By Eva Briggs, MD
To meet the criteria for mania, the episode must last at least one week. People with this disorder may seem out of the ordinary — happy and elated, even euphoric or they may be irritable and angry
Have you ever had the experience where a friend, neighbor or family member seems much more energetic than usual: sleeping less, spending money willy-nilly, talking more and perhaps faster than usual, neglecting work or family to pursue hairbrained schemes?
That person might be experiencing a bout of mania.
Mania is a mental illness characterized by elevated energy, mood and activity.
To meet the criteria for mania, the episode must last at least one week. People with this disorder may seem happy and elated, even euphoric. Or they may be irritable and angry. It’s a change from their baseline state. Patients with mania can make rash, impulsive decisions. This could take the form of spending sprees, reckless sex or foolish business decisions. They can be fidgety, jittery or pace around. Some people become obsessed with an activity. Their thoughts race and they become easily distracted. People often think they are invincible. They can feel rested even with little or no sleep.
Sometimes episodes of mania are so severe that the patient becomes psychotic.
Delusions or false beliefs are one symptom of psychosis. For example, people can believe they’re being followed or that someone is transmitting their thoughts directly into their brain. Another psychotic symptom is hallucination which can take the form of hearing voices or seeing things that are not there.
Often people with mania lack the insight to recognize their abnormal behavior. They may like the feelings of energy and creativity that accompany mania.
The most common cause of mania is bipolar 1 disorder. This mental health disorder is characterized by mood swings from low (depression) to high (mania). At least one episode of mania is required to be diagnosed with bipolar 1. Although most people have episodes of both depression and mania, some have episodes of mania with few or no bouts of depression.
Mania can also occur in other illnesses: seasonal affective disorder, postpartum psychosis, schizoaffective disorder, and cyclothymia.
Sometimes episodes of mania seem to come out of the blue. Other times there is a trigger. Triggers can include a stimulating environment such as noise and bright lights or crowds of people. Major life changes such as divorce or job loss can be a trigger. Lack of sleep and substance use are other potential triggers.
The diagnosis can be made by an appropriate health care professional. The first step is a history, including personal mental and physical health, family history, social history to identify potential stressors, medications, supplements and substance use. The health care provider will evaluate for medical conditions such as hyperthyroidism that could mimic mania.
Treatment involves medications, talk therapy and support from friends and family. Classes of medication used for mania include antipsychotic medicines and mood stabilizers for patients with additional mood disorders. Talk therapy might include psychotherapy, cognitive behavioral therapy and family therapy. Support may also come from local support groups.
If the mania is associated with bipolar 1 disorder, this is a lifelong condition. Many patients don’t recognize or believe this when they become stable again following a manic episode. But it’s important to continue treatment and monitoring for recurrences. Seeing a doctor as soon as the patient or family recognizes the onset of symptoms could allow treatment adjustments to stave off a full-blown manic episode.
Eva Briggs is a retired medical doctor who practiced in Central New York for several decades. She lives in Marcellus.