mania (redirected from manias)

Mania 

Definition

Mania is an abnormally elated mental state, typically characterized by feelings of euphoria, lack of inhibitions, racing thoughts, diminished need for sleep, talkativeness, risk taking, and irritability. In extreme cases, mania can induce hallucinations and other psychotic symptoms.

Description

Mania typically occurs as a symptom of bipolar disorder (a mood disorder characterized by both manic and depressive episodes). Individuals experiencing a manic episode often have feelings of self-importance, elation, talkativeness, sociability, and a desire to embark on goal-oriented activities, coupled with the less desirable characteristics of irritability, impatience, impulsiveness, hyperactivity, and a decreased need for sleep. (Note: Hypomania is a term applied to a condition resembling mania. It is characterized by persistent or elevated expansive mood, hyperactivity, inflated self esteem, etc., but of less intensity than mania.) Severe mania may have psychotic features.

Causes and symptoms

Mania can be induced by the use or abuse of stimulant drugs such as cocaine and amphetamines. It is also the predominant feature of bipolar disorder, or manic depression, an affective mental illness that causes radical emotional changes and mood swings.

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the diagnostic standard for mental health professionals in the U.S., describes a manic episode as an abnormally elevated mood lasting at least one week that is distinguished by at least three of the following symptoms: inflated self-esteem, decreased need for sleep, talkativeness, racing thoughts, distractibility, increase in goal-directed activity, or excessive involvement in pleasurable activities that have a high potential for painful consequences. If the mood of the patient is irritable and not elevated, four of these symptoms are required.

Diagnosis

Mania is usually diagnosed and treated by a psychiatrist and/or a psychologist in an outpatient setting. However, most severely manic patients require hospitalization. In addition to an interview, several clinical inventories or scales may be used to assess the patient's mental status and determine the presence and severity of mania. An assessment commonly includes the Young Mania Rating Scale (YMRS). The Mini-Mental State Examination (MMSE) may also be given to screen out other illnesses such as dementia.

Treatment

Mania is primarily treated with drugs. The following mood-stabilizing agents are commonly prescribed to regulate manic episodes:

• Lithium (Cibalith-S, Eskalith, Lithane) is one of the oldest and most frequently prescribed drugs available for the treatment of mania. Because the drug takes four to seven days to reach a therapeutic level in the bloodstream, it is sometimes prescribed in conjunction with neuroleptics (antipsychotic drugs) and/or benzodiazepines (tranquilizers) to provide more immediate relief of mania.
• Carbamazepine (Tegretol, Atretol) is an anticonvulsant drug usually prescribed in conjunction with other mood-stabilizing agents. The drug is often used to treat bipolar patients who have not responded well to lithium therapy. As of early 1998, carbamazepine was not approved for the treatment of mania by the FDA.
• Valproate (divalproex sodium, or Depakote; valproic acid, or Depakene) is an anticonvulsant drug prescribed alone or in combination with carbamazepine and/or lithium. For patients experiencing "mixed mania," or mania with features of depression, valproate is preferred over lithium.

Clozapine (Clozaril) is an atypical antipsychotic medication used to control manic episodes in patients who have not responded to typical mood-stabilizing agents. The drug has also been a useful preventative treatment in some bipolar patients. Other new anticonvulsants (lamotrigine, gubapentin) are being investigated for treatment of mania and bipolar disorder.

Prognosis

Patients experiencing mania as a result of bipolar disorder will require long-term care to prevent recurrence; bipolar disorder is a chronic condition that requires lifelong observation and treatment after diagnosis. Data show that almost 90% of patients who experience one manic episode will go on to have another.

Prevention

Mania as a result of bipolar disorder can only be prevented through ongoing pharmacologic treatment. Patient education in the form of therapy or self-help groups is crucial for training patients to recognize signs of mania and to take an active part in their treatment program. Psychotherapy is an important adjunctive treatment for patients with bipolar disorder.

Resources

Organizations

American Psychiatric Association. 1400 K Street NW, Washington, DC 20005. (888) 357-7924. http://www.psych.org.

National Alliance for the Mentally Ill (NAMI). Colonial Place Three, 2107 Wilson Blvd., Ste. 300, Arlington, VA 22201-3042. (800) 950-6264. http://www.nami.org.

National Depressive and Manic-Depressive Association (NDMDA). 730 N. Franklin St., Suite 501, Chicago, IL 60610. (800) 826-3632. http://www.ndmda.org.

National Institute of Mental Health. Mental Health Public Inquiries, 5600 Fishers Lane, Room 15C-05, Rockville, MD 20857. (888) 826-9438. http://www.nimh.nih.gov.

Key terms

Hypomania — A less severe form of elevated mood state that is a characteristic of bipolar type II disorder.

Mixed mania — A mental state in which symptoms of both depression and mania occur simultaneously.

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mania /ma·nia/ (ma´ne-ah) [Gr.] a phase of bipolar disorders characterized by expansiveness, elation, agitation, hyperexcitability, hyperactivity, and increased speed of thought and ideas.man´ic

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ma·ni·a (mn-, mny)

n.

A manifestation of bipolar disorder characterized by profuse and rapidly changing ideas, exaggerated gaiety, and excessive physical activity.

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mania

[mā′nē·ə]

Etymology: Gk, madness

a mood characterized by an unstable expansive emotional state; extreme excitement; excessive elation; hyperactivity; agitation; overtalkativeness; flight of ideas; increased psychomotor activity; fleeting attention; and sometimes violent, destructive, and self-destructive behavior, delusions, or hallucinations.

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Mania

A hyperkinetic reaction or symptom complex seen in bipolar and other affective disorders, temporarily or regularly affecting up to 1% of the population

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mania [ma´ne-ah] (Gr.)

a phase of bipolar disorders characterized by expansiveness, elation, agitation, hyperexcitability, hyperactivity, and increased speed of thought or speech (flight of ideas). adj., adj man´ic.

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mania,

n the episode of intense euphoria found in people with bipolar disorder. Manic episodes may include rapid thought and speech, insomnia, setting unrealistic goals, or engaging in risky behaviors.

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mania

a disordered mental state of excitement. Affected animals act in bizarre ways and appear to be unaware of their surroundings. Their actions include licking and chewing of foreign materials, abnormalities of voice, apparent blindness, aggression and lack of response to normal stimuli.

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mania

Psychiatry A hyperkinetic psychiatric reaction or Sx complex seen in bipolar disorder and other affective disorders, temporarily or regularly affecting up to 1% of the population Clinical Inappropriate elation or irritability, exaggerated gaiety, severe insomnia, grandiose thoughts, and a sense of invincibility, ↑ talking speed and/or volume, disconnected and racing thoughts, hypersexuality, ↑ energy, poor judgment, poor concentration, hyperactivity, inappropriate social behavior. See Hypomania.

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Patient discussion about mania.

Q. could my child have manic depression? My 15 year old girl has been too upset about her weight but I see her at different times with too different moods. sometimes it looks like she's very depressed and sometimes she's happy but too happy- like unreal happiness. can it be bipolar? I'm really afraid

A. At 15 it is really difficult to have these conversations with your mom... does she have a good firend that you can talk to?? Or a family memeber that she gets along with and respects? If so I would take the third party approach... I would give it a little time and talk to this person about your concerns, encourage that person to talk to her about how she has been feeling/behaving and see if she will open up more with that person. Ultimately if she is sick the goal is to get her into some kind of treatment. However having said that keep in mind again that 15 year old girls can be very moody. I think if you open doors of communication with her, share with her and make sure she is aware that if she has any problem (no matter what it is) she can come to you (without consequnece) it will take time but if she ever finds herself in a dangerous position she will feel comfortable to come to you.

I wish you both well...

Q. Who will help me then? I moved out of my parents house at 18 because I couldn't deal with my dads mood swings or his drinking anymore. A friend of mine went over to my parents house one day and saw how he was acting and my mom told her about all this stuff that had been going on. My friend then said she recognized the signs of him having manic depression. I want to know what the signs are and I wanted to know if there was anything I could do to help. It doesn't help that he's making my mom depressed (she really is .I don't know what you'd call it yet though) and she has become addicted to prescription medication for her headaches). I was searching for An information and posted these questions on many forums but i didn't get any valuable response at last i found a solution and I belong to this community called iMedix. Here they have a very supportive and helpful Bipolar support group. This site has helped me a lot and I would like to share it with all of you here.

A. Hello Michael. I see you care for your parents. It may be hard for them to take advice from you. All you can do is try and get them to go see their doctor. Its wise to move away from a situation involving addiction and alcoholism as you have done. You have to go on with your life and hopefully not let the other situation drag you down. Perhaps your parents have friends or relatives that you could contact and ask for help in dealing with them. If the suggestions come from multiple fronts than maybe there is better hope the light will come on for them to seek help. For you, there is a group called Al-Anon. Its not AA. Al-Anon is for people who have been on the receiving end of having to live with an alcoholic or addicted person. They can help you. Alcoholism and drug addiction affect everyone around the one with the problem. You have been living in a tough situation. But you are strong enough to do something about it. Good for you.

Q. Effexor Hi! I am new to the forum. I was diagnosed eight months ago with effexor - induced mania and now have been diagnosed as Bipolar II, rapid cycling, with mixed states. I have a 30 year old history of treatment-resistant depression. No mania prior to the effexor. I also self-treat the depression with one hour of vigorous exercise daily, sunlight, healthy diet, regular sleep, and no stimulants or depressants including coffee and alcohol. I take omega 3, magnesium malate, calcium, zinc, selenium, and super b-complex supplements as well.

A. Hi Thank you for all... Justin,I was also ultra-rapid cycling for some months. What finally helped me was depakote. I tried Lamictal, trileptil and lithium without success prior to the depakote. I still cycle a bit but not as often, and much less drastically. I also take klonapin at night and occasionally during the day for irritable hypomanic breakthrough. The exercise and healthy lifestyle changes have hugely decreased the depressive side of me.