Mania

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.

Questions and answers on "Mania"

My brother s son inlaw having Sulpitac 50mg since the last 2 years for Mania . He has no interest in sex. Is it a side effect of medicine? what is the remedy?

doctor1 MD

Hi,

It is possible that loss of interest in sex is due to a side effect of Sulpitac. Sulpitac raises serum prolactin level which causes sexual dysfunction. Get his blood tested for serum prolactin level. If the level if higher than normal, consult his doctor with the report. Two things can be...

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Hi I'm a 37 yr old mum of three. Diagnosed mild bi polar at 18 yrs. treated with tegretol and prozec then seroxat inbetweeen pregnancies. My middle son 12 was diagnosed at 7 with ADHD, all the 'dys' and ODD. Medicated with concerta XL 36. I have frequent Episodes of depression and mania. Forgetfulness. OCD. I am sure a am on the ADHD spectrum too as am unable to relax for a second. will hyper focus on obscure things. obsessive cleaner and tidier. Am the SENCo an top British school here. Main concern is insomnia. My brain will not switch off at night. Have had sleep paralysis for 1 yr now. I am on 10mg nexito. Have come off the contraceptive pill. I use immovane at night. Would like to eventually be pill free but don't know how to. Have regularly therapy as life has thrown its challenges at me. Am always the life and soul of the party but feel possibly is a facade for deep rooted self esteem issue. What can I do about my sleep disorder and can I eventually get off the meds. Have heard horrible stuff about the Escitalopram ........

doctor1 MD

From the history you have provided, you have bipolar disorder for almost 20 years now.
In long standing bipolar disorder you need to be on medications for long period of time for prophylaxis even when your symptoms are well controlled.

Esciatalopram may have been added for a recent depressive...

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What following psychological instruments would you use to rule out the following…
- mood syndrome
- psychosis
- personality assessment / inventory
- Risk assessment for suicide / self-harm

doctor1 MD

Hi XXXXXXX

The following psychological instruments can be used:-

Mood disorders:
Depression:-
- Beck's Depression Inventory (BDI)
- Hamilton's Depression Rating Scale (HDRS)
- Montgomery-Asberg Depression Rating Scale (MADRS)
- Bech-Rafaelsen Melancholia Scale (MES)

Mania:-
- Young Mania Ratig...

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how do I stay strong while living with my husband of 43 years who was diagnosed with bi-polar 7 years ago. His psychiatrist increased the dose of abillify he was on 3 1/2 weeks ago. from 2 mg to 5 . WE discussed it with him previously deciding his dose should stay low.so it wouldn t increase his mild mania. Now he s not sleeping at all. Today he was the most depressed I have seen him since he was diagnosed. He needs to be able to sleep tonight. he takes 50 mg of trazadone at bedtime. I am ready to scream . Really could use a support group.

doctor1 MD

5 mg of Abillify containing aripiprazole may not be an adequate dose for bipolar disorder, if diagnosis is correct

This does not have any significant antidepressant effect

Aripiprazole is not a first line drug for bipolar disorder

I would suggest, you can discuss all these issues with your doctor...

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I take zolof and abilify for trichotillomania...can I take HCG?

doctor1 MD

Hello,
Thanks for using health care magic for posting your query.
Before answering your query, I would appreciate if you can help me with some details about your illness:
1) You have selected the category mania. Do you have mood disorder as well which you would like to discuss?
2) How are keeping...

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Hello, my name is XXXXXXX I am a 58 yo white female. Gastric bypass surgery history. Ulcer history. Took Prilosec, Karafate, Protonix. I was prescribed Zydus and it kicked me into a mildly manic state. I am bipolar disorder I since 08/03. Mostly stress induced Am experiencing unusual side effects. Mild hallucinations, delusions of grandeur, epiphanys, etc. I sleep only 4 hours. Just prior to awakening, I briefly experiences these feelings. Feel total clarity and peace. Am rested with no fatigue or stress. Is there any record of this happening to anyone in clinical trials, OP studies, etc. ? Am not complaining but would like feedback. Thanks

doctor1 MD

Brief Answer:
Some clarifications required

Detailed Answer:
Hello,
Thanks for using health care magic for posting your query.
I have gone through your question in detail and I can understand what you are going through.
However I would require a couple of more details to help you in answering your...

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hi dr's, ive been suffereing from soft bipolar or in the bipolar spectrum with depression and dyphoric mania which is not the feeling good mania. anyway, i had a few qeeg 's done and my dr who is dr cancro from nyu had said quite a few times that i have
Thalamocortical_dysrhythmia. the only drugs for depression that helps is depikote which i will not go on because of weight gain and lamictal which im on a very high dose because i needed to get my levels to 8 to 10 which i have felt much better for a year but it poopped out. he said calcium, sodium or t-channel blockers will help me tremendously. oxicontin is one of them and when i was on it for 8 months, i felt reborn, not high, but normal which i havent felt in years. im 48 my height is 5'7' and weigh 154. which drugs block these channels completly so i can feel better. ( i went off of oxixontin a while back) i didnt want to get addicted to it. please let me know what drugs can i tell my dr about. thanks so much

doctor1 MD

Hello,

Thanks for your query.

Important points of your query:
•     Known case of soft bipolar
•     Treatment history: Lamictal in past, oxicontin (oxycodone)

Following medicines are well researched and found to effective for Bipolar disorder: Lithium, Depakote (Valproate), Lamictal (Lamotrigine) and...

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I need to know how to find out if I am bipolar with out seeing a doctor I have no money or isurence.

doctor1 MD

Hi,

Thanks for your question.
Bipolar disease is a combination of recurrent attack mania and depression.

Manic features are aggressive and abusive behaviour, decrease sleep, on may also noticed during attack when she become more talkative and appear that she gain some more energy.

Depressive...

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Hello Doctor, My wife having Depression, anxiety, tension hyper anger, recalling those previous incidents in her life, over thinking on any incident, growing grudge on people whom she don't like and taking revenge with bad words while arguing, talking in her self, moving objects in her eyes, smiling in her self and facial expression while alone.

doctor1 MD

Hi,

Thank you for the clear description.

After reading the problem thoroughly, it seems your wife probably could be suffering with bipolar disorder with psychotic features.

Bipolar disorder is a combination of recurrent attack mania and depression. Manic features are aggressive and abusive...

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I always feel tired and not fresh in the morning? What is the solution?

doctor1 MD

Dear Nisar,


Tiredness and un-refreshing mornings could be due to lot of reasons like thyroid problem, stress in life, sleep problems and illnesses, problems with breathing called sleep apnea etc----all physical reasons or it could be due to psychological problems like depression, mania etc....

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Recent questions on  Mania

doctor1 MD

Hello, my name is XXXXXXX I am a 58 yo white female. Gastric bypass surgery history. Ulcer history. Took Prilosec , Karafate, Protonix. I was prescribed Zydus and it kicked me into a mildly manic state . I am bipolar disorder I since 08/03. Mostly...

doctor1 MD

I take2- 5 mg of abilify every night. For the past three weeks. I have come down from a month and a half of manic episode. I am doing better to some degree. I am back to being to tired and have to rest in between tasks and resting In the afternoon. This is not a life for me. I take topamax 4-25mg morning and night, 1-0.5mg clanazapam at bedtime, and 1-90mg cymbalta at supper. I take medication for cholesterol and blood pressure and medication for sleeping, zopiclone 1-7.5mg bedtime. I want energy to carry on anormal life. Right now I feel I am slipping back to my old self of sit and do a task and sit and wait for the energy to come back.

doctor1 MD

My brother s son inlaw having Sulpitac 50mg since the last 2 years for Mania . He has no interest in sex. Is it a side effect of medicine? what is the remedy?

doctor1 MD

I need to find a local psychiatrist , I think. I was diagnosed with bipolar II about 5 yrs ago. I have been having performance issues at work-ie not focusing and unable to concentrate. Someone has accused me of being ADD-I'm wondering if maybe my...

doctor1 MD

Hi Doctor I am new immigrant to Canada.these days i am taking a course at private career college, so i want need about adult dosage ,side effects ,and interactions about oral ''Haloperidol''.for my assignment to be completed tomorrow.

I appreciate your kind consideration regard this matter.

Thank you
Sincerely

doctor1 MD

I take zolof and abilify for trichotillomania ...can I take HCG?

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