There are three stages of mania:
Both a manic and a hypomanic episode include three or more of these symptoms: Abnormally upbeat, jumpy or wired. Increased activity, energy or agitation. Exaggerated sense of well-being and self-confidence (euphoria)
Symptoms of a manic episode
Feeling extremely happy or excited — even euphoric. Not sleeping or only getting a few hours of sleep but still feeling rested. Having an inflated self-esteem, thinking you're invincible. Being more talkative than usual.
Signs a Manic Episode Is Ending
Slowing down and feeling less urgent and pressured all the time. Feeling more tired and getting more sleep. Being able to think more clearly, even if your memories of the manic episode are fuzzy. Making fewer impulsive decisions.
Bipolar episodes decrease brain size, and possibly intelligence. Grey matter in the brains of people with bipolar disorder is destroyed with each manic or depressive episode.
When left untreated, the symptoms of Bipolar Disorder will often increase in severity and may lead to suicide; there is a high suicide rate for people with the disorder. When treated, it's possible to control the symptoms of Bipolar Disorder and enjoy a more stable and fulfilling life.
Steroids, levodopa and other dopaminergic agents, iproniazid, sympathomimetic amines, triazolobenzodiazepines and hallucinogens were the agents that most commonly induced manic syndromes. The most common characteristics of drug-induced manic episodes were increased activity, rapid speech, elevated mood, and insomnia.
Mania lasts 1 week or longer. Alternating hypomanic (less severe mania in intensity) and depressive episodes of varying lengths. Hypomania lasts 4 days or longer. A chronic but milder form of bipolar disorder.
Mania may sometimes lead to psychotic episodes, which can trigger a misdiagnosis of schizophrenia. Bipolar may worsen with age or over time if this condition is left untreated. As time goes on, a person may experience episodes that are more severe and more frequent than when symptoms first appeared.
The healthcare professional will only diagnose a person as having a manic episode if the unusual elevated mood or irritability lasts for at least a week or if the symptoms are severe enough to make hospitalization necessary.
If they are displaying truly worrisome behaviors, like hallucinations or suicidal or homicidal thoughts, or if they seem unable to care for themselves or seem to be losing complete control of their actions, call 911.
Untreated, an episode of mania can last anywhere from a few days to several months. Most commonly, symptoms continue for a few weeks to a few months. Depression may follow shortly after, or not appear for weeks or months. Many people with bipolar I disorder experience long periods without symptoms in between episodes.
Hospitalization is considered an emergency option in bipolar disorder care. It becomes necessary in extreme cases where the disorder is causing someone to be an immediate threat to themselves or others. It may also be used when medications need monitoring or adjustment.
Learning how to manage stress through relaxation techniques, exercise, and healthy coping mechanisms can help to prevent episodes of mania or depression.
Let them know you're worried. If you're worried that your friend or family member is becoming unwell, try to address this with them gently. Don't criticise or accuse, and stay calm and non-confrontational. Explain that you've noticed changes in their behaviour and why it concerns you, and ask if they've noticed it too.
You might have hypomania and/or mania on their own or as part of some mental health problems – including bipolar disorder, seasonal affective disorder, postpartum psychosis or schizoaffective disorder. Some people find hypomania and mania enjoyable. Or you might find them very uncomfortable, distressing or unpleasant.
To help prevent a manic episode, avoid triggers such as caffeine, alcohol or drug use, and stress. Exercise, eat a balanced diet, get a good night's sleep, and keep a consistent schedule. This can help reduce minor mood swings that can lead to more severe episodes of mania.
MRIs and CT scans can provide detailed images of the brain and its structures. But currently, doctors don't use them to diagnose bipolar disorder. Detecting bipolar disorder is typically done through a diagnostic interview with a mental health professional.
Chemical imbalance in the brain
For example, there's evidence that episodes of mania may occur when levels of noradrenaline are too high, and episodes of depression may be the result of noradrenaline levels becoming too low.
Lithium remains a highly effective pharmacological treatment for acute mania. For patients with classic mania, which refers to the presence of euphoria, grandiosity and hyperactivity in a person with a stable episodic course, many experts prefer lithium as a first-line medication.
A bipolar depression crash is usually the emotional fallout of a hypomanic or manic episode. It can also occur when something triggers bipolar depression or as a result of chemical or hormonal changes in the brain.