Symptoms and Diagnosis of Bipolar Mania

Diagnosis Relies on a Cluster of Known Symptoms

Symptoms of Bipolar Mania
GSO Images Collection/Photographer's Choice RF/Getty Images

Mania is a phase of bipolar disorder characterized by sustained periods of abnormally elevated mood and other behaviors considered extreme or exaggerated. The features of bipolar mania can vary from person to person and can last anywhere from a few days to several months.

As a facet of bipolar disorder, a manic episode can be interspersed with periods of depression during which an individual may experience many of the opposite symptoms (fatigue, sadness, hopelessness).

In addition to "classic" bipolar mania, there is a milder form called hypomania which is typically shorter lasting and more manageable.

Variations in Bipolar Mania

Mania fits into the bipolar puzzle in different ways depending on the type of bipolar disorder involved. Broadly speaking:

Diagnosis of Bipolar Mania

Typically speaking, bipolar mania is diagnosed by an abnormally elevated mood, which doesn’t mean the person is necessarily upbeat. Rather, it suggests an exaggeration of behaviors ranging from an expansiveness and grandiosity to extreme irritability or hostility.

A person experiencing bipolar mania will also have an abnormal increase in energy, which can play out as a sudden burst of creativity or a scattered period of frenzied activity.

In and of themselves, none of these behaviors diagnose bipolar mania unless:

  • All other causes of the behaviors have been ruled out including drugs, anxiety disorders, panic attacks, etc.
  • The behavior is seen to interfere with a person’s day-to-day living.

Generally speaking, a manic episode must last for a period of no less than one week or have required hospitalization.

Features of Bipolar Mania

When either confirming or ruling out bipolar mania, a licensed mental health professional will look for at least three of the following features:

  • Inflated self-esteem or grandiose thinking in which a person believes he or she is better at doing something than anyone else or is able to accomplish a difficult task in hours instead of days or weeks.
  • Needing little sleep and not feeling fatigued when sleep deprived.
  • Rapid and relentless verbosity, including the pressure to keep talking (pressured speech) even when others try to speak.
  • Flight of ideas and/or racing thoughts which manifest a continuous stream of consciousness, a repetitive cycle of thoughts, or as fragmented, incoherent thought.
  • Being easily distracted, unable to focus, or fixated on a task you can’t pull yourself away from.
  • Psychomotor agitation, a severe form of restlessness which manifests with pointless movement, jitteriness, or repetitive motion.
  • Inappropriate behavior that either doesn’t strike the person as being offensive or is easily brushed off.
  • Indulging in high-risk activities, including gambling, excessive or lavish spending, and obsessive hypersexual behaviors.

In extreme circumstances, a person may experience symptoms of psychosis, defined as a break from reality characterized by hallucinationsdelusions, or paranoia.

Treating Bipolar Mania

A person diagnosed with a full manic episode will typically be prescribed antipsychotic drugs in association with psychotherapy (including cognitive behavioral therapy (CBT), family-focused therapy, or group therapy).

Mood stabilizers are most often used for long-term management and the prevention of future episodes.

Persons with persistent or severe manic episodes may benefit from electroconvulsive therapy (ECT), particularly if there are suicidal thoughts.

Source:
National Institute of Mental Health: National Institutes of Health. "Bipolar Disorder." Bethesda, Maryland; updated April 2016.

Continue Reading