The English used in this article may not be easy for everybody to understand. (September 2011)
Mania is a symptom, not an illness by itself. Many different things can cause mania. These things include illegal drugs and brain tumors. However, most of the time, mania happens in people with bipolar disorder. Bipolar disorder causes periods of mania that switch off with periods of depression.
Like with other symptoms, mania can be mild (not very bad), severe (very bad), or anywhere in between. Mild mania is usually called "hypomania." Very bad mania can cause psychosis, with hallucinations and delusions.
In some cases, people with mania may need to be hospitalized so they do not hurt themselves or other people. On the other hand, many people with mania and hypomania have special creativity and artistic talents.
The most common symptoms of mania are:
- A mood that is either euphoric (very happy) or irritable (easily irritated or angered)
- Being very talkative. This includes talking very quickly (pressured speech) and jumping from one idea to the next very quickly (flight of ideas).
- Having an unusual amount of energy
- Not needing sleep
- Being very hyper
Other symptoms of mania can include:
- Racing thoughts, which can sometimes make it impossible for the person to concentrate on anything other than their thoughts
- Acting impulsively (doing things without thinking them through), like spending a lot of money or having unsafe sex. People are more likely to put themselves in danger when they are manic.
- Physical symptoms, like sweating, pacing, and losing weight
- Hypersexuality (wanting to have sex much more than usual)
- Delusions, like:
- Delusions of grandeur: The person believes he is very important - for example, that he knows everything, or is famous, all-powerful, or very wealthy
- Delusions of potential: The person believes he can do things he cannot really do (for example, believing he can build a house on his own, when he has never built anything before)
- Delusions of persecution: The person believes other people are "out to get him" and are causing his problems on purpose
Official diagnosis (DSM-5)
In the United States, a book called The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, is used to diagnose mental illnesses. According to the latest version of the DSM, the DSM-5, a person is having a "manic episode" if all of these things are true:
- The person's mood has been unusually euphoric or irritable for seven days or more
- The person's mood changes are not caused by illegal drugs, medicine, or a medical illness
- The person's mania is:
- Causing them obvious problems at work, with family, or friends; OR
- Making them psychotic; OR
- Making them a danger to self or others
In addition, the person must also have three or more of these symptoms:
- Inflated self-esteem or grandiosity (the person feels like he is very important and special)
- Needs only a little sleep to feel rested
- More talkative than usual; or the person seems like they have to keep talking (pressured speech)
- Jumping from one idea to another; or the person feels like their thoughts are racing
- Increase in "goal-directed activity," like taking on big new projects; or "psychomotor agitation" (moving around a lot, unable to sit still)
- Being easily distracted (the person's attention is drawn too easily to things that are not important)
- Doing a lot of activities that have a high risk of turning out badly (for example, spending a lot of money; going on sexual adventures)
Official diagnosis (ICD-10)
- The person's mood is euphoric, and can change from being happy and carefree, to "almost uncontrollable excitement"
- The person has an unusual amount of energy and is always doing some kind of activity
- The person seems like they have to keep talking
- The person does not seem to need sleep
- The person cannot pay attention to anything, and gets distracted very easily
- Often, the person feels very important, is much more confident than usual, and has unreasonable ideas about what they can do (for example, they may feel like nothing can stop them from getting what they want)
- The person does not have normal social inhibitions (a sense of what is right and appropriate to do around other people). This can lead to behavior that is inappropriate, reckless, and unusual for the person.
Mania is usually a symptom of mental illness, most often bipolar disorder. A diagnosis of type I bipolar disorder (bipolar I disorder) can be made based on a single manic episode. This is the most common cause of mania.
- Endocrine: Hyperthyroidism, hypothyroidism, or Cushing's syndrome can cause mania. (These are all problems with hormones in the body)
- Medications: Many different medications can have mania as side effects. These medications include amphetamines (often used to treat Attention-Deficit Hyperactivity Disorder, or ADHD); antidepressants; corticosteroids; opiate painkillers, and many others.
- Abuse of alcohol or illegal drugs: Alcohol and many other drugs can cause mania. These drugs include cocaine, amphetamines, phencyclidine (PCP), lysergic acid diethylamide (LSD), inhalants, opiates, anabolic steroids, and MDMA (Ecstasy).
- Neurologic problems: Many different problems with the brain can cause mania. For example, brain tumors, brain injury, multiple sclerosis, and Huntington's disease can all cause manic symptoms.
- Infection: Infections in the brain can cause mania. Examples include meningitis, brain infections caused by HIV/AIDS, and neurosyphilis (the last stage of syphilis, when the disease reaches the brain)
- Cardiovascular causes and Cerebrovascular accidents (strokes)
If mania is caused by a medical problem, the best thing to do is to treat that medical problem.
Doctors usually treat mania with a combination of mood stabilizers and antipsychotic medicines. While taking these medicines, the patient should see their doctor regularly to be checked for side effects.
When the symptoms of mania have ended, long-term treatment then focuses on preventative treatment. The goal of this kind of treatment is to prevent periods of mania or depression from happening. Very often, this is done using a combination of drugs and psychotherapy. Medication works best for bipolar disorder, and other mental illnesses, when it is combined with other treatments like psychotherapy.
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