Mania in bipolar disorder can blindside you, but you can manage it mindfully if you know what to look for.
For people living with certain types of bipolar disorder, episodes of mania can be intense, challenging experiences.
Mania is when a person feels extremely energetic, euphoric, or irritable, for days, weeks, or months on end.
When you’re experiencing symptoms of mania, you might do things impulsively that have social, sexual, financial, work-related, or legal consequences. You may also need only a few hours of sleep but still feel lively.
It can be challenging to function — learn, work, parent, and so much more — when an episode arises, but learning strategies to cope can give you an advantage in managing your mania.
While we have some ideas, experts don’t know the exact cause of bipolar disorder or mania. Still, there are several strategies you can try to help reduce or prevent episodes of mania.
Don’t miss a dose of your meds
It’s important to take yours meds every day as prescribed. Sticking to your treatment plan is essential for preventing mania from escalating.
If you’re concerned about medication side effects or want to make adjustments, you can reach out to your treatment team. They can help you figure out the best next steps.
Avoid anything that may interact with your meds
Drinking alcohol while taking medications for bipolar disorder can lead to issues with memory, poor judgment, confusion, dizziness, and more.
The same goes for cannabis use. Despite some opinions that cannabis can help calm symptoms of mania, it can actually exacerbate manic episodes.
If you’re not sure what else might interact with your meds, you can reach out to your doctor or a pharmacist for advice.
Get regular sleep
Getting enough sleep not only helps your overall well-being, but can make a difference in managing bipolar disorder symptoms.
Make sure to prioritize your sleep. Consider:
- Sleeping and waking up at the same time every day.
- Develop a peaceful, regular sleep routine that works for you.
- Create a soothing sleep environment and avoid screens before bed.
Track your symptoms and moods
To figure out when you might start having an episode of mania, it can help to keep track of any mania-related shifts in your moods and symptoms. Using a calendar, planner, app, or journal, you can learn your body’s rhythm and cycle.
It can be enlightening and motivating to check in with yourself, like how you’re feeling and any changes in behaviors that you or others have noticed.
Practicing any type of self-care — even if it’s small — can help improve your mood. So make time every day to do things you enjoy.
Creating specific routines and forms of self-care can help you better manage your condition and prevent mood episodes.
Everyone is different, but several things that happen in your day-to-day life can potentially trigger mania:
- not getting enough sleep
- stress, such as from school or work,or in your relationships
- substance use
- certain medications
Understanding how everyday events may lead to mania means you can be proactive in your mental health and well-being.
For people with bipolar disorder, the causes of mania are still unclear. Mania can be set off by certain lifestyle factors like lack of sleep or substance use. It may also occur after a significant event such as childbirth or trauma.
Some other possible causes of mania include:
- changes in season; some people may be more likely to experience mania in the spring
- a big life change, like moving or going through a breakup
- side effects of a medication change
- someone in your family having bipolar disorder
Manic episodes have specific symptoms that can let you know if you may be about to enter into one.
For some people, an episode of mania may result in hospitalization if symptoms are severe.
Types of bipolar disorder that include mania
Mania is a feature of bipolar I disorder and bipolar disorder with mixed episodes.
In other types of bipolar disorder like bipolar II, someone might experience hypomania. This is a slightly more subdued form of mania where the symptoms are the same but less severe.
In hypomania, symptoms may be aggravating or a nuisance, but aren’t usually as noticeable as symptoms of mania.
Episodes of mania in bipolar disorder can be challenging to navigate. It can be tricky to recognize the signs of an impending mood episode or know what to do when one comes on.
Everyone’s lived experience with bipolar disorder is unique, and the same goes for mania. Mania may present differently for you than for someone else, so learning more about it can help you figure out what your episodes look like.
With the help of preventive strategies, medication, and self-care, you can feel better and manage your mania before it escalates.
Dealing with Bipolar Disorder Manic Episodes - Psychology
Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and abnormally elevated moods. If the elevated mood is severe or associated with psychosis, it is called mania if it is less severe, it is called hypomania.
DSM-5 Diagnostic Criteria
While all of us feel highs and lows and may even experience euphoria and depression, bipolar disorder is a much more severe, debilitating clinical disorder. The “bipolar spectrum” refers to the range in which these alternating moods may occur and includes bipolar I, bipolar II, cyclothymia, and other specified bipolar and related disorder. For all of these diagnoses to be made, the symptoms must indicate a major change from the person’s typical mood.
Anxiety and Mania - Is There A Relationship?
Many people feel as though they are somewhat "manic" and energized when they have anxiety. But anxiety doesn't cause or contribute to mania.
The reason that mania occasionally contributes to anxiety is because manic episodes themselves can be extremely stressful. During a manic episode, a person feels completely energized to get numerous things completed. They may even be more sexually risky, or have some awkward social engagements. Experiences of mania may also feel out-of-control which could lead to anxiety.
Mania and anxiety are sometimes even similar. Anxiety can create a feeling of nervous energy, as can mania. Mania is harder to control though and tends to result in marked personality changes in a way that anxiety doesn't and there is a "high" to mania that isn't present with anxiety. Anxiety and mania may also both be characterized by racing thoughts or distractibility.
So while they may be similar, and mania can cause anxiety, mania and anxiety are definitely two separate conditions.
Signs of Bipolar Disorder
The defining feature of bipolar disorder is mania. It can be the triggering episode of the disorder, followed by a depressive episode, or it can first manifest after years of depressive episodes. The switch between mania and depression can be abrupt, and moods can oscillate rapidly. But while an episode of mania is what distinguishes bipolar disorder from depression, a person may spend far more time in a depressed state than in a manic or hypomanic one.
Hypomania can be deceptive it is often experienced as a surge in energy that can feel good and even enhance productivity and creativity. As a result, a person experiencing it may deny that anything is wrong. There is great variability in manic symptoms, but features may include increased energy, activity, and restlessness euphoric mood and extreme optimism extreme irritability racing thoughts, unusually fast speech, or thoughts that jump from one idea to another distractibility and lack of concentration decreased need for sleep an unrealistic belief in one's abilities and ideas poor judgment reckless behavior including spending sprees and dangerous driving, or risky and increased sexual drive provocative, intrusive, or aggressive behavior and denial that anything is wrong.
The duration of elevated moods and the frequency with which they alternate with depressive moods can vary enormously from person to person. Frequent fluctuation, known as rapid cycling, is not uncommon and is defined as at least four episodes per year.
Just as there is considerable variability in manic symptoms, there is great variability in the degree and duration of depressive symptoms in bipolar disorder. Features generally include lasting sad, anxious, or empty mood feelings of hopelessness or pessimism feelings of guilt, worthlessness, or helplessness a loss of interest or pleasure in activities once enjoyed, including sex decreased energy and feelings of fatigue or of being "slowed down" difficulty concentrating, remembering, or making decisions restlessness or irritability oversleeping or an inability to sleep or stay asleep change in appetite and/or unintended weight loss or gain chronic pain or other persistent physical symptoms not accounted for by illness or injury and thoughts of death or suicide, or suicide attempts.
The symptoms of mania and depression often occur together in "mixed" episodes. Symptoms of a mixed state can include agitation, trouble sleeping, significant change in appetite, psychosis, and suicidal thinking. At these times, a person can feel sad yet highly energized.
Triggers of mania and depression in young adults with bipolar disorder
Background: Early intervention significantly decreases the impact of bipolar disorder. However, there is little research investigating triggers that may be unique precipitants of manic/hypomanic episodes, and how these may differ from triggers specific to bipolar depression, in young adults with the disorder.
Methods: Individuals aged 18 to 30 years who had been diagnosed with bipolar disorder (n=198) completed an online survey to identify triggers unique to mania/hypomania and depression, as well as triggers which were common to both. Respondents rated how frequently a series of situations and behaviours had precipitated either a manic/hypomanic episode or a depressive episode in the past. Survey data was supplemented by in-depth face-to-face interviews (n=11).
Results: Triggers specifically associated with the onset of manic/hypomanic episodes included falling in love, recreational stimulant use, starting a creative project, late night partying, going on vacation and listening to loud music. Triggers associated with depressive episodes included stressful life events, general stress, fatigue, sleep deprivation, physical injury or illness, menstruation and decreases in physical exercise. A further set of triggers were identified as being common to both manic/hypomanic and depressive episodes. Consistent themes arose from the analysis of face-to-face interviews, which extended and illuminated the findings of the survey data.
Conclusions: Identification of a unique set of triggers for mania/hypomania and a unique set for depression in young adults with bipolar disorder may allow for earlier identification of episodes, thus increasing opportunities for early intervention.
Depression and Mania in Bipolar Disorder
Background: Episode duration, recurrence rates, and time spent in manic and depressive phases of bipolar disorder (BD) is not well defined for subtypes of the disorder.
Methods: We reviewed the course, timing, and duration of episodes of mania and depression among 1130 clinically treated DSM-IV-TR BD patients of various types, and compared duration and rates as well as total proportion of time in depressive versus manic episodes during 16.7 average years at risk.
Results: As expected, episodes of depressions were much longer than manias, but episode-duration did not differ among BD diagnostic types: I, II, with mainly mixed-episodes (BD-Mx), or with psychotic features (BD-P). Recurrence rates (episodes/year) and proportion of time in depression and their ratios to mania were highest in BD-II and BD-Mx subjects, with more manias/year in psychotic and BD-I subjects. In most BD-subtypes, except with psychotic features, there was more time in depressive than manic morbidity, owing mainly to longer depressive than manic episodes. The proportion of time in depression was highest among those who followed a predominant DMI course, whereas total time in mania was greatest in BD with psychotic features and BD-I. and with an MDI course.
Conclusions: Subtypes of BD patients differed little in episode-duration, which was consistently much longer for depression. The findings underscore the limited control of bipolar depression with available treatments.
Keywords: Bipolar disorder cycle length depression duration of episodes mania polarity.
How to Cope with Bipolar Disorder (Manic Depression)
This article was co-authored by Ran D. Anbar, MD, FAAP. Dr. Ran D. Anbar is a pediatric medical counselor and is board certified in both pediatric pulmonology and general pediatrics, offering clinical hypnosis and counseling services at Center Point Medicine in La Jolla, California and Syracuse, New York. With over 30 years of medical training and practice, Dr. Anbar has also served as a professor of pediatrics and medicine and the Director of pediatric pulmonology at SUNY Upstate Medical University. Dr. Anbar holds a BS in Biology and Psychology from the University of California, San Diego and an MD from the University of Chicago Pritzker School of Medicine. Dr. Anbar completed his pediatric residency and pediatric pulmonary fellowship training at the Massachusetts General Hospital and Harvard Medical School and is also a past President, fellow and approved consultant of the American Society of Clinical Hypnosis.
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Bipolar disorder can make it really hard to live the life you want, but there is hope. It's possible to manage your condition so that it has a smaller impact on your life. You can cope with bipolar disorder by learning how to handle both depressive and manic episodes. Additionally, you may be able to regulate your moods by managing stress and following a treatment plan.
What does the Bible say about Bipolar Disorder?
Note: as with many psychological issues, there are often both a physical and spiritual aspect of manic depression/bipolar disorder. While we believe psychologists often miss the true spiritual nature of the sickness, we strongly encourage anyone suffering with a mental illness to seek medical attention and counseling.
Answer: “Bipolar disorder” is a name that first appeared in 1957 for a severe mental illness. Before that, the same illness was called “manic depressive illness” or “manic depression,” though that name only dates back to 1921. Neither term appears in the Bible, but the Bible teaches us a number of lessons we can apply to bipolar disorder.
Bipolar disorder or manic depression is a serious mental illness characterized by severe mood fluctuations. These fluctuations go far beyond simply being “happy” or “sad.” The “manic” symptoms can include feelings of extreme euphoria, marked increase in risk-taking, racing thoughts, forced speech, and increased energy. The “depressive” symptoms can include feelings of extreme sadness or hopelessness, fatigue/lethargy, changes in appetite, inability to concentrate, and suicidal/morbid thoughts. There are several types of the disorder, usually defined by the severity or intensity of the symptoms. The most severe type can even include psychotic symptoms such as auditory or visual hallucinations.
The exact cause of bipolar disorder is unknown, although science has demonstrated a genetic component to the disorder. Some practitioners are also employing brain imaging. Bipolar disorder is generally diagnosed based on the symptoms displayed by an individual, which has led to some controversy. In popular culture, “bipolar disorder” has been used as an excuse for destructive or sinful behavior, and the label has even been used as a source of pride among the entertainment elite. Being “bipolar” has become chic, but, to those who truly suffer from the disease, this trendiness has done more harm than good.
A Christian who suffers from bipolar disorder or manic depression should treat it like any other physiological disease. While God certainly has the ability to work miracles and cure any malady, He often lets us continue our journey with a “thorn in the flesh” to remind us that He is sufficient (2 Corinthians 12:7&ndash9). If a believer had diabetes, he would seek medical advice from trained doctors, take prescribed medications, and seek godly counsel on how to deal with both his physical and emotional symptoms. The same holds true for a believer with bipolar disorder.
Because bipolar disorder or manic depression affects the way a person thinks, finding godly counsel (Proverbs 1:5) and spending time in God’s Word (2 Timothy 3:16–17) are essential. In order to do what is right, we must know what is true. Bipolar disorder alters a person’s perceptions of reality, so a strong foundation in truth is a necessity when dealing with its symptoms.
Someone with bipolar disorder or manic depression might give in to the misperceptions caused by the disease and commit sinful acts. A person with bipolar disorder must treat those sins like any other person should. He should recognize his actions as sinful, repent, and seek forgiveness. Believers with bipolar disorder should never blame their illness for their actions (see John 15:22).
Believers should treat a person with bipolar disorder or manic depression with the same compassion they would show toward everyone else (James 2:1). The church offers people with bipolar disorder something they desperately need in their lives&mdashtruth (John 17:17). One thing people with bipolar disorder need more than anything else is the hope that is in Jesus Christ. Even though their illness tries to steal their lives away, they can have an abundant life in Christ (John 10:10).
Manic episodes can also make someone act impulsively or carelessly even if they feel “up” or euphoric, and as a result, can lead to serious consequences.
“It’s a common experience for people with bipolar disorder to spend a ton of money during manic episodes. I’ve had patients waste their fortunes or go into debt,” Dr. Galynker says. Mania may also lead someone to become very sexual and behave sexually in ways that may be totally out of character for them. “These are classic examples of risky behaviors associated with mania in bipolar disorder,” Dr. Marsh adds.
Sarah*, 25, who was diagnosed with bipolar II last year, has felt these types of urges during hypomanic episodes: “You feel like you want to spend money and have as much sex as possible,” she says. “It feels almost as if you have taken Adderall or cocaine. You feel confident, like anything you do is right, and there will be no consequences for your behavior.”
Gracie, 30, has experienced these issues firsthand during hypomania. “When I was manic I thought I could take on the world. I craved attention from anyone. I was unfaithful to my live-in boyfriend whom I love beyond words and never wanted to hurt. [I knew] what I was doing would destroy him, but [I was] unable to stop myself from doing it,” she recalls.
Gracie also says she made poor choices with money, by “spending on things I didn’t need and could not afford.” In the back of her mind she knew she was making poor decisions, she says, but she couldn’t get herself to stop.
But Gracie does acknowledge that there are aspects of mania that can feel quite positive in the moment: “I love the amount of energy I have and my ability to multitask, talk fast, keep up with jokes and sarcasm, and be the life of the party without a care in the world while manic,” she says.
Andrea, 46, says that the bursts of energy she gets during a hypomanic episode can “lead to lots of creativity.” (She was diagnosed with bipolar II in 2010.) “When I was younger, I could get by on less sleep and be active all day long,” she tells SELF. “Even now, people call me energetic, though I don't see myself that way at all.”
Dr. Marsh agrees that hypomania or mania can bring on periods of great creativity or confidence for a person with bipolar disorder. “Mania can feel like a wonderful, exciting, productive place to be when it is going on, that absolutely does happen” she says. “But it can also be extremely disconcerting or even dangerous for a person when they still feel this sense that something is not right, that they are not fully in control of themself.”