Mania: What Is It, Causes, Triggers, Symptoms & Treatment

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A manic episode is a period of abnormally elevated, extreme changes in mood, behavior and activity and energy level. It's a more severe ... ComingtoaClevelandCliniclocation?Visitation,maskrequirementsandCOVID-19information Home / HealthLibrary / Disease&Conditions Mania Maniaisaconditioninwhichyoudisplayanover-the-toplevelofactivityorenergy,moodorbehavior.Thiselevationmustbeachangefromyourusualselfandbenoticeablebyothers.Symptomsincludefeelingsofinvincibility,lackofsleep,racingthoughtsandideas,rapidtalkingandhavingfalsebeliefsorperceptions. Appointments866.588.2264 Appointments&Locations RequestanAppointment Overview SymptomsandCauses DiagnosisandTests ManagementandTreatment Prevention Outlook/Prognosis LivingWith FrequentlyAskedQuestions Mania Overview SymptomsandCauses DiagnosisandTests ManagementandTreatment Prevention Outlook/Prognosis LivingWith FrequentlyAskedQuestions BackToTop Overview Whatismania? Maniaisaconditioninwhichyouhaveaperiodofabnormallyelevated,extremechangesinyourmoodoremotions,energyleveloractivitylevel.Thishighlyenergizedlevelofphysicalandmentalactivityandbehaviormustbeachangefromyourusualselfandbenoticeablebyothers. What'sconsideredan“abnormal,”extremechangeinbehaviorandwhatdoesitlooklike? Abnormalmanicbehaviorisbehaviorthatstandsout.It’sover-the-topbehaviorthatotherpeoplecannotice.Thebehaviorcouldreflectanextremelevelofhappinessorirritation.Forexample,youcouldbeextremelyexcitedaboutanideaforanewhealthysnackbar.Youbelievethesnackcouldmakeyouaninstantmillionairebutyou’venevercookedasinglemealinyourlife,don’tknowathingabouthowtodevelopabusinessplanandhavenomoneytostartabusiness.Anotherexamplemightbethatyoustronglydisagreewithawebsite“influencer”andnotonlywritea2,000wordpostbutdoanexhaustivesearchtofindallthewebsitesconnectedtotheinfluencersoyoucanpostyourlettertheretoo. Althoughtheseexamplesmaysoundliketheycouldbenormalbehavior,apersonwithmaniawillexpendagreatdealoftimeandenergyincludingmanysleeplessnightsworkingonprojectssuchasthese. Whatisamanicepisode? Amanicepisodeisaperiodoftimeinwhichyouexperienceoneormoresymptomsofmaniaandmeetthecriteriaformanicepisode(see“symptoms”and“diagnosis”sections).Insomecases,youmayneedtobehospitalized. CanIhaveamanicepisodeasitsownconditionorisitalwayspartofanothermentalhealthcondition? Technicallyifyouhaveamanicepisode,youhaveamentalhealthcondition.Maniacanbeapartofseveralmentalhealthconditionsincluding: BipolarIdisorder(mostcommonconditionformaniatooccur). Seasonalaffectivedisorder. Postpartumpsychosis. Schizoaffectivedisorder. Cyclothymia. WhatisbipolarIdisorder? BipolarIdisorderisamentalhealthillnessinwhichapersonhasmajorhighandlowswingsinmood,activity,energyandabilitytothinkclearly.TobediagnosedwithbipolarIdisorder,youhavetohaveatleastoneepisodeofmaniathatlastsforatleastsevendaysorhaveanepisodethatissoseverethatitrequireshospitalization. Mostpeoplehavebothepisodesofbothmaniaanddepression,butyoudon’thavetohavedepressiontobediagnosedwithmania.ManypeoplewithabipolarIdisorderdiagnosishaverecurring,back-to-backmanicepisodeswithveryfewepisodesofdepression. Whatarethetriggersofmanicepisodes? Manicepisodetriggersareuniquetoeachperson.You’llhavetobecomeabitofadetectiveandmonitoryourmood(evenkeepinga“mooddiary”)andstarttotrackhowyoufeelbeforeanepisodeandwhenitoccurs.Askfamilyandclosefriendswhoyoutrustandhaveclosecontactwithtohelpidentifyyourtriggers.Asoutsideobservers,theymaynoticechangesfromyourusualbehaviormoreeasilythanyoudo. Knowingyourtriggerscanhelpyouprepareforanepisode,lessentheeffectofanepisodeorpreventitfromhappeningatall. Commontriggerstobeawareofinclude: Ahighlystimulatingsituationorenvironment(forexample,lotsofnoise,brightlightsorlargecrowds). Amajorlifechange(suchasdivorce,marriageorjobloss). Lackofsleep. Substanceuse,suchasrecreationaldrugsoralcohol. Whathappensafteramanicepisode? Afteramanicepisodeyoumay: Feelhappyorembarrassedaboutyourbehavior. Feeloverwhelmedbyalltheactivitiesyou’veagreedtotakeon. Haveonlyafeworunclearmemoriesofwhathappenedduringyourmanicepisode. Feelverytiredandneedsleep. Feeldepressed(ifyourmaniaispartofbipolardisorder). SymptomsandCauses Whatarethesymptomsofmania? Symptomsofamanicepisode Havinganabnormallyhighlevelofactivityorenergy. Feelingextremelyhappyorexcited—eveneuphoric. Notsleepingoronlygettingafewhoursofsleepbutstillfeelingrested. Havinganinflatedself-esteem,thinkingyou’reinvincible. Beingmoretalkativethanusual.Talkingsomuchandsofastthatotherscan’tinterrupt. Havingracingthoughts—havinglotsofthoughtsonlotsoftopicsatthesametime(calleda“flightofideas”). Beingeasilydistractedbyunimportantorunrelatedthings. Beingobsessedwithandcompletelyabsorbedinanactivity. Displayingpurposelessmovements,suchaspacingaroundyourhomeorofficeorfidgetingwhenyou’resitting. Showingimpulsivebehaviorthatcanleadtopoorchoices,suchasbuyingsprees,recklesssexorfoolishbusinessinvestments. Psychoticsymptomsofamanicepisode Delusions.Delusionsarefalsebeliefsorideasthatareincorrectinterpretationsofinformation.Anexampleisapersonthinkingthateveryonetheyseeisfollowingthem. Hallucinations.Havingahallucinationmeansyousee,hear,taste,smellorfeelthingsthataren’treallythere.Anexampleisapersonhearingthevoiceofsomeoneandtalkingtothemwhenthey’renotreallythere. Howlongdoesamanicepisodelast? Earlysigns(called“prodromalsymptoms”)thatyou’regettingreadytohaveamanicepisodecanlastweekstomonths.Ifyou’renotalreadyreceivingtreatment,episodesofbipolar-relatedmaniacanlastbetweenthreeandsixmonths.Witheffectivetreatment,amanicepisodeusuallyimproveswithinaboutthreemonths. Whatcausesmania? Scientistsaren’tcompletelysurewhatcausesmania.However,thereareseveralfactorsthatarethoughttocontribute.Causesdifferfrompersontoperson. Causesmayinclude: Familyhistory.Ifyouhaveafamilymemberwithbipolarillness,youhaveanincreasedchanceofdevelopingmania.Thisisn'tdefinitethough.Youmayneverdevelopmaniaevenifotherfamilymembershave. Achemicalimbalanceinthebrain. Asideeffectofamedication(suchassomeantidepressants),alcoholorrecreationaldrugs. Asignificantchangeinyourlife,suchasadivorce,housemoveordeathofalovedone. Difficultlifesituations,suchastraumaorabuse,orproblemswithhousing,moneyorloneliness. Ahighlevelofstressandaninabilitytomanageit. Alackofsleeporchangesinsleeppattern. Asasideeffectofmentalhealthproblemsincludingseasonalaffectivedisorder,postpartumpsychosis,schizoaffectivedisorderorotherphysicalorneurologicconditionsuchasbraininjury,braintumors,stroke,dementia,lupusorencephalitis. DiagnosisandTests Howismaniadiagnosed? Yourhealthcareproviderwillaskaboutyourmedicalhistory,familymedicalhistory,currentprescriptionsandnon-prescriptionmedicationsandanyherbalproductsorsupplementsyoutake.Yourprovidermayorderbloodtestsandbodyscanstoruleoutotherconditionsthatmaymimicmania.Onesuchconditionishyperthyroidism.Ifotherdiseasesandconditionsareruledout,yourprovidermayreferyoutoamentalhealthspecialist Tobediagnosedwithmania,yourmentalhealthspecialistmayfollowthecriteriaoftheAmericanPsychiatricAssociation’sDiagnosticandStatisticalManualofMentalDisorders,DSM-5.Theircriteriaformanicepisodeis: Youhaveanabnormal,long-lastingelevatedexpressionofemotionalongwithahighdegreeofenergyandactivitythatlastsforatleastoneweekandispresentmostoftheday,nearlyeveryday. Youhavethreeormoresymptomstoadegreethatthey’reanoticeablechangefromyourusualbehavior(foursymptomsifmoodisonlyirritable).(Seethesymptomssectionofthisarticleforalistofthesymptomsusedascriteria.) Themooddisturbanceissevereenoughtocausesignificantharmtoyoursocial,workorschoolfunctioningorthere’saneedtohospitalizeyoutopreventyoufromharmingyourselforothers,oryouhavepsychoticfeatures,suchashallucinationsordelusions. Themanicepisodecan’tbecausedbytheeffectsofasubstance(medicationsordrugabuse)oranothermedicalcondition. ManagementandTreatment Howismaniatreated? Maniaistreatedwithmedications,talktherapy,self-managementandfamilyandfriendssupport. Medications Ifyouhavemaniaonly,yourhealthcareprovidermayprescribeanantipsychoticmedication,suchasariprazole(Abilify®),lurasidone(Latuda®),olanzapine(Zyprexa®),quetiapine(Seroquel®)orrisperridone(Risperdal®). Ifyouhavemaniaaspartofamooddisorder,yourprovidermayaddamoodstabilizer.Someexamplesincludelithium,valproate(Depakote®)andcarbamazepine(Tegretol®).(Ifyou’repregnantorplantobecomepregnant,letyourproviderknow.Valproatecanincreasethechanceofbirthdefectsandlearningdisabilitiesandshouldn’tbeprescribedtoindividualswhoareabletobecomepregnant.) Sometimesantidepressantsarealsoprescribed. Talktherapy(psychotherapy) Psychotherapyinvolvesavarietyoftechniques.Duringpsychotherapy,you’lltalkwithamentalhealthprofessionalwho'llhelpyouidentifyandworkthroughfactorsthatmaybetriggeringyourmaniaand/ordepression(ifyou’rediagnosedwithbipolarIdisorder). Cognitivebehavioraltherapycanbeusefulinhelpingyouchangeinaccurateperceptionsthatyouhaveaboutyourselfandtheworldaroundyou. Familytherapyisimportantsinceit’sveryhelpfulforyourfamilymemberstounderstandyourbehaviorandwhattheycandotohelp. Askyourproviderforcontactinformationforlocalsupportgroups.Youmightfindithelpfultotalkwithotherpeoplewhohavesimilarmedicalexperiencesandshareproblems,ideasforcopingandstrategiesforlivingandcaringforyourself. Othertreatments Electroconvulsanttherapy(ECT)maybeconsideredinrarecasesinindividualswhohaveseveremaniaordepression(ifbipolar).ECTinvolvesapplyingbriefperiodsofelectriccurrenttoyourbrain. Prevention WhatstepscanItaketobettercopewithormanagemymania? Althoughepisodesofmaniacan’talwaysbeprevented,youcanmakeaplantobettermanageyoursymptomsandpreventthemfromgettingworsewhenyoufeelamanicepisodemaybestarting. Someideastotryduringthistimeinclude: Avoidstimulatingactivitiesandenvironment–suchasloudorbusyplacesorbrightplaces.Insteadchoosecalmandrelaxingactivitiesandenvironments. Sticktoroutines.Gotobedatasettime,evenifyou’renottired.Also,sticktothesametimesforeatingmeals,takingmedicationsandexercising. Limitthenumberofsocialcontactstokeepyoufromgettingtoostimulatedandexcited. Postponemakinganymajorlifedecisionsandbigpurchases. Avoidpeopleandsituationsthatmighttemptyoutomakepoororriskychoices,suchastakingrecreationaldrugsordrinkingalcohol. Considerselectingsomeonetomanageyourfinancesduringamanicepisode. Ifyoueverhavethoughtsofharmingyourself,tellfamilyorfriends,callyouhealthcareproviderorcontacttheNationalSuicidePreventionLifelineat800-273-(TALK)(1-800-273-8255).Counselorsareavailable24/7. Outlook/Prognosis WhatoutcomecanIexpectifI’vebeendiagnosedwithmania? IfyourmaniaisrelatedtoadiagnosisofbipolarIdisorder,thisisalifelongdisease.Althoughthere’snocureformania,medicationandtalktherapy(psychotherapy)canmanageyourconditioninmostcases. LivingWith HowcanIinvolvefamilyandfriendsinunderstandingmymania? It’simportanttohaveanhonestconversationwithyourfamilyandclosestfriends. Letyourfamilyandfriendsknowwhatyoudoanddon’tfindhelpful.Forexample,ifyou’dappreciateafriendlyreminderabouttakingyourdailymedicationsoraquestionaboutifyouaregettingenoughsleep,letthemknow.Ontheotherhand,ifyoudon’tlikealwaysbeingaskedifyourcurrentstateofhappinessisasignyou’rehavingamanicepisode,discussthis. Askyourfamilyandfriendsiftheycanhelpidentifyyourtriggersifyoucan’t.Theymaybeabletospottriggersthatyoucan’tspotyourself.Askwhatthey’venoticedoranypatternstheymayseearoundthetimesofyourepisodes.Assoonasyourecognizeanearlysign,makeanappointmenttoseeyourhealthcareprovider.Youmayormaynotneedamedicationadjustment.However,it’sgoodtobeonthealertsinceyoursymptomscouldrapidlychange. Describehowyoursymptomsfeeltoyou.Yourfamilyandfriendswillhaveabetterunderstandingofyourcondition. Letfamilyandfriendsknowwhattypeofhelpyou’dlikefromthemandwhenyou’dlikeit.Theremaybetimeswhenyoufeelyoucancopeonyourown.Knowingthedifferencewillbehelpfulforeveryone. FrequentlyAskedQuestions Whatisacutemania? AcutemaniaisthemanicphaseofbipolarIdisorder.Itisdefinedasanextremelyunstableeuphoricorirritablemoodalongwithexcessactivityorenergylevel,excessivelyrapidthoughtandspeech,recklessbehaviorandfeelingofinvincibility. Whatisunipolarmania? Unipolarmaniaisadisorderinwhichonlyexcitement,excessactivityorenergylevelandeuphoricsymptomsareseen.Thisisararecondition. What’sthedifferencebetweenmaniaandhypomania? Hypomaniaisalesssevereformofmania.Thecriteriathathealthcareprofessionalsusetomakethediagnosisofeitherhypomaniaormaniaiswhatsetsthemapart.Thedifferencesbetweenthesetwoconditionsisasfollows: ManiaHypomaniaHowlongtheepisodelasts.Atleastoneweek.Atleastfourconsecutivedays.Severityofepisode.Causessevereimpactonsocialorwork/schoolfunctioning.Notsevereenoughtosignificantlyaffectsocialorwork/schoolfunctioning.Needforhospitalization.Possibly.No.Psychoticsymptomspresent(delusionsorhallucinations).Isamongpossiblesymptoms.Can’tbepresentforadiagnosisofhypomania. CanmydiagnosischangebetweenbipolarIdisorderandbipolarIIdisorder? No.OnceyouhaveadiagnosisofbipolarIdisorder—evenifyouneverhaveanothermanicepisodeorapsychoticevent(delusionsorhallucinations)—yourdiagnosiscanneverbechangedtobipolarIIdisorder.You’llalwayshaveabipolarIdisorderdiagnosis. AnotefromClevelandClinic Problemscandevelopinyoursociallife,work/schoolfunctioningandhomelifewhenyouhavesymptomsofmania,whichincludemoodswingsandanabnormallevelofenergyandactivity.Youmayrequirehospitalizationifyouhaveseverehallucinationsordelusions,ortopreventyoufromharmingyourselforothers.It’simportanttohaveagoodunderstandingofmania,maniasymptoms,yourparticulartriggersandwaystobettermanageyourmanicepisodes.Medications,talktherapyandsupportgroupsaswellassupportfromyourfamilyandfriendscanhelpmanageyourmania.Stayinclosecontactwithallyourhealthcareproviders,especiallyduringtimesofmanicepisodes.Yourproviderwillwanttoseeyouandmayneedchangestoyourmedicationsordose. 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