what is a manic episode

What is a manic episode? – Nancy

What is a manic episode?  Recognizing a true manic episode is critical to the diagnosis of bipolar 1 disorder.  It is not merely feeling energetic, or high-spirited.  During a manic episode, one may not be able to work, may avoid or seem fearful of family members and other close associates, and may require hospitalization.  Similar, but at a milder level, is the hypomanic state, and cyclothymia is the name of a more rare condition in which the mood swings are less intense, but still cause disruption in one’s work and daily life.

It may not always be easy to discern these varying levels of energetic states on one’s own.  Friends and family members may have a clearer view of what the symptoms are.  So think back yourself to a time when you felt excessively energized, active, optimistic or irritable.  Then ask a close associate to share their memories of that time too.  Consider the following:

Mania:  The highly energized state lasts at least a week and is characterized by:

  • Inability to perform simple functions, such as self care (preparing and eating food on a regular schedule, washing, changing clothes, and other daily tasks).
  • Inability to complete work or school work.
  • Maintaining distance from friends and family, may feel paranoia or a sense of persecution.
  • May include psychotic symptoms such as hallucinations, unrealistic beliefs or other delusions.
  • May not sleep at all for several days.
  • Engaging in risky behavior: fast driving, unsafe sex, overspending money.
  • Grandiosity: “I can do anything”.
  • Distractibility: cannot focus on a single task or thought, constantly moving on.
  • Constant activity without much accomplishment, constant talkativeness, texting and calling to the point where people are annoyed by you.
  • May require hospitalization for your own or others’ safety.

Hypomania:  Similar symptoms at a more moderate level.  May only last a few days. Characterized by:

  • Problems completing work and self-care.
  • Some sense of alienation from family members and friends.
  • Getting by on 4 or 5 hours of sleep (or much less than is usual for you).
  • Talking to people in the streets or while shopping, being talkative and more outgoing than is normal for you.
  • Spending too much money, unusual sexual behavior or other risk-taking.
  • Having an unrealistic sense of what you can do or be.
  • Heightened awareness of smells, sounds, colors; difficulty reading or focusing on one thing for long.
  • Increased activity to the point where people around you notice a significant increase.

Cyclothymia: A very mild version of the ups and downs of a mood disorder.  However, these mood swings can interfere with your regular life functions and relationships and could lead to developing the much more disruptive bipolar disorder.  The energetic phase is characterized by:

  • Hyperactivity, impulsive decision making, reckless thrill seeking.
  • Optimistic or somewhat over-optimistic view of ones abilities.
  • Getting by on less sleep than usual, some insomnia.
  • Talkativeness, sending longer emails than usual, texting more frequently.
  • Euphoria, enjoyment of the world. Still able to focus when necessary.
  • May behave more irresponsibly and impulsively.

Note that it is also possible that some or all of these symptoms may be triggered by other medical conditions, medication or substance use, and if so are not considered mania or hypomania.  However, it can be tricky to distinguish between them, and if you are concerned about any of these symptoms, you should consult a medical professional to clarify them.