How Do You Define Mania, And What Are The Symptoms?

Bipolar disorder is a mood disorder marked by shifts between periods of depression and mania. Mania is a symptom of bipolar disorder that may be misunderstood, including by those who experience it. Common symptoms of mania include an elevated mood, increased energy levels, rapid speech, decreased need for sleep, and reckless behavior. One way to understand and cope with mania is education. When you know what signs to look out for, your chances of seeking care may increase. 

While it may seem a positive experience when one is experiencing it, mania can lead to serious, potentially dangerous outcomes, especially without treatment. For this reason, it may be helpful to familiarize yourself with common symptoms related to mania.

What is a manic episode?

Mania involves an elevated mood and a spike in energy levels for at least a week. It is a symptom of bipolar I disorder and can severely affect health and well-being. Mania is considered when the extreme mood shift impacts functioning levels. For some people with bipolar disorder, the symptom is accompanied by psychosis, paranoia, and significant delusions. Someone with mania might become irritable, euphoric, or easily distracted. Mania symptoms can also include racing thoughts, delusions of grandeur, and rapid speech. 

Mania is not happiness or positivity. To be diagnosed with mania, you must live with bipolar I disorder. Mania is also different from hypomania, which is a less severe form of the symptom seen in bipolar II disorder. 

The symptoms of manic episodes 

The presentation of mania may vary from person to person and episode to episode, so not all symptoms must be present for a person to require support. Below are a few of these symptoms. 

Sleep deprivation 

When someone is experiencing mania, they may struggle to fall or stay asleep for hours or days on end. Despite sleep deprivation, they might not experience the effects of the lack of sleep during a manic episode, believing they do not need sleep. 

Extreme changes in mood

Elation, euphoria, and a sense that one is not real can occur during mania. This mood switch may drastically change a person's appearance and personality.  

Obsessive behaviors

Some people experiencing mania showcase obsessive behaviors, like cleaning excessively or focusing on tiny details without being able to move forward. This category can also include racing thoughts or excessive talking. 

Ignoring hygiene 

A person experiencing mania may invest little time in daily tasks like brushing their teeth, changing clothes, or eating. Contrarily, they may obsess over these routines and focus more on their appearance. 

Risky behavior 

Mania can lead to grandiose delusions, which may cause an individual to become unconcerned with the consequences of their actions. Because of these thought patterns, they may be more likely to engage in dangerous or impulsive behaviors. They may, for instance, pick fights when they go out or speed excessively when they drive. Poor spending habits, risky sexual encounters, and other examples of changes in a person's behavior may point to mania.

Mania and bipolar disorder

Bipolar disorder is a serious mental illness characterized by extreme mood swings that range between intense highs (mania) and lows (depression). Those with bipolar disorder may experience symptoms like those mentioned above in addition to depressive or hypomanic symptoms. In a pattern known as rapid cycling, an individual with bipolar disorder experiences at least four hypomanic, manic, or depressive episodes in a year. Many people also experience mixed episodes, which are characterized by both manic and depressive symptoms. According to a study published in the International Journal of Bipolar Disorders (Int J Bipolar Disord), “5–40% of manic subjects present with concomitant depressive symptoms”. 

While the exact cause of bipolar disorder is unknown, one of the primary contributors is abnormalities in the structure and function of certain brain regions. For example, there is thought to be a link between decreased volume in the prefrontal cortex and mania. Other common risk factors include a family history of psychiatric disorders, traumatic or stressful events (e.g., a serious medical condition or an extreme change in one’s life circumstances), and the use of recreational drugs. 

Bipolar disorder can have a significant impact on an individual’s relationships, occupational functioning, and mental well-being. In some cases, people with mania require hospitalization. If you believe you’re living with bipolar disorder, a healthcare provider can administer screenings and determine whether further tests, a diagnosis, and treatment are necessary. 

The three primary types of bipolar disorder are bipolar I disorder, bipolar II disorder, and cyclothymic disorder. 

Bipolar I disorder

Bipolar I disorder is diagnosed when someone with bipolar disorder has experienced at least one manic episode for one week or more. Major depressive episodes may also occur in this subtype but do not need to be present for diagnosis. Mania can only be experienced by those with bipolar I disorder and is absent in other subtypes. 

Bipolar II disorder

Bipolar II disorder is diagnosed when someone experiences at least one episode of major depression and one hypomanic episode. While hypomanic and manic episodes produce similar symptoms—both involve impulsivity, increased mental activity, and heightened mood—hypomania is a less severe form of mania. People with bipolar II disorder must not experience true mania and must have depressive episodes.  

Cyclothymic disorder

Cyclothymic disorder is diagnosed when a person has mild symptoms of bipolar disorder that last over two years. While cyclothymia and bipolar I and II are characterized by similar symptoms, periods of low or high mood are generally less severe in cyclothymic disorder and do not rise to the level of depression or hypomania (though they may be more frequent). 

Treatments and lifestyle changes 

Regardless of where your mania stems from, treatment is possible, and some people with bipolar disorder find symptom relief with support. Research suggests combining cognitive-behavioral therapy (CBT) and medication may improve treatment outcomes. Additionally, psychosocial interventions—which often focus on improving social or occupational functioning—are often incorporated into treatment plans.  

Medication

Specific prescriptions may help you manage the symptoms of mania. Mood stabilizers and antipsychotics are frequently prescribed to alleviate manic symptoms. However, results can differ depending on the individual. It may take trial and error to locate a medication that helps you feel better, so be patient and be honest with your doctor about side effects and symptoms. In addition, consult your doctor before starting, changing, or stopping any medication. 

Journaling 

Writing about your moods and thoughts in a journal may be beneficial to track how they change throughout your life. If you struggle to remember your manic episodes, a journal can help you determine what events might incite mania and what behaviors to target in therapy. 

Avoiding inciting events 

Once you know what incites your mania, attempt to avoid these situations. For example, using substances, being around an unkind family member, or going to a bar with friends may cause symptoms to arise for some people. 

If you are struggling with substance use, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at (800) 662-4357 to receive support and resources.

Support system

In a study published in the Journal of Affective Disorders (J Affect Disord), researchers found that episodes of mania may weaken social connections more severely than episodes of depression. Humans are social beings, and there is evidence that a substantial and healthy social support systems can improve mental and physical health. 

Healthy eating 

Nourishing yourself by eating healthy foods can equip you to maintain your routine and keep yourself on track. In addition, it's healthy for your mind and body. 

Sleeping well 

Mania can cause people to lose sleep. Conversely, sleep disruptions can cause or worsen mania (sleep loss is also thought to contribute to postpartum psychosis in individuals with bipolar disorder). Because of these potential negative effects, sleeping at least seven hours and at the proper times can be essential. You may have to put yourself on a sleeping schedule to get the rest you require. If you experience extreme insomnia, consider reaching out to a sleep doctor for support.

Therapy 

As you seek treatment for mania, having a place to turn to for support, advice, and guidance can be helpful. In addition to speaking to a medical professional like a doctor or psychiatrist, you can contact a therapist. A qualified professional can provide you with emotional support, identify the sources of your symptoms, and help you address symptoms of potential comorbid mental disorders. 

If you face barriers to in-person therapy, online therapy through a platform like BetterHelp may be more reachable. Because you can join sessions from home, work, your car, or wherever you have an internet connection, you may be able to fit online therapy into your schedule with more ease. In addition, you may be able to save yourself time and money by avoiding making commutes to an in-person office. 

Including for severe symptoms like mania, research suggests that web-based treatment can be as effective as in-person therapy. One recent study analyzing the impacts of smartphone-based and online counseling services for people with bipolar disorder found the services impactful in managing symptoms.