What is Mania?
Mania is the mood of an abnormally elevated arousal energy level. Elevated irritability is common along with behavior that seems on the surface to be the opposite of depression. Mania, of varying degrees, is a necessary symptom for the diagnosis of bipolar affective disorder and similar psychiatric illnesses. The word derives from the Greek μανία (mania), "madness, frenzy" and that from the verb μαίνομαι (mainomai), "to be mad, to rage, to be furious".
The nosology of the various stages of a manic episode has changed over the decades. In current DSM-IV nomenclature, hypomanic episodes are separated from the more severe full manic episodes, which in turn are characterized as either mild, moderate, severe, or severe with psychotic features. Kraepelin, however, divided the “manic states” into four forms — hypomania, acute mania, delusional mania, and delirious mania — and noted that his observation revealed “the occurrence of gradual transitions between all the various states.” In a similar vein, Carlson and Goodwin, in their elegant paper of 1973, divided a manic episode into “three stages”: hypomania, or stage I; acute mania, or stage II; and delirious mania, or stage III. The cardinal symptoms of mania are the following: heightened mood (either euphoric or irritable); flight of ideas and pressure of speech; and increased energy, decreased need for sleep, and hyperactivity. These cardinal symptoms are most plainly evident in hypomania. In acute mania, they exacerbate and may be joined by delusions and some fragmentation of behaviour, and in delirious mania, only tattered scraps of the cardinal symptoms may be present, otherwise being obscured by florid and often bizarre psychotic symptoms.
Mania may be caused by drug intoxication (notably stimulants, such as cocaine and methamphetamine), medication side effects (notably SSRIs), and malignancy (the worsening of a condition), to name but a few. Mania, however, is most commonly associated with bipolar disorder, a serious mental illness in which episodes of mania may alternate unpredictably with episodes of depression or periods of euthymia. Gelder, Mayou, and Geddes (2005) suggest that it is vital that mania be predicted in the early stages because otherwise the patient becomes reluctant to comply with the treatment. Those who never experience depression also experience cyclical changes in mood. These cycles are often affected by changes in sleep cycle (too much or too little), diurnal rhythms, and environmental stressors.
Mania varies in intensity, from mild mania (hypomania) to full mania with extreme and frenzied energy, severe racing thoughts, and incomprehensibly rapid speech. Standardized tools such as Altman Self-Rating Mania Scale and Young Mania Rating Scale can be used to measure severity of manic episodes. Because mania and hypomania have also been associated with creativity and artistic talent, it is not always the case that the clearly manic bipolar person needs or wants medical help; such persons often either retain sufficient self-control to function normally or are unaware that they have "gone manic" severely enough to be committed or to commit themselves. Manic persons often can be mistaken for being on drugs or other mind-altering substances.