Symptoms of Mania in Bipolar Disorder

Mania and hypomania are heightened phases in bipolar disorder characterized by elevated mood, extreme energy, and diminished sleep. Mania, a feature of bipolar I disorder, involves an abnormally high mood accompanied by hyperactivity and reduced sleep. Hypomania is a milder form seen in bipolar II disorder.

Untreated bipolar mania can disrupt daily functioning. Hence, recognizing the symptoms is critical for seeking appropriate care.

At a Glance

Mania in bipolar disorder presents changes in thoughts, mood, energy levels, speech, and judgment. To be diagnosed with bipolar-associated mania, an individual needs to experience three or more of these symptoms for a week or longer. Accurate diagnosis leads to effective treatment and care.

# Experiencing one or two symptoms of mania is not necessarily indicative of bipolar disorder. Other possible causes include emotional trauma, brain injury, drug reactions, or undiagnosed anxiety disorders.

Bipolar mania can manifest in some or all of the following ways:

• Changes in thought patterns
• Development of psychosis
• Impaired judgment
• Mood changes
• Speech disruptions
• Sudden changes in energy and activity

To receive a diagnosis of mania or hypomania, symptoms must be reviewed against criteria outlined in the "Diagnostic and Statistical Manual of Mental Disorders" (DSM) published by the American Psychiatric Association.

Changes in Thought Patterns

Changes in thought patterns are discernible by individuals interacting with the affected person. They may be innovative insights or appear fragmented and nonsensical.

Examples include:

• Augmented emphasis on religion or religious activities
• Mental disorientation or disjointed thinking
• Enhanced creativity or inventiveness (often seen as a "breakthrough" or epiphany)
• Stream of consciousness (rapid succession of thoughts jumping from one idea to another without connection)
• Rapid thoughts (a flurry of thoughts often repetitive)

Development of Psychosis

Psychosis is a severe manifestation of bipolar disorder that can occur during manic or depressive mood states. It requires medical treatment and hospitalization. Psychosis is generally not seen in a hypomanic phase.

Symptoms may include: * Delusions (firmly believing things that are not true) * Hallucinations (hearing, seeing, smelling, touching, or feeling things that are not real) * Paranoia (irrational fear of things that are not real)

Psychotic symptoms often align with the mood state. During a manic phase, individuals might believe they have special powers or engage in reckless behaviors. During a depressive episode, they might believe someone is out to harm them.

Impaired Judgment

Impaired judgment can sometimes be mistaken for a momentary lapse or an overflow of generosity, passion, boldness, or goodwill. However, it may result in risky, hurtful, or even perilous behavior.

Examples include:

• Lack of awareness of the ramifications of actions
• Extreme impulsivity (such as gambling and risk-taking)
• Inappropriate humor and impulsive behavior
• Hypersexuality and provocative sexual behaviors
• Reckless and extravagant spending, including showering friends, acquaintances, and even strangers with gifts

Mood Changes

Mood changes are characterized by a sudden outburst of activity and an expansive mood, described as being more significant than life. These alterations are long-lasting and diverge from the natural mood state.

Symptoms may include:

• An elated mood
• Extreme excitability
• Grandiosity and dominance
• Sudden swings to severe irritability, hostility, or even anger

Speech Disruptions

Speech disruptions are an easily recognizable sign of a manic episode. Individuals may have a "motor mouth" and be difficult or impossible to interrupt.

Speech disruptions may include: * Clang associations (grouping words that sound similar even if they don’t make sense) * Incoherent speech (often described as rambling and unremitting) * Speedy, pressured speech (as if you cannot utter enough words)

Sudden Changes in Energy

It is one thing to have a sudden rush of energy; it is quite another when the energy is unrelenting, protracted, and overwhelming. Like mood changes, the sudden energy surge is not considered normal and can cease as quickly as it began.

Symptoms may include:

• Decreased need for sleep with little apparent fatigue
• Abrupt increase in goal-oriented activities (like a project that demands exclusive attention, neglecting other activities)
• Persistent and often purposeless movement
• Restlessness and inability to remain still

Diagnosis of Mania in Bipolar Disorder

According to the DSM, bipolar mania can be diagnosed if an individual experiences at least three of the following symptoms for no less than a week:

• Increased engagement in goal-oriented activities
• Heightened pursuit of risky or dangerous activities
• Being easily distracted
• Stream of consciousness
• High self-esteem
• Rapid speech
• Reduced need for sleep
• Psychomotor agitation (such as pacing or hand-wringing)

If you are confronting manic symptoms that are impairing your ability to function, find a mental health professional in your locality who can diagnose your symptoms and prescribe treatment if necessary.

You can request a referral from your primary care physician or contact the National Alliance on Mental Illness (NAMI) hotline at 800-950-NAMI from Monday to Friday, 10:00 a.m. to 6:00 p.m. Eastern Time.

Treatment of Mania in Bipolar Disorder

Treating mania in bipolar disorder involves medication, psychotherapy, and lifestyle changes. There is no cure for the condition, but it can be managed with appropriate treatment.

Medications

Medications often prescribed to address bipolar mania include antipsychotics (often utilized to manage acute episodes) and mood stabilizers (which can help prevent future episodes).

Therapy

Psychotherapy can assist individuals in recognizing triggers that contribute to manic episodes. Beneficial types of therapy include cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and family therapy.

Lifestyle Changes

Taking care of your health can also be a crucial part of managing manic episodes in bipolar disorder. This can encompass getting enough sleep, engaging in regular exercise, and maintaining a healthy diet.

Following your healthcare provider's treatment recommendations is essential.

Takeaway

Mania is a distinctive symptom of bipolar I disorder, involving excessively heightened mood, amplified energy, and diminished sleep. Signs of mania include impaired judgment, changes in thoughts, psychosis, mood changes, increased energy/activity, and speech disruptions. If you or someone you know is experiencing such symptoms, it is imperative to consult a doctor to obtain an accurate diagnosis and appropriate treatment.