Mania: Definition, Causes, Symptoms and Treatment

What is mania?

People suffering from mania experience unreasonably high levels of emotional euphoria, intense moods, hyperactivity and hallucinations. It is common for people with bipolar disorder to experience manic episodes (or manic episodes).

For several reasons, mania is a potentially dangerous condition. During a manic episode, people may not sleep or eat. Risky behavior may lead them to harm themselves. Psychotics who suffer from mania are more likely to experience hallucinations and other perceptual disturbances.

Read: Mild Cognitive Impairment

What is a manic episode?

Manic episodes are periods of time when you experience one or more symptoms of mania, also known as manic episodes (see “symptoms” and “diagnosis” sections). The need for hospitalization may arise in some cases.

What are the triggers of manic episodes?

Every person experiences manic episodes in a different way. Start keeping track of how you feel before and when an episode occurs and become a detective by monitoring your mood (even keeping a mood diary). If you trust and have close relationships with your family and friends, they can help you identify your triggers. It may be easier for them to notice changes in your behavior than for you, as they are outside observers.

When you know what triggers your episodes, you can prepare for them, reduce their impact, or prevent them from occurring.

You should be aware of the following triggers:

• High levels of stimulation (for example, loud noises, bright lights, or large crowds)
• Changing your life (such as getting divorced, getting married, or losing your job)
• Sleep deprivation
• Consumption of substances, such as recreational drugs and alcohol

What happens after a manic episode?

You may experience the following after a manic episode:

• Have a positive or negative feeling about your behavior.
• Taking on so many activities makes you feel overwhelmed.
• During a manic episode, you may only have vague memories or have only a few details to recall.
• Having a very tired feeling and needing to sleep.
• Feel depressed (if bipolar disorder is causing your mania).

What causes mania?

Mania may be influenced by family history. Those who have parents or siblings with the disorder are more likely to experience manic episodes. People with manic episodes are less likely to experience them if they have a family member with these episodes.

Bipolar disorder is one type of disorder that can lead to mania or manic episodes. These people can suffer from mania caused by a trigger or combination of triggers.

Mania patients with different brain structures or activities can be detected with brain scans. Bipolar disorder and mania are not diagnosed with brain scans.

Mania can be triggered by environmental changes. The death of a loved one can trigger mania as can other stressful life events. Relationships, illness and financial stress can also cause manic episodes. Manic episodes are also linked to conditions like hypothyroidism.

What are the symptoms of mania?

People with mania are characterized by extreme excitement, euphoria and other intense moods. Their behavior is hyperactive and they may develop delusions or hallucinations. Many patients feel anxious and jumpy. People with manic episodes often experience depressive episodes with extremely low levels of energy.

People who are experiencing manic episodes feel as if they are full of energy. As if everything in the world we’re moving faster, they can cause the body systems to speed up.

Mania can cause rapid speech and racing thoughts. Mania can affect sleep or performance at work. Maniacs may develop delusions. They may exhibit risky behavior, be easily irritated or go on spending sprees.

People with mania may behave aggressively. Alcohol and drug abuse are also symptoms of mania.

It is called hypomania if it is milder than mania. Symptoms of hypertension are associated with hyperthyroidism to a lesser degree. The duration of hypomania episodes is shorter than that of manic episodes.

Here are some typical behaviors you may notice during a manic episode, which may help you recognize if help is needed.

Read: Catatonia

Decreased need for sleep

Stay up all night with friends or loved ones. Then wake up at 8 a.m. You’re ready to go, are you? A decrease in sleep needs is common during the onset of mania symptoms. As a result, bipolar disorder and sleep problems can feed off one another, as manic episodes may lead to sleep problems likewise.

Engaging in multiple activities at once

Manic episodes often cause you to try to work off more energy by doing something restless. A person who experiences this symptom usually takes on many projects or has a burst of increased productivity beyond what they normally would accomplish during a set period of time.

Excessive talking, rapid speech or pressured speech

In the early stages of a manic or hypomanic episode, loud and rapid speech is a common symptom. If rapid speech is to be categorized as such, it has to differ from someone’s normal speech pattern. People who normally speak slowly when choosing their words can suddenly talk more rapidly. Be aware of this when someone who usually does so begins to speak rapidly.

Read: Brief Psychotic Disorder

Easily distracted

Beware if someone makes “clang” associations (such as rhyming with words such as ice cream cones, microphones and xylophones). In the case of bipolar disorder, clang associations may seem poetic at first, but they are inappropriate and out of character for someone with manic symptoms.

Increase in risky behaviors

During a manic episode, people may engage in risky behaviors, especially when it comes to money, such as overspending, gambling and shopping sprees.

Rapid thinking

Observe if your friend or family member is complaining that their minds are racing. Bipolar disorder can make a person seem like they are talking fluidly and happily while inside they are having unquiet, repetitive thoughts. If you hear them talk about their thoughts racing, make sure you find out what they mean.

Flight of ideas

It may be difficult to follow the flight of ideas when someone enters the manic phase of bipolar disorder. Take notice if you have trouble following a discussion’s logic.

There are times when words are thrown together in a non-logical progression: “I wonder what the weather will be like tomorrow. What is the purpose of life?” Come on, you have moments like that. Observe whether your loved one’s ideas have changed.

Read: Body Dysmorphic Disorder

Grandiosity

People with bipolar disorder, especially those in manic or hypomanic phases, are often accused of having grandiose ideas, such as Justin Bieber is sending them love letters or I am the president of Yemen this weekend.

It is an exaggerated feeling of importance, often associated with religion (“I am sent to serve my flock”), that is defined as grandiosity. Hypomania is not characterized by delusions of grandeur, but grandiose thinking, such as “I’ll quit my job and write a novel”, maybe a symptom.

It is important to keep the context in mind. It may be very normal for a budding author to make such a comment. Those who have never tried to write a novel under their own names or do not enjoy writing are more likely to be suspicious than those who do.

Hostility and/or increased irritability

If you see unreasonable hostility or irritability, be cautious and seek help. Make sure you do not try to handle this situation by yourself.

Suicidal thoughts

An episode of manic depression can make a person feel hopeless or worthless or even lead to thoughts of death or suicide.

Read: Asperger’s Syndrome

Excessive devotion to religion

Another manic symptom is increased religious zeal or participation. Keep a note if you see this.

Bright clothing

When a person is experiencing hypomanic or manic episodes, he or she is more likely to wear bright colors or flamboyant clothing. The vast majority of people who wear brightly colored clothing do not suffer from manic depression.

When clothing coincides with other symptoms of manic or hypomanic behavior, it is a subtle clue. An increase in your dress sense, such as revealing clothing, may also signal other symptoms, like hypersexuality.

Mania in children

It is not uncommon for people to notice symptoms of mania in children. It is relatively rare to diagnose children with bipolar disorder, as the behaviors may simply be considered a behavioral disorder.

Consult a pediatrician if you have concerns about a child in your family. An appropriate way to talk to someone whose child happens to be a family member or a friend’s child is to be gentle and thoughtful. If you have questions about how to go about this, you might want to consult with a mental health professional first.

Read: Disorganization Schizophrenia

How is mania diagnosed?

The symptoms of mania can be evaluated by a doctor or psychiatrist by asking questions and discussing them. The direct observation of a patient may indicate manic symptoms.

A manic episode meets the criteria laid out in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association. Patients must be hospitalized for at least a week during the episode. There must be three other symptoms in addition to the disordered mood:

• His or her attention is easily diverted.
• Taking risks or acting impulsively is his or her way of life. Investing in risky businesses, or buying expensive items, are all examples.
• They have racing thoughts.
• Sleep needs are reduced.
• His or her obsessions are intrusive.

When a person suffers from a manic episode, their relationships, jobs, and schools are negatively affected. Hospitalization is often necessary to stabilize a manic episode and prevent self-harm.

During manic episodes, hallucinations and delusions can occur. People may believe that they are famous or possess superpowers, for instance.

An individual’s state must not be the result of outside influences, such as drug abuse or alcohol abuse, in order to be considered a manic episode.

Read: Schizoaffective Disorder

What is the treatment for mania?

Psychosis and severe mania may require hospitalization. Hospitalization can prevent a patient from injuring themselves.

Medications

Treatment for mania usually begins with medication. Medication like this is prescribed to reduce self-injury risk and balance a patient’s mood.

Medicines include:

• Lithalith (Cibalith-S, Eskalith, Lithan)
• Antipsychotic drugs such as aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel), and risperidone (Risperdal).
• Some anticonvulsants include valproic acid (Depakene, Stavzor), Divalproex (Depakote) and lamotrigine (Lamictal).
• Benzodiazepines such as alprazolam diazepam (Valium), chlordiazepoxide (Librium), clonazepam (Klonopin), (Niravam, Xanax)  or lorazepam (Ativan).

Only medical professionals should prescribe medications.

Read: Types of Schizophrenia

Psychotherapy

Patients can identify mania triggers through psychotherapy sessions. Stress management is another benefit of these treatments. You may also find help through family therapy or group therapy.

Coping with manic episodes

Manic episodes can be managed more effectively through lifestyle changes than medication and therapy. Consider some of these.

• Exercise on a regular basis. Ensure that you engage in some form of physical activity every day.
• Eat a well-balanced diet and don’t skip meals.
• Maintain a consistent sleep-wake cycle (even on weekends) through proper sleep hygiene.
• Keeping a journal can be helpful. It may be beneficial to keep a journal for recording manic and depressive symptoms. Take note of triggers, such as job changes, breakups, moves, or situational triggers like staying out late or listening to loud music, beginning a new project, or leaving on vacation.
• Be sure to keep appointments with your doctor and take your medication as prescribed.

Helping loved ones with manic episodes

Self-care is essential if you are caring for someone with bipolar disorder. Maintain your own health and well-being in order to be able to provide them with the mental and physical strength they need to cope better with manic episodes and other symptoms of bipolar disorder.

Keep an eye out for any signs of manic behavior. Try journaling and recording your loved one’s symptoms for them by asking them to share their experience.

Educating yourself about the disorder can also be helpful. There are resources available for dealing with depression and bipolar disorder, such as the Depression and Bipolar Support Alliance, or NAMI, the National Alliance on Mental Illness. Manic episodes can be understood better if you understand their causes and effects of them.

Preventing mania

Manic episodes can be prevented with prescription medications. Psychotherapy or group therapy may also be beneficial to patients. The treatment of manic episodes can help patients recognize the signs of onset and seek help.

What is the outlook for mania?

The incidence of manic episodes is estimated at 90 percent in patients who have already experienced one episode (Kaplan et al., 2008). The prevention of mania can be achieved through lifelong management if its cause is bipolar disorder or another psychological condition.