Goal

The goal of this session is for patients to learn to detect their (hypo)manic relapses in time, and make their own lists of operational early signs so that these are available for identification of future episodes. Procedure

• The session can begin with a reminder of the symptoms of mania and hypomania, and the difference between the two as, although this may seem strange, at this stage in the program there are still patients who do not have the clear distinction between depression and mania.

• To meet our objective, we quickly go around the group to name all the symptoms of mania.

• We ask the group the following questions: “Do you believe all these symptoms can act as alarm signals? Which should we remove from the list? Should we add anything?”

• The answers to these questions will lead to some important considerations for the session: some symptoms appear so suddenly that they are of no use as warning signs, while other – non-pathological – behaviors are actually good indicators of a relapse.

• With the co-operation of the group, we go around again to come up with the General Warnings List.

• We explain to the patients how to prepare the Personal List of Operational Warnings, always emphasize the need to individualize the knowledge of the disorder: I am trying to learn not about the illness of bipolar disorder but about my bipolar disorder – an idea that perfectly fits the concept the patients have of their psychiatric disorder.