Mania in bipolar disorder causes high energy levels and may come with euphoria or agitation. The symptoms include a reduced need for sleep, racing thoughts, and restlessness.

Manic episodes can also alter a person’s perception of reality. For example, someone with mania may believe they are invincible. Therefore, it can affect a person’s judgments, leading to impulsive or unsafe behavior.

This article will discuss mania in bipolar disorder, its stages, symptoms, potential triggers, and how people can manage and treat it.

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Mania is a period of high energy that can occur in some people with bipolar disorder. The person may experience euphoria or agitation, decreased sleep, rapid speech, and distorted beliefs.

Not everyone with bipolar disorder experiences mania. There are three types of bipolar disorder:

  • bipolar 1 disorder
  • bipolar 2 disorder
  • cyclothymic disorder

In bipolar 1 disorder, mania can sometimes be the only symptom. Usually, though, people alternate between mania and depression or experience features of both simultaneously.

To some, it may seem as though mania is the less serious of these two mental states, but because it can alter perceptions, it can be just as harmful.

Mania in bipolar disorder can take two forms: hypomania and acute mania. Hypomania is less severe, and those with it can usually carry on their usual activities without major disruptions.

In contrast, acute mania is more severe and significantly affects a person’s ability to function. It can also last longer, with a duration of at least 1 week as opposed to several days. However, if someone requires hospitalization, they have acute mania regardless of how long it has lasted.

Only people with bipolar 1 disorder experience hypomania that progresses to acute mania. People with other types of bipolar disorder, such as bipolar 2 and cyclothymia, only experience hypomania.

The symptoms of mania vary depending on the person and whether they have hypomania or acute mania. In hypomania, the symptoms may include:

  • feeling energized or excited
  • feeling happy or euphoric
  • irritability or agitation
  • sleeping less than usual
  • higher sex drive
  • higher self-confidence
  • fewer social inhibitions
  • difficulty concentrating
  • racing thoughts

If hypomania becomes acute mania, a person may also experience:

  • intense excitement
  • difficulty sleeping or not sleeping at all
  • a flight of ideas, which is when someone’s thoughts and speech move rapidly from one idea to another
  • grandiose ideas, such as a belief they are invincible or understand things others cannot
  • impatience or hostility toward others
  • hallucinations

These symptoms can lead people to take risks and decisions that can be harmful to their safety, such as spending lots of money, traveling far away, having sex without a barrier method, or damaging property.

The factors that may trigger manic episodes can vary from person to person. According to the United Kingdom charity Mind, these can include:

  • high stress
  • lack of sleep
  • alcohol or drugs
  • loss or bereavement
  • a major life event, such as job loss or divorce
  • childbirth
  • certain medications
  • seasonal changes, as some people are more likely to experience mania in spring

Understanding what triggers mania can help people who have bipolar disorder reduce the frequency of manic episodes.

To diagnose mania, doctors ask the person or their loved ones about their recent symptoms. Doctors sometimes use the acronym DIG FAST to measure this, which stands for:

  • distractability
  • impulsivity or irritability
  • grandiosity
  • flight of ideas
  • increased activity
  • decreased sleep
  • excessive talkativeness

One episode of mania can be enough to meet the criteria for a diagnosis of bipolar 1 disorder.

Treatment for mania in bipolar disorder typically involves a combination of talk therapy and medications. The medications can help reduce mania and may also stabilize a person’s mood to prevent future episodes. Classes of drugs that a doctor may prescribe include:

  • mood stabilizers
  • antipsychotics
  • antidepressants

It may take some time to find the medication or combination of medications that works best.

Talk therapy can help people accept their condition, learn new skills to manage stress and other potential triggers for episodes, and recognize the warning signs of an incoming episode.

Education of family and friends can also help. This may help loved ones understand the symptoms and what to do if they arise.

Coping with mania

Certain self-care strategies may help people with mania reduce the frequency of episodes. This includes:

  • taking medications as a doctor has prescribed
  • reducing stress
  • avoiding alcohol or drugs
  • keeping a consistent sleep routine
  • eating a nutritious diet
  • exercising regularly
  • keeping a mood journal to understand mood patterns
  • checking with a doctor before taking new supplements or medications to prevent any drug interactions
  • updating doctors about any changes in symptoms or side effects

People who experience mania or suspect they may have bipolar disorder should contact a doctor as soon as possible. Treatment is available and can help avoid manic episodes and their potential risks.

If a person experiences an acute manic episode, they or their loved ones should seek medical attention. If the individual’s behavior is putting them or others in danger, it may be necessary to go to the emergency room.

Taking medication is vital for managing bipolar disorder and reducing the risk of manic or depressive episodes returning. If a person notices someone with bipolar disorder has not been taking their medications, an individual needs to speak with them about this promptly.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Mania in bipolar disorder is a state of mind in which a person feels extremely energetic. They may feel agitated or euphoric, sleep much less than usual, and have false beliefs or a distorted perception of reality.

People can experience a milder form of mania, known as hypomania, or a more severe form, which doctors call acute mania. The former does not significantly interfere with daily life, but acute mania can require a stay in the hospital.

Treatment for mania can stabilize a person’s mood and reduce future episodes. If an individual’s mood suddenly becomes energetic, irritable, or euphoric with no clear cause, they should seek medical advice.