Bipolar disorder and mania

Mania is an abnormal mood state with excessively elevated and expansive, euphoric mood tone, tendency to talk rapidly, psychomotor excitement, hyper-evaluation of oneself and one’s own abilities, leading to dispersion in many interests, unwarranted optimism and undertaking numerous initiatives.

Mania is a clinical sign opposite to depression and the key symptom in bipolar disorder.

Bipolar disorder (or bipolar depression) consists of alternating major depressive episodes and manic or mixed episodes (bipolar I disorder) or hypomanic episodes (bipolar II disorder). It used to be called manic-depressive psychosis, to distinguish it from reactive depression and depressive neurosis.

The passage from one polarity to another of the mood (between low and high) can be fast or gradual; the alternation of the diverse episodes is almost never regular, and the depressive episodes are more frequent.

We speak of hypomania when there are the same symptoms as in mania, to a lesser extent or in an attenuated manner; it generally does not impede the subject’s normal life but can predispose him/her to more serious episodes.

How to recognize an episode of mania

Hypomania makes the person appear somewhat more cheerful than normal, but it may not be easy to spot. Exaggerated activism, with excessive talkativeness and an exalted ego, are striking.

A manic episode, on the other hand, is very surprising and usually develops within a few hours and is accompanied by delusional ideas. The person usually does not feel the need to sleep, is hyper aroused, with ideas of grandiosity.

Risky or flashy activities are frequent, unusual for the person, such as very high stakes, unwise economic investments, unforeseen and unconsidered trips, uncontrolled sexual activity or recourse to prostitution, etc.

Diagnostic signs of bipolar disorder

A single episode of mania is sufficient for the diagnosis of bipolar disorder. In general, a period of abnormally and persistently elevated, expansive or irritable mood, lasting one week or less, and three or more of the following symptoms are required:

hypertrophic self-esteem or grandiosity;
decreased need for sleep (e.g., feeling rested after only three hours of sleep);
increased talkativeness or continuous urge to talk;
flight of ideas or subjective experience that thoughts follow each other in rapid succession;
distractibility (attention easily diverted by unimportant external stimuli);
increased social, work, school, sexual activity, or agitation;
excessive involvement in playful activities with high potential for harmful consequences (overspending, inappropriate sexual behavior, unwise business investments).

Coping with bipolar disorder and mania.

It is necessary to take into account what is recommended for depression. In addition, in mania, as when there are psychotic symptoms, words are less effective: it is urgent to go to a doctor or an emergency service, and most likely the use of stabilizing drugs will be necessary.

Mania, if well confronted by a professional and treated with drugs, can be like a thunderstorm and everything returns to normal in a few days.

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