By Olivia Guy-Evans, published Sept 20, 2021
A manic episode is a distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week. Manic episodes usually begin abruptly and last for between 2 weeks and 4-5 months (median duration about 4 months).
This condition usually affects about 1% of the population and is usually associated with bipolar disorder or manic depression. Bipolar disorder, formerly known as manic depression, is a mental health condition where an individual will experience extreme mood swings, including emotional highs (mania or hypomania) and lows (depression).
With depression, an individual may experience feelings of hopelessness and lose interest or pleasure in many activities. When the mood shifts to mania, this individual may feel euphoric, intense energy, or irritable. People who experience mania may also experience psychosis symptoms, including hallucinations and delusions, indicating a separation from real life.
Mania and hypomania are two different types of episodes, but with the same symptoms. Hypomania is not as severe as mania, with mania causing more noticeable problems for personal and social functioning. With the possibility of mania resulting in psychosis, this can make the effects of this period more long-lasting and may even result in hospitalization.Mania can be a dangerous condition as those experiencing an episode may not be able to sleep or eat. They may also engage in more risky behaviors or harm themselves. The symptoms of mania can last for around a week or more and can only be diagnosed if the symptoms of mania are significantly different from the usual behavior of an individual.
Family history may play a factor in somebody experiencing mania, as it has been found that those who have parents or siblings with this condition are more likely to experience a manic episode.
As previously stated, mania could also be a symptom of another mental health condition such as bipolar disorder. Likewise, environmental changes could also be a trigger for mania.
This can include stressful life events such as the death of a loved one, financial strain, breakdowns in relationships, and illness.
When considering the symptoms of mania, it is important to take into account the individual's typical behavior. Some of the symptoms of mania may be the usual behaviors displayed by an individual, therefore they may not necessarily be linked to experiencing a manic episode.
For mania, it is important to look at the considerable changes in behavior from normal. Below are some of the symptoms that can be associated with mania.
For mania to be diagnosed, an individual can be evaluated through being asked questions regarding their symptoms. Sometimes direct observations from a physician or psychiatrist can indicate that someone is experiencing a manic episode.
The Diagnostic and Statistical Manual of Mental Disorders (DSM- 5) outlines criteria that an individual must meet in order for mania to be diagnosed.
The DSM-5 criteria states that abnormally and persistently elevated mood must have lasted one week and be present most of the day, every day, to meet the criteria for manic.
During this period, three or more of the following symptoms must be present to a significant degree and represent a noticeable change from usual behavior:
Inflated self-esteem or grandiosity Decreased need for sleep More talkative than usual or pressure to keep talking Flight of ideas or the experience that thoughts are racing Distractibility, such as attention being drawn to unimportant or irrelevant stimuli Decreased need for sleep Increase in goal-directed activity (either socially, at work, school, or sexually) or agitation Excessive involvement in risk-taking activities such as unrestrained spending sprees, sexual indiscretions, or foolish business investments
These disturbances in mood need to be significantly severe enough to have caused impairment in social or occupational functioning for it to meet the criteria of mania.
Similarly, if there is the need to hospitalize the individual or there are psychotic features, such as hallucinations and delusions, this also meets the criteria for diagnosis.
Finally, it is important to note that for a manic episode to be diagnosed, the episode cannot be attributed to other physiological causes, such as an effect from drug misuse or other medications.
Antipsychotics generally work by blocking a subtype of the dopamine receptor, known as D2. Dopamine is a neurotransmitter which plays a vital role in mood, so blocking D2 receptors should work to balance out mood.
Some types of antipsychotics are aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel), and risperidine (Risperdal).
Lithium is type of medication is often used for the long-term treatment of mania to reduce how frequently and severe the episodes are experienced. Lithium works by stimulating the glutamate receptor NMDA in order to increase glutamate availability.
Glutamate is essential for the normal functioning of the brain. Types of lithium include Cibalith-S, Eskalith, and Lithane.
Valproate is a type of anticonvulsant medication which is usually prescribed for epilepsy but has shown effectiveness for treating some of the symptoms of mania (being over-excited, overactive, irritable, and distracted).
This works on the brain by increasing the amount of chemical called gamma-aminobutyric acid (GABA), which blocks the transmission across neurons in the brain and has a calming effect as a result.
Psychotherapy is also a type of treatment which can help individuals with mania identify when their moods are changing. With a mental health professional such as a psychotherapist, they can also identify the triggers which may cause a manic episode so that moods can be better managed.
Therapies such as cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) can help individuals to find ways to manage and cope with their mania, understand it better, and work to find methods to help reduce symptoms when they are noticed.
Other methods than can be used to manage a manic episode when they occur are some lifestyle changes that individuals can do on their own. These can include:
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Guy-Evans, O. (2021, Sept 20). What is a manic episode. Simply Psychology. www.simplypsychology.org/how-to-recognize-a-manic-episode.html
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Purse, M. (2020, July 11). What Is a Manic Episode? Very Well Mind. https://www.verywellmind.com/how-to-recognize-a-manic-episode-380316#what-is-a-manic-episode
Substance Abuse and Mental Health Services Administration. (2016). DSM-5 Changes: Implications for Child Serious Emotional Disturbance. https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t7/
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