Unpacking Mania: What Does It Mean To Have A Manic Episode?

Mania is usually associated as a symptom of bipolar disorder, and it can be quite stressful to deal with. In fact, we have all heard of and used words with ‘mania’ as a suffix, such as ‘megalomania’, ‘egomania’, and so on – but what exactly is ‘mania’, or more precisely, a ‘manic episode’ alone?

Generally, mania is characterized by a sudden and abnormal increase in energy and mood. A manic episode usually lasts one week or more, which means that one would be experiencing symptoms for most of that week, most of the time. In more extreme circumstances, mania can lead to psychosis, which means losing touch with reality entirely.

If you are a person who suffers from mania, lives with a relative experiencing mania, or a student currently studying a CMHC degree online and wishes to address the disorder in your future career, then keep reading on as the following will dissect as to what really constitutes to. mania as well as methods to cope with a manic episode.

Mania and Hypomania

We must first establish the difference mania has with its milder counterpart, hypomania. Like mania, hypomania is too associated with bipolar disorder and is characterized by elevated moods, energy, and emotions.

What sets the two apart however is their durations and intensity. While mania can last for weeks, hypomania usually stays for only a couple of days to one-week maximum. Despite having similar symptoms, compared to mania which can severely affect one’s ability to perform daily activities such as work, school, and other endeavors, hypomania is overall mild and manageable enough for a person to function normally and engage in such activities.

In terms of which particular form of bipolar disorder each is associated with, mania is correlated with bipolar I disorder, which usually consists of at least one manic episode with a possible depressive episode; and hypomania with bipolar II disorder, which typically consists of at least one depressive episode and one hypomanic episode. Ultimately, bipolar is not the sole cause of mania and hypomania, as things such as recreational drug and alcohol use, highly stimulating situations, external environments, lack of sleep, and other mental health disorders such as depression can all potentially be causal factors.

A Manic Episode: What Goes on in the Brain?

Frankly speaking, having manic episodes can be quite frightening not only for people around but also for the person experiencing it. Mania is displayed in 80% of patients with bipolar I disorder, but this at the same time does not necessarily mean everyone will experience it. So, besides having elevated moods, what is really going on in the brain when one has a manic episode? And what are its effects? Researchers have traced manic episodes to dysfunction in the prefrontal cortex, which is responsible for self-control, problem-solving, and planning; and the amygdala, an almond-shaped region in the limbic system known for emotional processing, especially for fear and anger.

Researchers at the University of Gothenburg, Sweden conducted a study in 2021 and found a correlation between the number of manic episodes a person experiences and the degree of structural changes to the cortical sections. Patients who had experienced more manic episodes were found to have more cortical thinning, while those who did not have mania exhibited no changes.

Simultaneously, another investigation from the University of Texas found that amygdala dysfunction, that is the amygdala not releasing appropriate signals, was a key factor in the expression of manic episodes. This dysfunction ultimately leads to increased risk-taking or reward-seeking behavior – such as making a risky investment, spending more money than needed, or over-multitasking – which is typical of mania.

However, structural changes in the prefrontal cortex and the amygdala dysfunction are all typical of bipolar disorder in general as well. For example, the influence of amygdala dysfunction over manic episodes is insofar as it is one of the foundations for the development of bipolar disorder.

Managing a Manic Episode

To manage a manic episode is not without trial and error. Like every other condition, how a manic episode manifests is different for each individual. The first step is to know yourself, that is to learn about your condition. Some questions you can ask yourself include:

• How do you act during a manic episode?
• Do you have an increased self-esteem?
• Do you talk faster?
• Do you have racing thoughts?
• Do you feel easily distracted?
• Do you suddenly do a lot of activities at once?
• Do you feel the need to engage in high-risk behavior?

One great way to do this is to create a mood diary, where you record and chart your moods. It not only allows you to spot early warning signs of a manic episode but is also a worthwhile means of reflecting upon symptoms, especially if they have escalated.

The next thing is to start practicing self-care, and this involves avoiding triggers. Some strategies, though not all, include:

• Avoiding alcohol and other substances – As mentioned before, stimulants can be a causal factor for manic episodes. Especially if you have bipolar or another mental health condition, it is best to avoid such substances, as they can worsen symptoms.
• Managing and getting adequate sleep – Again, sleep deprivation can be a factor in your manic episode. While it can be challenging to sleep during an episode, not sleeping at all would only exacerbate it. Simple changes that can allow sleep management include creating a sleep routine, a sleep diary, a dark and quiet environment, and avoiding screens 2 hours before bed.
• Having a healthy diet – It is recommended to eat more fresh fruits, vegetables, and lean meat, as well as fatty acids, mainly Omega-3, along with seafood, folic acid and zinc. It is also important to avoid too much caffeine, high-fat meals, and sugary foods if you have bipolar disorder with manic episodes. Ensuring you have regular meal schedules can also be useful.
• Engaging in exercise – Vigorous exercise can be very stimulating, so more rhythmic exercises such as walking, running, or swimming are preferable for those with mania, according with a research from the Royal Melbourne Institute of Technology University. Doing a moderate level of physical activity regulates moods and can also improve sleep.
• Relax – Winding down and practicing mindfulness, such as meditation, is always an effective way to relax the heightened energy from a manic episode or reduce symptoms of bipolar disorder in general, as a study conducted at the Tata Institute of Social Sciences found.

Thirdly and lastly, always reach out if you feel there is an impending episode. Talk to your mental health team and get your family and friends involved in the journey. These are useful preemptive measures to prevent an episode from worsening.

Treatment Options

If you have a treatment option, make sure to stay on it. Usually, mania is treated with either medications, therapy, or self-management with support from friends and family. With medication and psychotherapy, there are several options:

• Doctors usually prescribe antipsychotics such as olanzapine (Zyprexa), risperidone (Risperdal), and quetiapine (Seroquel) to reduce the symptoms of a manic episode. But often, mood stabilizers such as lithium (Eskalith), divalproex sodium (Depakote), and carbamazepine (Tegretol) can also be provided to prevent future episodes.
• Therapy can range from psychotherapy, which involves talking about your condition with a mental health professional; to cognitive behavioral therapy, which consists of changing your perceptions; and family therapy, which is allowing your family members to learn what they can do in assisting with your mental health issues and behavior.

Always avoid self-diagnosing as it can potentially lead you astray. If you think you are experiencing manic episodes, always reach out to your healthcare team first. For more support, the Depression and Bipolar Support Alliance (DBSA) contains valuable information and guides on managing bipolar disorder and mania.

References:

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