mania sets in. Recognizing the differences between you, and you with bipolar is a key first step. This aspect of bipolar often overlooked, is the dynamic of "two you". It is an understanding that much of a persons life with bipolar is in conflict with that very person, and they know it. Essentially, even though you have bipolar, you still exist. It is often expressed by sufferers as being trapped behind the disease. A sufferer of bipolar must first understand these dynamics within themselves, and then pass it on to

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