How to Use This Script

This script is designed to be read aloud during your coaching session. "You" sometimes addresses you as the coach and sometimes your loved one — just as it would in a natural conversation. Speak it in your own voice; paraphrase where it feels right. Sections in blockquotes are exercises to do together.

You: "Relapse doesn't usually happen overnight. There are almost always warning signs first. We call these your 'Signature Signs' — and in bipolar, you need to know them for BOTH poles."

You: "Let's start with mania. Think back to the last time you got manic. What was the very first thing that changed? Was it your sleep? Your spending? Your talking speed? Did you start big projects at 2 AM? Did you feel like you didn't need your medication?"

Common Mania Warning Signs:

Sleeping less than 5 hours and feeling 'fine'
Talking faster, interrupting more
Starting multiple projects simultaneously
Increased spending or impulsive decisions
Feeling invincible, irritable, or 'wired'
Questioning whether you need medication

You: "Now let's look at the other side. What are your depression warning signs? Withdrawing from people? Sleeping more? Losing interest in things you usually enjoy?"

Common Depression Warning Signs:

Canceling plans or avoiding people
Sleeping significantly more or less
Neglecting hygiene or daily routines
Increased negative self-talk
Loss of appetite or overeating
Difficulty concentrating or making decisions

You: "Now, let's decide what we do when we see each sign. If you sleep less than 4 hours two nights in a row, what's the rule? Call the doctor? No caffeine after noon? If you cancel plans three days in a row, what's the action? These are your 'If-Then' rules."

Important for the Supporter: You may notice warning signs before they do — especially mania signs, which often feel good to the person experiencing them. Have a pre-agreed signal or conversation starter: 'I'm noticing [specific behavior]. Can we check the warning signs list together?' Frame it as partnership, not surveillance.

Nervous System Regulation Exercise: 4-7-8 Breathing

You: "Let's practice a breathing technique that directly stimulates your vagus nerve. It's called 4-7-8 Breathing."

You: "Sit comfortably. Inhale through your nose for a count of 4. Hold for 7. Exhale through your mouth for 8. The exhale is twice as long as the inhale — that's the key."

You: "Let's do four cycles together. Inhale, 2, 3, 4... hold, 2, 3, 4, 5, 6, 7... exhale, 2, 3, 4, 5, 6, 7, 8."

Why this works: The extended exhale directly stimulates the vagus nerve, shifting your autonomic nervous system toward rest-and-digest. The hold phase increases CO2 tolerance, which reduces panic sensitivity over time.

You: "If holding for 7 feels too long, start with 4-4-6 and build up. This is particularly good for sleep and general anxiety."

Nervous System Regulation Exercise: Humming / Vocal Toning

You: "Here's one you can do anywhere, even quietly. It's called Humming or Vocal Toning."

You: "Take a normal breath in. On the exhale, hum at a comfortable pitch — or try a low 'voo' sound. Feel the vibration in your chest, throat, and face. Continue for a few minutes."

Why this works: The vagus nerve passes through your larynx. Vibration from humming mechanically stimulates it, triggering parasympathetic activation. Peter Levine specifically recommends the 'voo' sound for people who feel frozen or numb.

You: "Even sub-vocal humming has an effect. How does that feel in your body?"

Nervous System Regulation Exercise: Bilateral Movement

You: "Let's get your body moving. Stand up and march in place — bring your right hand to your left knee, then your left hand to your right knee. Keep alternating."

You: "Let your arms swing naturally. Breathe normally. Continue for 2 to 3 minutes. Notice if you feel more present, less foggy."

Why this works: Cross-lateral movement activates both brain hemispheres simultaneously, promoting integration. It also generates proprioceptive input, helping your body locate itself in space — critical when someone feels disconnected.

Go Deeper

Polyvagal Theory — The autonomic nervous system's role in mood regulation and why co-regulation between supporter and person matters at this stage of the program

You: "This is a great first move when someone is shut down and can't access breathing exercises. Movement often works when stillness doesn't."