Creating a Care Plan for Bipolar Disorder

Understand how goals, preferences, symptoms, health history, and follow-up can shape an individualized care plan. Get clear information from Tinka Health.

A bipolar disorder care plan is a personalized guide that organizes treatment, follow-up, daily support, early warning signs, and crisis procedures in one place.

The plan helps answer practical questions such as:

What symptoms are currently being treated?
Which healthcare professionals are involved?
What medications are prescribed?
What therapy or practical support is recommended?
What early warning signs should be monitored?
Who should be contacted when symptoms change?
What steps should be taken during a crisis?
How will progress be reviewed?

A care plan is not a guarantee that another manic, hypomanic, depressive, or mixed episode will never occur. It is a structured way to make treatment more coordinated and to reduce confusion when mood, sleep, judgment, motivation, or functioning begins to change.

Bipolar disorder is commonly treated with medication, psychotherapy, or a combination of approaches. Different medications may be used during an acute mood episode and during longer-term maintenance care. Psychotherapy can provide education, coping strategies, support, and tools for patients and families.

The most useful care plans are individualized. A plan for someone recovering from severe mania may look different from a plan for a person whose main difficulty is recurring bipolar depression. The plan should reflect the patient’s diagnosis, symptoms, medical needs, treatment history, relationships, responsibilities, preferences, and safety concerns.

This page focuses on how the different parts of bipolar disorder care can be organized into one practical plan. For a broader explanation of available treatment approaches, visit Bipolar Disorder Treatment Options.

What Is a Bipolar Disorder Care Plan?

A bipolar disorder care plan is a written or clearly documented outline of how the condition will be evaluated, treated, monitored, and supported over time.

It may be created by the patient and psychiatric healthcare professional, with input from therapists, primary-care professionals, family members, or other appropriate people.

A care plan may include:

Current diagnosis or diagnostic questions
Main treatment goals
Current symptoms
Medication instructions
Therapy recommendations
Follow-up schedule
Laboratory and physical-health monitoring
Sleep and routine goals
Personal warning signs
Strategies for daily functioning
Family or caregiver roles
Substance-use considerations
Work or school planning
Pregnancy-related considerations
Crisis and emergency instructions

The care plan should be understandable to the patient. It should not consist only of medical terms or instructions that the person cannot explain in their own words.

A patient should know what the plan is intended to accomplish, what they are responsible for, and what to do when something changes.

Why a Care Plan Can Be Helpful

Bipolar disorder can affect several areas of life at the same time.

During mania or hypomania, a person may have reduced insight, sleep very little, become unusually confident, begin multiple projects, spend impulsively, or resist concerns from others.

During depression, the same person may struggle to get out of bed, attend appointments, answer messages, make decisions, or complete basic self-care.

These changes can make it difficult to create a plan during the episode itself.

A care plan developed during a period of greater stability can provide clearer guidance when symptoms return.

It may help:

Reduce uncertainty
Improve communication
Clarify treatment responsibilities
Identify warning signs earlier
Support medication consistency
Protect sleep and routines
Reduce financial or safety risks
Coordinate family involvement
Prepare for urgent situations
Support recovery after an episode

The plan can also reduce disagreements among patients, relatives, and healthcare professionals by documenting what was discussed and agreed upon before a crisis developed.

A Care Plan Should Begin With a Clinical Evaluation

A care plan should be based on a professional evaluation rather than an online checklist or self-diagnosis.

The evaluation may review:

Current mood symptoms
Previous manic or hypomanic periods
Depressive episodes
Mixed symptoms
Psychotic symptoms
Sleep patterns
Daily functioning
Medical history
Medication history
Alcohol and substance use
Family psychiatric history
Previous treatment
Suicide or safety concerns

Bipolar disorder is diagnosed according to the severity, length, frequency, and lifetime pattern of symptoms. Medical evaluation may also be used to identify conditions that can resemble bipolar symptoms.

A care plan may remain provisional while the diagnosis is still being clarified.

For example, the clinician may need to determine whether periods of increased energy are consistent with hypomania, anxiety, ADHD, substance-related symptoms, medication effects, or ordinary responses to stress.

The care plan can still address current concerns while additional information is gathered.

Visit How Bipolar Disorder Is Evaluated.

Identify the Current Phase of Care

Bipolar disorder care may have different priorities depending on the patient’s current condition.

Acute Care

Acute care addresses symptoms that are currently active and clinically significant.

These may include:

Mania
Severe irritability
Agitation
Psychosis
Bipolar depression
Mixed symptoms
Suicidal thinking
Major sleep disruption
Unsafe impulsive behavior
Inability to complete basic self-care

The immediate plan may focus on stabilization, safety, medication review, sleep restoration, closer monitoring, or a higher level of care.

Recovery Care

Recovery care begins after the most severe symptoms have improved.

The plan may focus on:

Rebuilding sleep and routines
Returning to work or school
Addressing financial consequences
Repairing relationships
Improving concentration
Managing medication side effects
Reconnecting with therapy
Identifying personal warning signs
Reducing fear of another episode

Recovery may continue even after the person no longer meets full criteria for an acute mood episode.

Maintenance Care

Maintenance care focuses on longer-term stability.

Goals may include:

Reducing the risk of future episodes
Maintaining treatment consistency
Monitoring sleep and mood
Supporting physical health
Recognizing warning signs early
Maintaining work, relationships, and daily responsibilities
Reviewing whether the current treatment remains appropriate

A care plan may move between these phases as the patient’s needs change.

Set Clear and Realistic Treatment Goals

A care plan should include goals that are specific enough to evaluate.

“Feel better” is understandable, but it may be difficult to measure.

More specific goals may include:

Sleep seven to eight hours on most nights
Attend scheduled medication follow-ups
Reduce impulsive spending
Return to work gradually
Complete basic hygiene consistently
Reduce suicidal thinking
Recognize reduced sleep as a warning sign
Avoid overnight work during elevated periods
Improve communication with family
Complete required laboratory testing
Reduce alcohol or substance use
Develop an emergency plan
Maintain regular therapy attendance

Goals should reflect the patient’s priorities as well as clinical concerns.

A clinician may be focused on reducing mania, while the patient is primarily concerned about sedation, returning to work, or repairing a relationship. Both perspectives may belong in the care plan.

Define the Role of Medication

If medication is included, the care plan should clearly state:

The name of each medication
The prescribed dose
When it should be taken
Why it has been prescribed
The symptoms it is intended to address
Common side effects to monitor
Serious symptoms requiring prompt attention
Required laboratory testing
What to do after a missed dose
Who to contact with questions

Different medications may be used for acute episodes and long-term symptom management. Mood stabilizers and certain atypical antipsychotic medications are commonly used in bipolar disorder. Some patients may need several medication trials before finding an effective and tolerable plan.

The patient should not be expected to follow a medication plan they do not understand.

Useful questions include:

What is this medication intended to treat?
How will we know whether it is helping?
What side effects should I report?
What monitoring is required?
What should I do if I miss several doses?
Could it interact with my other medications?
How could pregnancy or physical illness affect the plan?

Medication should not be stopped, restarted, increased, decreased, or combined without guidance from the prescribing professional.

Visit Medication Management for Bipolar Disorder.

Include Medication Safety and Monitoring

The care plan should explain how medication safety will be monitored.

Depending on the medication and patient, monitoring may involve:

Mood and sleep
Suicidal thoughts
Weight
Appetite
Blood pressure
Blood sugar
Cholesterol
Kidney function
Liver function
Thyroid function
Blood-cell counts
Medication blood levels
Movement-related symptoms
Pregnancy-related concerns
Medication interactions

The plan should identify:

Which tests are needed
When they should be completed
Where results will be sent
Who will review them
What happens if testing is missed
Which symptoms require urgent contact

A patient may feel well while a laboratory or physical-health concern is developing. Recommended monitoring may therefore remain important during periods of stable mood.

Visit Medication Safety and Monitoring for Bipolar Disorder.

Add a Therapy Plan

Therapy may support understanding, coping, communication, routines, and recovery.

The care plan may identify:

The type of therapy being used
The main therapy goals
How often sessions will occur
Whether family members will participate
How the therapist and prescriber will coordinate
What should happen if symptoms worsen
How therapy progress will be reviewed

Therapy may focus on:

Psychoeducation
Mood and sleep tracking
Stress management
Depression-related thinking
Daily routines
Relationship repair
Family communication
Treatment consistency
Substance-use concerns
Recovery after hospitalization

Interpersonal and social rhythm therapy may help patients understand relationships between mood and biological or social routines. Family-focused therapy can help patients and relatives learn about the condition, recognize warning signs, and respond more effectively.

A person experiencing severe mania, dangerous psychosis, or an immediate suicidal crisis may need stabilization before routine outpatient therapy can be effective.

Visit Therapy and Practical Support for Bipolar Disorder.

Make Sleep a Specific Part of the Plan

Sleep should not be treated as a minor detail.

Changes in sleep may occur before or during a mood episode. Disturbances in sleep and circadian rhythms are associated with the onset or worsening of bipolar symptoms.

A sleep plan may include:

A usual bedtime
A usual waking time
The minimum amount of sleep that should trigger concern
Limits on overnight work or social activity
Strategies for shift-work changes
Plans for travel across time zones
Caffeine or stimulant limits
Instructions for contacting the provider
Family observations when appropriate

The plan should distinguish between insomnia and reduced need for sleep.

Someone with insomnia may want to sleep but remain awake and tired.

During hypomania or mania, a person may sleep very little and still feel highly energized.

A sudden decrease in sleep alongside increased activity, rapid speech, irritability, unusual confidence, or impulsive behavior should be taken seriously.

Identify Personal Warning Signs

General bipolar symptoms are useful, but a care plan should include the patient’s personal early warning signs.

Possible elevated warning signs may include:

Sleeping less
Increasing social activity
Sending messages overnight
Starting many projects
Spending more
Talking faster
Becoming highly confident
Increasing sexual activity
Becoming unusually impatient
Ignoring normal routines

Possible depressive warning signs may include:

Canceling plans
Sleeping more
Staying in bed
Losing interest in music or hobbies
Falling behind at work
Avoiding messages
Skipping meals
Neglecting hygiene
Becoming highly self-critical
Expressing hopelessness

The patient may have highly individual signs.

For one person, the first warning may be online shopping. For another, it may be writing through the night, contacting former partners, reorganizing the home, missing morning appointments, or withdrawing from one particular friend.

Family members may help identify signs that the patient did not notice during previous episodes.

Visit Bipolar Disorder Warning Signs.

Decide What to Do When Warning Signs Appear

Recognizing warning signs is only useful when the plan explains what should happen next.

Possible steps may include:

Contact the psychiatric provider
Schedule an earlier appointment
Increase monitoring
Protect sleep
Reduce unnecessary commitments
Delay major purchases
Avoid driving when sleep deprived or impaired
Ask a trusted person to review financial decisions
Reduce alcohol or substance exposure
Resume mood tracking
Arrange childcare or practical help
Follow medication instructions
Seek urgent or emergency care when safety is affected

The plan should identify different levels of response.

Mild Early Changes

Examples may include sleeping slightly less, becoming more talkative, or withdrawing socially.

The plan may call for monitoring, protecting routines, and contacting the provider if the pattern continues.

Worsening Symptoms

Examples may include several nights of very little sleep, increasing spending, severe depression, agitation, or major functional decline.

The plan may require prompt contact with the treatment team and an earlier evaluation.

Emergency Symptoms

Examples may include suicide risk, dangerous mania, severe psychosis, overdose, aggression, or inability to care for basic needs.

The plan should direct the patient or family to emergency services.

Build a Daily Routine Plan

A practical care plan may include ordinary activities that support functioning.

These may include:

Waking at a consistent time
Eating regular meals
Taking medication as directed
Attending work or school
Completing one or two priority tasks
Participating in safe physical activity
Limiting overnight activity
Maintaining social contact
Preparing for sleep
Recording mood or sleep changes

The plan should be realistic.

An overly ambitious schedule may become difficult to maintain and may create shame when the patient cannot follow it.

During depression, a daily plan might begin with:

Get out of bed
Shower
Eat one meal
Take prescribed medication
Respond to one important message
Attend one appointment

During recovery from mania, the plan may focus on:

Limiting new commitments
Reviewing existing responsibilities
Restoring sleep
Avoiding major financial decisions
Addressing unfinished tasks gradually

Plan for Work or School

The care plan may need to address employment or education.

Questions may include:

Can the patient continue the current workload safely?
Is temporary leave needed?
Would a gradual return be helpful?
Are overnight shifts affecting sleep?
Are accommodations being considered?
Who can provide required documentation?
What should happen if attendance declines?
What warning signs are visible at work or school?

Possible practical supports may include:

Reduced workload
Consistent scheduling
Written priorities
Clear deadlines
Scheduled breaks
Academic support
Gradual return after hospitalization
Coordination with appropriate workplace or school resources

Questions about formal rights or accommodations should be directed to qualified workplace, school, disability, or legal professionals.

Add a Financial Safety Plan

Financial decisions can be significantly affected during mania or hypomania.

A care plan may include safeguards agreed upon during a stable period.

Possible safeguards include:

Transaction alerts
Spending limits
Separate essential household funds
Automatic payment of important bills
Delaying major purchases
Reviewing investments with a trusted person
Limiting access to new credit during warning periods
Securing business or legal documents
Identifying who should be contacted when spending changes

The goal is not to permanently remove financial independence.

The goal is to protect housing, food, transportation, children, and essential responsibilities during periods when judgment may be impaired.

Complex financial or legal arrangements may require qualified professional guidance.

Include a Family or Support-Person Plan

A trusted support person may help with:

Identifying warning signs
Transportation
Appointment attendance
Medication reminders
Childcare
Meals
Communication with the treatment team
Financial safeguards
Emergency planning

The care plan should clarify:

Who may be involved
What information may be shared
What observations are helpful
What boundaries should be respected
When the person should contact the provider
When they should call emergency services

Support should not automatically become control.

Family members should not interpret every disagreement, emotion, or preference as a bipolar symptom.

Specific observations are more helpful than labels.

For example:

“You have slept only three hours for four nights and made several large purchases” is more useful than “You are becoming bipolar again.”

Plan for Children and Dependents

A care plan should address responsibilities for children, older adults, pets, or other dependents when relevant.

The plan may identify:

Backup childcare
School transportation
Meal preparation
Emergency contacts
Medication storage
Who will care for dependents during hospitalization
How children will receive age-appropriate explanations
How they will be protected from adult conflict
What should happen if parenting becomes unsafe

Having bipolar disorder does not mean someone cannot be a caring and effective parent.

Planning provides additional support during periods when energy, judgment, or functioning changes.

Address Alcohol and Substance Use

Alcohol, cannabis, stimulants, sedatives, and other substances may affect mood, sleep, judgment, psychosis, and medication safety.

The care plan may include:

The patient’s current use
Substances associated with previous episodes
Medication interactions
Strategies for reducing use
Substance-use counseling
Recovery support
What to do during relapse
How withdrawal concerns will be handled
Coordination between psychiatric and substance-use professionals

Substance use should be discussed honestly and without shame.

The purpose is to improve safety and clarify what may be affecting symptoms.

Bipolar disorder can occur alongside substance-use concerns, and both may require coordinated treatment.

Include Physical-Health Care

Bipolar disorder care should not be separated completely from physical health.

The plan may identify:

Primary-care provider
Relevant specialists
Medical conditions
Required laboratory testing
Medication monitoring
Sleep-disorder evaluation
Nutrition or activity concerns
Pregnancy-related care
Coordination after hospitalization

Patients should report:

New medical diagnoses
New medications
Significant weight changes
Vomiting or dehydration
Kidney or liver concerns
Heart symptoms
Neurological changes
Pregnancy
Surgery or hospitalization

Changes in physical health may affect psychiatric medication safety and symptom interpretation.

Plan for Pregnancy and the Postpartum Period

Patients who are pregnant, planning pregnancy, breastfeeding, or recently postpartum may need a specialized care plan.

The plan may address:

Medication review
Coordination with obstetric care
Sleep protection
Family support
Postpartum appointments
Breastfeeding considerations
Warning signs
Emergency procedures
Childcare support

Medication should not be stopped abruptly after a positive pregnancy test without appropriate clinical guidance.

The risks of medication exposure must be considered alongside the risks of untreated or recurring bipolar symptoms.

Severe confusion, hallucinations, delusions, dangerous behavior, or thoughts of harming oneself or a baby after childbirth require emergency care.

Create a Crisis and Emergency Plan

A crisis plan should clearly explain what to do when routine outpatient care is no longer enough.

Emergency warning signs may include:

A suicide attempt
A specific suicide plan
Access to lethal means
Threats toward another person
Dangerous mania
Severe psychosis
Severe confusion
Inability to eat, drink, sleep, or complete basic self-care
Medication overdose
Behavior placing children or vulnerable people at risk
Inability to remain safe at home

The crisis plan may include:

Emergency contact names
Provider contact information
Local emergency department
Transportation plan
Current medication list
Allergy information
Preferred hospital when appropriate
Childcare or dependent-care arrangements
Steps to reduce access to firearms or large quantities of medication

During an immediate emergency, call 911 or go to the nearest emergency room.

A website form, voicemail, routine appointment request, or portal message should not replace emergency care.

Clarify Privacy and Communication

The care plan may explain how information will be shared among:

The patient
Psychiatric provider
Therapist
Primary-care professional
Family member
Caregiver
Other specialists

The patient may authorize certain people to receive or provide information.

A family member may sometimes provide observations to a clinician even when the clinician cannot disclose private patient information in return.

The plan should clarify:

Who may participate in appointments
Who may be contacted in an emergency
What consent forms are needed
How records will be requested
How providers will coordinate care

Decide How Progress Will Be Measured

Progress should be measured according to the goals of the care plan.

Possible measures include:

More regular sleep
Fewer manic or depressive symptoms
Reduced suicidal thinking
Fewer impulsive purchases
Improved medication consistency
Better concentration
Improved work or school attendance
More consistent personal care
Improved relationships
Fewer emergency visits
Reduced substance use
Better recognition of warning signs
Improved physical-health monitoring

Improvement may occur gradually.

A person may sleep better before concentration improves. Mood may stabilize before financial or relationship consequences are resolved.

The care plan should be reviewed when progress is limited, side effects become significant, or the goals no longer match the patient’s needs.

Schedule Regular Care-Plan Reviews

A care plan should not remain unchanged indefinitely.

Review may be needed:

After a new diagnosis
After hospitalization
After a medication change
When side effects develop
When symptoms return
After a major medical diagnosis
During pregnancy planning
After childbirth
When work or school circumstances change
When substance use changes
When a support person is no longer available
After a crisis
During a stable period

A stable period can be a useful time to review the plan because the patient may be better able to reflect on what helped and what did not.

Questions may include:

Are the goals still appropriate?
Are all medications still necessary?
Are monitoring tests up to date?
Are the warning signs accurate?
Does the crisis plan still work?
Are family boundaries clear?
Has contact information changed?
Are there new medical or practical needs?
Is the patient satisfied with the level of involvement in decisions?

What a Simple Written Care Plan May Include

A practical written plan may be organized into the following sections:

Clinical Information

Current diagnosis
Important co-occurring conditions
Current mood state
Relevant medical conditions

Treatment Team

Psychiatric provider
Therapist
Primary-care professional
Pharmacy
Other specialists

Medications

Medication names
Doses
Timing
Purpose
Monitoring requirements
Missed-dose instructions

Therapy and Support

Therapy type
Main goals
Appointment schedule
Family involvement
Practical supports

Daily Stability

Sleep goals
Work or school routine
Meals
Exercise
Substance-use plan
Mood tracking

Warning Signs

Personal signs of mania
Personal signs of depression
Mixed symptoms
Psychosis warning signs
Safety concerns

Response Steps

What the patient will do
Who will be contacted
Which decisions will be delayed
What family members may do
When urgent care is needed

Emergency Plan

Emergency contacts
Hospital information
Medication list
Dependent-care plan
Safety steps

The plan should be short enough to use during a stressful situation. More detailed medical information can remain in the clinical record.

Common Mistakes When Creating a Care Plan

Making the Plan Too General

“Call someone if things get bad” does not define which signs matter, who should be called, or what “bad” means.

Focusing Only on Medication

Medication may be important, but sleep, therapy, relationships, finances, substance use, functioning, and crisis planning may also require attention.

Excluding the Patient

A plan created without the patient’s input may be difficult to follow and may overlook the person’s concerns or priorities.

Relying Only on the Patient During Mania

Reduced insight may make self-monitoring difficult during mania. Agreed family or support-person observations may be useful.

Giving Family Members Unlimited Control

Support should be specific and proportionate. Broad or permanent loss of independence should not be treated as the default response.

Ignoring Physical Health

Psychiatric medication, sleep, pregnancy, medical illness, and substance use may all affect the plan.

Waiting Until a Crisis

A crisis is often the most difficult time to decide who should help, how finances will be protected, or where dependents will stay.

Never Updating the Plan

Treatment, health, relationships, and responsibilities change. The plan should change with them.

Questions to Ask When Creating the Plan

Patients may ask:

What are our main treatment goals?
Which symptoms are we treating first?
How will we measure progress?
What medication monitoring is required?
What should I do if I miss medication?
What are my early warning signs?
When should I contact the practice?
What situations require emergency care?
Who should be involved in my care?
How can my family raise concerns?
What financial safeguards may be appropriate?
What should happen if I cannot work or care for my children?
How should pregnancy affect the plan?
How often will we review the plan?
Who coordinates care among my providers?

Visit Questions to Ask About Bipolar Disorder.

When to Consider Creating or Updating a Care Plan

A care plan may be helpful when:

Bipolar disorder is being evaluated
A diagnosis has recently been made
Medication is being started
The patient is leaving the hospital
A mood episode has recently occurred
Warning signs are returning
Family members are unsure how to help
Work or school functioning is affected
Financial problems occurred during mania
Medication adherence is difficult
Pregnancy is planned
Substance use is affecting treatment
Several healthcare professionals are involved
The current crisis plan is unclear

A person does not need to wait for another severe episode before creating a plan.

When Emergency Help Is Needed

A care plan cannot replace emergency services.

Call 911 or go to the nearest emergency room when someone:

May harm themselves or another person
Has attempted suicide
Has a specific suicide plan and access to means
Is dangerously manic
Is experiencing severe psychosis
Is severely confused
Has taken an overdose
Cannot care for basic needs
Is placing children or vulnerable people at risk
Cannot remain safe

How Tinka Health Services Can Help

Tinka Health Services provides psychiatric evaluation, bipolar disorder assessment, therapy-informed support, medication management when clinically appropriate, and telehealth mental health care for eligible patients in Maryland, Washington DC, and Virginia.

Care planning may include discussion of:

Current symptoms
Treatment goals
Medication management
Medication safety and monitoring
Therapy-informed support
Sleep and daily routines
Personal warning signs
Daily functioning
Family involvement
Work or school concerns
Substance use
Physical-health coordination
Pregnancy-related needs
Crisis and emergency planning
Follow-up care

Seliat Dosunmu, DNP, PMHNP-BC, FNP-C, works with patients to develop individualized recommendations based on the clinical evaluation, medical history, treatment response, functional needs, risks, and personal preferences.

An appointment does not guarantee a bipolar disorder diagnosis, prescription, or specific treatment plan. Recommendations depend on the individual clinical findings.

Telehealth psychiatric appointments may be available for eligible patients physically located in Maryland, Washington DC, or Virginia at the time of care when virtual treatment is clinically appropriate.

Some patients may also need laboratory testing, physical examination, in-person treatment, hospital care, or coordination with other professionals.

Tinka Health Services is not an emergency service. For non-emergency psychiatric care, visit Appointment Booking.

Related Bipolar Disorder Resources

Bipolar Disorder Treatment Options
Medication Management for Bipolar Disorder
Medication Safety and Monitoring for Bipolar Disorder
What to Expect During Medication Follow-Up
Bipolar Disorder Warning Signs
How Bipolar Disorder Can Affect Daily Functioning
When to Seek Help for Bipolar Disorder
Questions to Ask About Bipolar Disorder
Taking Bipolar Medication Consistently

Key Takeaway

A bipolar disorder care plan is a personalized guide that brings treatment, monitoring, practical support, warning signs, and crisis procedures together.

The plan may include treatment goals, medication instructions, therapy, laboratory monitoring, sleep routines, daily-functioning support, family roles, financial safeguards, substance-use care, physical-health coordination, and emergency steps.

A useful care plan should be specific, understandable, collaborative, and regularly updated. It should explain not only what treatment is being provided, but also what to do when sleep, mood, behavior, judgment, or safety begins to change.

The plan should preserve the patient’s dignity and independence whenever possible while providing additional support during periods of significant impairment.

Dangerous mania, severe psychosis, suicidal behavior, overdose, or inability to remain safe requires emergency care rather than routine care-plan follow-up.

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