» Conditions » Bipolar Disorder » Manic Episode
What are Manic Episodes?
A manic episode is characterized by an unusually euphoric or agitated state that lasts at least one week. A manic episode represents a change from normal functioning and often profoundly interferes with work and personal relationships. Many times people experiencing a manic episode require hospitalization to return them to a normal level of functioning. A manic episode typically includes three or more of the following symptoms:
Inflated Self-Esteem or Grandiosity
This symptom can range from extreme self-confidence to delusional grandiosity. People may believe they can do things that they have no talent or training to do, such as win a sports championship, head a nation, or compose a symphony. Sometimes people claim they are being protected by powerful friends, such as government leaders. Keep in mind that not everyone who makes claims such as these is manic or delusional; always make sure you know more of a person's background before dismissing his or her ideas as inflated self-esteem.
Decreased Need for Sleep
This is one of the most common symptoms of a manic episode. People may get only a few hours of sleep a night, or may go for days without sleep and still seem to be (and claim to feel) refreshed and energetic.
Extremely Talkative/Pressured Speech
Speech becomes loud, fast, and difficult to interrupt. (Imagine one of Robin Williams' more hyperactive characters, talking faster and much more out of control than usual.) Family or friends may notice that a person is talking much more than usual.
Distractibility
People who seem to be easily distracted or have trouble concentrating on any one task may be experiencing this symptom. People with this symptom may be unable to carry on a logical conversation for any length of time.
Racing Thoughts/Flight of Ideas
For many people experiencing this symptom, it seems that thoughts are flying through their minds. Some people compare their thought process to watching two or three TV sets at once. Conversation may switch from topic to topic, with loose connections between topics.
Excessive Involvement in Pleasurable Activities
Involvement in pleasurable activities is considered a symptom of mania when it results in negative consequences. People experiencing this symptom may spend a lot of money on strange and/or excessive purchases. People may spend well beyond their means, sometimes buying many copies of one item or a collection of items that are all related to each other in
a peculiar way. This symptom could also appear as sexual behavior that is excessive and unusual for the person. This is sometimes called "hyper-sexuality" and can range from fantasizing excessively and being preoccupied with sex to actual behavioral excess, or acting out in a sexual manner.
Increase in Goal-Directed Activity/Agitation
High levels of activity are often aimed at accomplishing work or social goals. People experiencing this symptom may begin many different projects at one time or try to do more than is realistically possible. For example, in a single morning, a person may decide to mop the floor twice, paint the roof, mow the lawn, fill a pothole near the driveway and write letters to everyone that he or she graduated with from high school. Agitation (or restlessness) is another symptom. People may feel they have too much energy and can't sit still. Many people find themselves becoming easily irritated.
Causes
Although researchers have many more questions to answer, current evidence suggests that a chemical imbalance in the brain causes the symptoms of manic episodes. It seems that during an episode, there are unusually high levels of norepinephrine in a person's brain.
There is a strong genetic component to bipolar disorder--those with a family history of the illness are more likely to get it.
Treatment
The sooner a manic episode is treated, the sooner recovery can begin. Basic ways to treat the condition include therapy, medication, and a combination of the two.
Therapy
There are therapists who are especially skilled at helping people who are suffering from manic episodes. Therapy provides a safe, comforting, and confidential setting in which to receive the kind of help and understanding that can best assist in first relieving the symptoms, then recovering, and finally protecting the patient from future recurrences.
Medication
Medication is often the first step in treating manic episodes because of the relatively quick relief it can bring to physical symptoms.
Combination of Medication and Psychotherapy
Both therapy and medication used together can have very successful results in treating manic episodes. Combination therapy is especially helpful in dealing with the condition and how it affects their lives.
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