Many people associate the word mania with the presence of strange and prototypical customs of a person, which are usually repeated relatively often. However, far fewer people know that the concept of mania also has another meaning, which is generally referred to when we talk about psychopathologies.

Mania is also an alteration of the state of mind , being together with depression one of the main alterations that form part of bipolar disorder and that like this one supposes a serious alteration, discomfort and limitation in the person’s life. It is about this type of emotional state that we will talk throughout this article, defining it and visualizing its basic definition, in what contexts it appears and how it is usually treated.

Mania and Manic Episodes

Mania is understood as a psychological alteration characterized by the presence of an excessively euphoric, expansive and concurrent state of mind with a high level of energy . This is a pathological and temporary state that can appear in various contexts and that usually takes the form of episodes lasting at least a week almost every day and most of the day.

These episodes are characterized by the presence of the aforementioned expansive, euphoric and irritable mood, which usually appears together with a high level of restlessness and agitation that is manifested by hyperactive behavior. Generally the person has the sensation that his thoughts pass at great speed , and it is not unusual for the thread of thought to be lost in the face of the great influx of these thoughts.

The subject in the manic phase also suffers from a high level of distractibility, having great difficulty in concentrating and continually moving from one thing to another. In this state thoughts and delusions of grandeur and genius also appear , and the subject is often considered invulnerable and has unlimited resources. It is also common for a high level of impulsiveness and aggressiveness to appear, at the same time that the capacity for judgement and risk assessment is diminished, often leading to the performance of acts that may pose a risk to one’s health or integrity. They also tend to try to get involved in a large number of projects regardless of their viability.

It is common to see fights and conflicts both in the social field and at work or even within the family and/or couple, as well as great economic expenses (independently of their economic capacity), hypersexuality (often running risks) and sometimes even substance consumption that can make their condition worse (for example cocaine).

It is also not uncommon for hallucinations and delusions to appear , interpreting reality on the basis of them and reacting aggressively. Finally, it should be noted that often the behavioural alterations experienced make it necessary to hospitalise the subject in order to stabilise him/her.

Contexts of appearance

The occurrence of manic episodes is usually associated with the presence of a bipolar disorder. In fact, one of the most frequent types of bipolar disorder known, bipolar disorder type 1, requires only at least one manic episode not resulting from the consumption of toxins or from medical illnesses to be diagnosed, not actually requiring the appearance of a depressive episode.

But bipolar disorder isn’t the only context in which a manic episode or behavior can occur. And mania can also arise from the effects of using different drugs or substances as a result of intoxication. Some infections and diseases that have an effect on the brain can also lead to manic symptoms. These can also include some dementias or infections such as encephalitis.

In addition can also appear in other mental disorders , being an example of this some psychotic disorders. Specifically, schizoaffective disorder stands out, which has a subtype called bipolar in which episodes of mania also occur.

Usually, mania is the result of the presence of a neurochemical or functional alteration of the brain, whether it is caused by some toxic or drug or by an atypical functioning characteristic of some type of disorder or disease. Occasionally it can also be observed that in some cases manic symptoms can appear in situations of high psychosocial stress.

Consequences

The existence of a manic episode or phase usually has severe repercussions for those who suffer from it. At a social level, it is frequent, as we have seen , that there are conflicts or even verbal or physical fights , especially with strangers.

It is also common for problems to arise with the immediate environment or with the partner such as conflicts, arguments, accusations or infidelity, and these problems can have repercussions even after the episode has ended. In addition, it is also common that the environment does not understand the subject’s behaviour , or that this is due to an alteration of the state of mind beyond the subject’s control.

In the labour field, the presence of conflicts is not infrequent, as well as a loss of productivity derived from excess energy and distractibility.

At the economic level, as we have seen , large excesses are often made, often as a result of impulses or to acquire unnecessary products . The risks that they can commit can generate that the subject suffers various mishaps, such as work accidents, falls and trauma, intoxication or substance abuse, contagion of sexually transmitted diseases or infections or unwanted pregnancies. Also, on some occasions, people in a manic phase may even carry out illegal acts or become involved in criminal activities.

The high level of activation of the subject and his behavioural disorders often require some kind of hospitalization in order to stabilize him, generally through pharmacological treatment .

Mania vs. hypomania: a matter of degree

Mania is a psychological disorder of an emotional nature that can have serious repercussions on the life of the person suffering from it. However, there is another concept that assumes the existence of virtually identical symptoms and with which it is very easy to confuse mania: hypomania.

As we can deduce from the name, hypomania is a somewhat less extreme version of mania , with an expansive, euphoric mood and a high level of agitation and energy. The main difference between mania and hypomania lies in the intensity with which the symptoms occur.

Although hypomania involves an alteration of the mood perceptible by the environment and which can also have repercussions for the subject, the symptoms are less severe and usually neither delusions nor hallucinations appear. Furthermore, they do not usually prevent the subject from having a functional day-to-day life, and hospitalisation is not usually necessary. Finally, hypomanic episodes last much less time than manic ones: they usually last between four days and a week.

The treatment of mania

The treatment of manic episodes is usually carried out by the administration of some type of euthimizer , that is to say a type of drug that allows the stabilization of the state of mind. Lithium salts are generally used for this purpose, although there are other options. In some cases it may also be necessary to apply antipsychotic drugs.

In the case that its appearance is due to an intoxication, it will be necessary to treat this fact in a differential way. The same applies to infections, which must be treated in order to reduce or eliminate the symptoms. In disorders such as bipolar or schizoaffective bipolar type, depending on the case and especially if there are characteristics that imply a medical emergency (such as the appearance of suicidal behavior) or drugs are not effective, it may be advisable to apply electroconvulsive therapy in a hospital .

In addition, it is common to use psychological therapy (once stabilized at the pharmacological level), in order to be able to detect prodromes or symptoms that warn of the arrival of an episode. Psychoeducation and control of social and circadian rhythms (including sleeping and eating schedules) may also be helpful.

Bibliographic references:

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.
  • Belloch, Sandín and Ramos (2008). Manual of Psychopathology. McGraw-Hill. Madrid.