Everything You Need to Know About Manic Episodes

Published on: 29 Dec 2020
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We might all enjoy the feeling of an elevated mood from time to time, but for those who experience manic episodes, elevated moods become an overwhelming extreme that last much longer than one would like. A manic episode is an intense experience that significantly impacts an individual and those around them.

Manic episodes can first occur at any age in life. The average age of onset is eighteen, but they can start at any age from childhood to adulthood, according to the American Psychiatric Association. Manic episodes should be taken seriously; they are a sign of a medical condition that needs attention. If you or a loved one experiences manic episodes, rest assured that treatment is available to help manage them along with the mental health conditions they are associated with.

What Is a Manic Episode?

A manic episode is a psychological state of extremely heightened mood and impulsivity experienced for a significant period of time. Manic episodes are most often associated with bipolar disorder, according to the National Institute of Mental Health. Those who suffer from bipolar disorder experience manic episodes that can be accompanied by depressive episodes and lead to intense cycles of mood.

Manic episodes occur in varying degrees of severity. Some individuals experience hypomania, where symptoms of mania are less intense than those of a full manic episode. Hypomanic episodes may not impair functioning to the same degree as full mania, but they can still lead to manic episodes later on and should be treated.

Additionally, according to Mayo Clinic, manic episodes can occur in conjunction with other physical or psychological issues besides bipolar disorder called secondary or organic mania. A manic episode could be caused by a brain injury, sleep deprivation, misuse of drugs or alcohol, a stroke, metabolic abnormalities, or infections, among other possibilities. A medical professional should be seen to consider all the possible causes of a manic episode.

Symptoms of a Manic Episode

There are many distinct symptoms associated with a manic episode. In order to determine if someone has experienced a manic episode, doctors and psychologists analyze the amount, intensity, and duration of symptoms.

Three or more of the following symptoms must be experienced for at least one week to be diagnosed as a manic episode. If these symptoms occur less intensely for a minimum of four days, it is considered a hypomanic episode.

Significant symptoms of a manic episode include:

  • Decreased need for sleep
  • Grandiosity and exaggerated self-esteem
  • Engaging in many activities at once
  • Extremely talkative, speaking loudly, quickly, or with pressured speech
  • Easily distracted
  • Increased desire for sex
  • Increased risky behavior
  • Rapid thinking and flight of ideas
  • Hostility and increased irritability
  • Thoughts of suicide
  • Excessive religious dedication
  • Bright or flashy clothing
  • In extreme cases, psychosis

These intense symptoms greatly impact the functioning of the person experiencing them. Even if they do not meet the diagnostic criteria to be a manic or hypomanic episode, manic symptoms can still be a sign of mood instability and be connected to bipolar disorder.

Most often, a manic episode follows or precedes a major depressive episode in those with bipolar disorder. A depressive episode includes intense feelings of sadness, extreme hopelessness, disrupted sleep cycles, changes in appetite, and loss of interest in daily activities. When depressive and manic episodes occur in sequence, this leads to intense mood instability that is hard to cope with in daily life.

Manic Episodes and Bipolar 1 Disorder

Bipolar disorder is divided by psychologists into four different diagnoses: bipolar 1 disorder, bipolar 2 disorder, cyclothymic disorder, and unspecified bipolar disorder. Manic episodes are closely tied to bipolar 1 disorder. The main characteristic of bipolar 1 disorder is having at least one manic episode.

Whether someone has experienced at least one manic episode in their lifetime will determine whether someone has bipolar 1 disorder or receives a different diagnosis. If they’ve experienced a full manic episode, then bipolar 1 disorder is most likely the mental disorder they’re struggling. Depressive episodes can occur with bipolar 1, but a manic episode is the primary feature of this type of bipolar disorder.

Manic episodes in individuals with bipolar 1 disorder have intense symptoms that impair typical daily functioning. Other people interacting with the person having a manic episode will often notice their shifts in disposition and impulsive behavior. A bipolar 1 manic episode can have significant consequences because of the impulsivity of this disorder.

Mania and Bipolar 2 Disorder

Bipolar 2 disorder is a different diagnosis than bipolar 1 disorder and consists of less severe manic symptoms. Unlike bipolar 1, bipolar 2 does not include full manic episodes. This is a key differentiator in diagnosing someone with bipolar 1 versus bipolar 2. 

Those with bipolar 2 disorder have lower levels of mania than bipolar 1, though it can still impact daily life because hypomania is experienced. Additionally, a depressive episode is always associated with bipolar 2, leading to significant cycles of mood highs and lows.

If someone with bipolar 2 disorder goes on to experience a full manic episode, their diagnosis will shift to bipolar 1 disorder. This often occurs when younger people begin experiencing symptoms that increase in intensity as they grow up.

Mania and Cyclothymic Disorder

The third type of bipolar disorder is cyclothymic disorder, where less severe symptoms of mania and depression occur for at least two years. While symptoms of mania are part of cyclothymia, they are not considered severe enough to be labeled hypomania or a manic episode.

Cyclothymic disorder is less severe than bipolar 1 or 2, but it still impacts an individual’s mental health, especially given that it includes cycling between emotional highs and lows for a prolonged period of time. Balance and healthy regulation of emotions make a difference in long-term positive mental health and well-being for all of us but can be especially important for those with cyclothymic disorder.

Comorbid Conditions

Bipolar disorder often occurs with other mental or physical illnesses. These comorbid conditions are important to recognize and diagnose to ensure an individual is being treated for all aspects of their health issues. Bipolar disorders often occur comorbidly with ADHD, anxiety disorders, substance disorders, and/or eating disorders, according to research by the CME Institute. Other health factors such as obesity, metabolic syndrome, cardiovascular disease, migraines, and pain disorders are also more prevalent in those with bipolar disorder.

Individuals suffering from bipolar disorder must be treated holistically and with a single fixed diagnosis. Other conditions need to be taken into account when treating any illness, but especially bipolar disorders. Be sure your doctor or psychologist is aware of any other health issues you struggle with when seeking a diagnosis.

Risk Factors for Manic Episodes

Genetics and family history of mania are significant risk factors for developing manic episode symptoms. There is a strong relationship between family history and mania. If you have a family member with bipolar disorder, you are 80 to 90 percent more likely to also have the condition or major depression. Bipolar tends to run in families, so knowing if you have a family history can indicate whether you are at risk. 

Environmental factors also contribute to manic episodes, according to the National Alliance on Mental Illness. Stress is a significant risk factor for the onset of manic symptoms. Often life stressors bring about manic episodes in someone with a genetic predisposition toward the condition. This could be any type of stress from work, school, family, or your personal life.

Drug and alcohol use can also be an environmental trigger that impacts the onset of mania. Those with a predisposition towards bipolar disorder are more at risk for being impacted by drugs and alcohol that precipitates a manic episode.

Treatment for Manic Episodes

Therapy and medication are the best treatment options available for mania and bipolar disorders. Antipsychotic medications and mood stabilizers effectively treat mania and can bring mood back to within a normal, stable range. A psychiatrist can prescribe a mood-stabilizer or antipsychotic medication that best fits your needs and symptoms. 

Talk therapy, often in combination with medication, is also one of the best ways to treat mania and bipolar disorder symptoms. Therapists help you work through underlying causes of struggles and learn skills to manage symptoms. Therapy provides a safe space to process emotions, thoughts, and feelings while working towards your goals. Therapy can help you achieve a healthier and happier daily life.

Lifestyle changes, when done in tandem with medication and talk therapy, can also help. Ensuring you’re in the best place to make healthy decisions and take care of yourself is important for stabilizing your mental health. A licensed therapist can help you strategize what lifestyle choices will work for you to best manage your symptoms. 

If you believe that you or a loved one could be experiencing symptoms of mania, you should consult a doctor or psychologist. If you aren’t sure where to start, speak with a licensed Talkspace therapist for affordable, convenient help with this difficult condition.

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