Julie is currently answering questions live on Facebook


Hello! I’m currently live on my Julie A. Fast Facebook page for the next few hours to answer your questions about mental health disorders including bipolar disorder, depression, anxiety, psychosis, borderline, ADD and medications.

I will also post the questions and answer here.




Julie, What do you do when your psychosis is raging, and manic/hypo manic. How do you manage your daily goals?


Hello Zih,

Let’s start at the beginning. We share the same symptoms as we both have bipolar disorder with psychosis.  (The diagnosis is called schizoaffective disorder.) This means we have to deal with a lot of mood swings- sometimes all at once.  I have an overall plan that I used for symptom management. This is in my books.  Here is what I do specifically:

Getting started:  I know my symptoms from the very beginning. I have a list of ALL of my mania and psychosis symptoms that I have compiled for many years. I did this through charting my moods.  This process is outlined in my books Take Charge of Bipolar Disorder and The Health Cards Treatment System for Bipolar Disorder.  I will post the links below.  You obviously know your symptoms as well. Do you have them written down? It helps to have a very detailed list.

Step #1.  Manage your sleep. Once I wrote down my symptoms- and believe me, I add to the list regularly, I created a plan to deal with each symptom in a way that keeps me from going further into the mood swing.

For example, ALL management plans have to have a plan for regular sleep. Let’s start there.

If you are manic and psychotic, sleep is going to be a huge issue. What is your plan tonight to sleep no matter what? For many of us, that means a good dose of sleep meds or taking more of the meds we take for mania and psychosis.  This isn’t fun and I’m sorry we have to sometimes medicate ourselves this way, but sleep is paramount.  Knock yourself out and sleep for at least eight hours and let the brain help you heal.

One of the main reasons hospitals work so well when a person is manic and psychosis is the regimented sleep.

Step #2.   Be careful not to take your symptoms out on the people around you. I have to do this as I can get very aggressive and loud, mean and nasty, negative and bombastic when the mania is raging.  This is my dysphoric mania and it’s so unpleasant! I make sure that I warn the people around me that I’m in an episode and I ask for help. I say, “As you can see, I’m having a hard time controlling my negativity. I don’t want to be this way. It’s the mania. You can help by reminding me that this is an illness and I will get through this as I always do. ”

Step #3.  Look for triggers. What do you think led to the current mania and psychosis? If you can pinpoint the trigger, make changes in that area immediately. I just had a relationship issue and believe me, the paranoia was raging. That is my regular symptom when I have contentious conversations. It is no one’s fault. It is my brain. I have to remind myself that for me, paranoia is simply a symptom. Nothing terrible has happened. I just had an argument with a family member. Nothing has changed. This leads to the next step.

Step #4. Talk to yourself about your symptoms. I do this regularly. Julie, when you are manic you talk too fast, spend too much money and love to drink. This is a sign you are sick. It’s ok to have these symptoms, but you don’t have to act on them. What do you need to do right now to make sure you minimize mistakes and don’t do something you will regret? I have a plan in place for this and I USE it.

Step #5 Ask for help. You are already doing this by writing me. If you need to talk to a health care person, even if it’s just to check in, do it. I will write my therapist or call a friend when I need help. My illness tells me I have no friends, but I don’t listen and force myself to call!


This is a short list of what I do!





Julie, I have talked to u before. Which book of yours should I start with? I’m specially interested in ur card system. Thnx!


Hello Erat,

I would start with Take Charge of Bipolar Disorder and then move to the Health Cards. I call the Health Cards the Moneyball of bipolar disorder management. They really work, but are only for those who are ready to make a lot of changes in lifestyle in order to get better. I use them with all of the parents and partners I coach. Take Charge outlines the basic system and really explains bipolar disorder management for the whole family. I would definitely start with this book!





Julie, What is the most unusual reason for causing mania that you’ve heard of? Rudy.
Hi Rudy,
STEROIDS! I am working with a client right now where steroids are leading to mania. This means HGH, testosterone, prednisone, cortisone, etc. We use them so cavalierly in this country and yet they are very dangerous for people with bipolar disorder. Lately, high THC pot is the main cause of mania in my coaching work.
Hi Julie…my daughter is diagnosed bipolar 2. She often lies. Is this common with a bipolar person? Marsha


My daughter was also recently diagnosed with borderline personality and bipolar and lying is a big issue with her
Hello Marsha,
Yes, but ONLY during a mood swing. Bipolar disorder is episodic. There are NO exceptions. You can see I am being very firm in this answer.   That is because people often confuse bipolar disorder – a mood disorder- with personality disorder. People who have bipolar disorder only have symptoms when in a mood swing. We are absolutely regular in terms of behavior when we are not sick. Is your daughter’s lying cyclical or consistent over time?
 Julie, she was also diagnosed with borderline.  Marsha
Ah, you just answered my question. If she regularly lies, that is much more of a personality disorder symptom than bipolar disorder. But, please know that we ALL lie when manic. LYING IS A SYMPTOM OF MANIA.








Are you Manic? Answer the questions below about bipolar disorder mania and find out!

trampoline 50Have you experienced any of the following in the past few months?

– Slept less but felt more energized?  Had the thought… sleep is a waste of time!

– Had the thought- Thank god the depression is gone, I feel SO much better!    ?

– Felt like spending more? Drinking more? Are you behaving in a way that has people asking you what’s wrong and you want to reply- NOTHING! Don’t wreck my buzz man. Do you want me to be depressed forever?

–  Do you feel more sexual than normal? Do you have sexual thoughts about anyone who is good looking? Do you fantasize in a way you don’t normally do when stable? 

–  Are you eating less than you normally do?

If you answer yes to any of these, you know what it means. You might be manic!  


NO MANIA THIS YEAR can be your motto.

It’s time to get help now:  Check your meds, go back on meds if they worked in the past, tell the truth to friends, partner and family, read my books and take care of yourself.

Mania is always up to no good- even when it feels totally awesome!


Accepting New Family Member and Partner Coaching Clients

b father

(A note from Julie: I specialize in crisis coaching that eventually becomes a management plan for the whole family. My work is extremely discrete. I never share my client list and offer help even when change feels impossible.  You are not alone. Coaching works. Over 50% of my coaching clients come to me for help with a loved one who is using marijuana and having mood swings.)


Over six years ago, I started coaching partners and family members of people with bipolar disorder as an addition to my writing career.

I never thought I would find work that I enjoy as much as I enjoy coaching. I feel at home with the parents and partners as I have been where they are- and I remain calm during the crises that many of my clients are going through while we are working together. Bipolar disorder is like a puzzle. It’s not always easy to find the right pieces on your own. It helps to have a coach as a guide.

My coaching practice has room for new clients. It’s a partnership that saves relationships and often lives.

Coaching is not for everyone, but if you are concerned about your relationship with a person with bipolar disorder, it may be a good fit for you. The following link will tell you more. I look forward to talking.

Julie Fast Family and Partner Coaching



PS: My work often involves custody cases, loved ones in the justice system, helping loved ones get into the hospital, problems with loved ones who have a substance abuse problem (especially marijuana) and many more situations that require extreme discretion.


Can Energy Drinks Lead to Bipolar Disorder Mania?

 (This is one of my top ten posts. Let me know what you think! Julie)

I’ve written many books on bipolar disorder and they all discuss mania extensively- but they don’t discuss energy drinks and how they might affect mania. The reason is that the explosion of these drinks on the market is so new that it wasn’t even a topic of concern a few years ago.  

How did so many products get on the market so quickly? I think it was the success of Red Bull and it moved on from there.  I have to ask:  Are we really that tired?  Or do we just like feeling buzzed?  Who knows?  But I do know it’s a potential problem.

Can these energy drinks lead to mania or exacerbate mania?


But it might not be in the way you think.

It’s not that the energy drinks are bad for you because they directly cause mania. They don’t.  They are not like drugs that go into your system and potentially cause a manic episode such as meth, cocaine, ADHD stimulants or anti depressants.

 Instead, the problem is that energy drinks significantly affect  sleep. Consistent research shows that one of the top triggers of bipolar disorder is a change in sleep patterns.  Thus, there is a link with the energy drinks and how they can rev you up to the point that sleep is significantly impaired or impossible. This is a fire-starter for mania. (Is there a drink called Fire Starter? It wouldn’t surprise me!)  People without bipolar disorder can drink all they want.  I know someone who drinks Rock Star all day and jumps around like a rabbit- but it is her choice.  She doesn’t  have a brain that gets manic.  You or someone you care about probably does get manic.  That is the difference. It’s why you have to make choices that consider bipolar disorder. Yes, it’s a bother and not fair, but it’s reality.  Who thought a little can could cause so much trouble!  The other night I was watching UFC  (mixed martial arts) with my brother at a bar.  The woman next to me ordered her second can of Red Bull. I thought- there is no way you could get me to drink that. I’d fly through the roof!  Here is what she said when it arrived:It’s not alcohol, but it gets me plenty high!

Another example:  I go to karaoke regularly and see people order a Red Bull and Guinness.  I am no prude and have had way, way too much to drink in my lifetime to judge, but this just sounds like a disaster waiting to happen.  And very few people stop at just one.

To be honest, having one energy drink early in the day may not affect your sleep.  You will have to experiment. Problems start when you drink them at night, all day or have more than enough at a bar and then can’t sleep.  Please think about it.

Energy drinks may be over the counter- but so are cigarettes. If you have trouble with mania (or anxiety), energy drinks are not your friend.

It’s as though the energy drinks lull people into thinking they are not really a problem as they are sweet and a pretty color in a vibrant can. But beware!


– For more information, click here to read an excellent article called Are Energy Drinks Safe?

– If you’re a parent of a child who feels that energy drinks are no problem- feel free to pass this on.

– My books that best explain mania the best are Take Charge of Bipolar Disorder  and  The Health Cards Treatment System for Bipolar Disorder.

– Information on my family coaching can be found here 

Note: I just received this excellent question:  What about coffee?   The first difference is the amount of caffeine. Some of the drinks have the same caffeine as a cup of coffee.  Some have quadruple. Another difference is sugar content (one has almost the double of a Coke) as well as other ‘natural’ stimulants used in the drink.  (Sugar free versions are available, but their stimulant content stays the same.) And finally, it’s simply rare for someone to drink espresso all day or all night. Can you imagine seeing someone with a big coffee mug of espresso and drinking it even while singing karaoke? Whew!



Do You Have a Bipolar Disorder Travel Plan?

IMG_8149Travel is exciting. Getting away from it all- the weather, no work, friends, beaches, family, new sights, languages, the exotic. It would be great if you could also take a vacation from bipolar disorder. Unfortunately this is not always possible. You may be someone who responds well to vacations and you actually get better mood wise. But for many, the stress of even the greatest vacation can create bipolar disorder symptoms. Luckily, there are strategies you can use to prevent these symptoms to ensure that your travels are the best they can be.


Bipolar disorder symptoms are triggered by outside events, especially those that affect sleep.

Travel can condense so many bipolar disorder triggers into a really short space of time. The triggers that may affect you over a year at home can all be present in just few weeks of travel. Our concept of travel as something positive often gets in the way of reality as bipolar disorder doesn’t really have a concept of positive. For this illness, a trigger is a trigger whether it’s in Paris or in the mountains of Montana.

Bipolar disorder doesn’t like change and it doesn’t like stimulation.

This sounds ridiculous doesn’t it! How can an illness not like change? The concept is odd, but it’s our reality. The minute our routine is upset, our brain can get upset. This is why having a plan ready before you travel is essential for your stability.

The Past Predicts the FutureIMG_8694

Ask yourself now- have you successfully traveled in the past? Is your health the same now? Then you are fine to keep doing what has worked for you. But if you’re like me and travel has always caused problems, you need to change now so that your next vacation isn’t ruined by mood swings. When your excitement is stronger than your reality, trouble happens. Be realistic. Is Las Vegas the best for you? Or would a quiet trip to the coast be better. you will have to decide.

Here are questions to ask yourself before you travel:

1. If you take medications, how will you manage the pills if you’re flying for example? I ALWAYS take more meds than I need and put them in separate bags. If I lose one bag, I still have meds. What if you need a prescription when in a foreign country? Talk to your prescriber about this before you leave. Have an email process in place in case you need help when you’re away from home. Think of every single thing that can happen with meds when you travel and prepare ahead of time. A friend of mine traveled half way around the world and realized she had counted her meds incorrectly for her stay. Luckily, there was a doctor where she was staying and her prescription was filled easily.

2. What will you do if you get sick in the airport? Panic attacks are a common reaction to travel preparation. Many people are fine once they reach a destination, but wow, getting there can be a pain! Be ready for the chaos of today’s airports. I arrive HOURS before I have to. I would rather make it through the process without anxiety than have to rush through customs while trying not to pass out from a panic attack.

3. Who will be your travel companions? Do you get along? What can you do in advance to create smooth sailing for your trip? If you’re visiting people, how do you get along with them? Have you had problems in the past with these relationships? Remember, the past predicts the future with bipolar disorder. Who you travel with is as important as where you’re going.

IMG_8337If you’re traveling soon, what can you do now to ensure a successful trip?

These questions will get you started. I lived in Europe for five months this year. It was a challenge. I planned it all very carefully and I still got sick. But I survived and am now where I want to be.

You can do the same.


Click the following for my travel writing and videos for Bp Magazine.

Julie A. Fast VIDEO: Bipolar Disorder & Travel—How I Use Sleep to Stay Stable.

Blog: Bipolar Disorder and Travel 1: The Europe Diaries

Bipolar Disorder and Travel 2: Pole Axed in England



Julie Interview in People Magazine about the Amazing Carrie Fisher


I was just interviewed by People Magazine about Carrie Fisher’s impact on our mental health world. What a wonderful woman. What a legacy she leaves behind. She will be missed. Click here to read the excellent article:

Inside Carrie Fisher’s Revolutionary Openness About Her Mental Illness: ‘She Changed the World’


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