Mania, Hypomania, Mixed State And Bipolar Disorder

Mania is a mood disturbance, which causes the person to have a severely elevated or irritable mood. Episodes of mania are generally associated with bipolar disorder.

To be diagnosed with Bipolar I Disorder, the person must have had at least one manic or mixed episode. For people who have bipolar disorder, their moods may fluctuate between episodes of mania and episodes of depression.

Besides the stereotypical euphoria of a manic episode, other symptoms of mania include extreme optimism, talkativeness and rapid speech, racing thoughts, agitation, poor judgment, recklessness, difficulty sleeping or decreased need for sleep, distractibility, and difficulty concentrating.

Some researchers and psychiatric professionals would like to have more classifications of manic episodes. The personal experience of manic episodes varies greatly from person to person. Currently, the Diagnostic and Statistical Manual (DSM IV) of the American Psychiatric Association only recognizes mania, hypomania, and mixed episodes as variations of mania. Emil Kraepelin, the pioneering German psychiatrist, described an additional classification of mania to refer to those who experience psychotic symptoms during manic episodes.

Researchers at Duke University have expanded upon Kraepelin's four classes of mania. They have described the variations of mania to include hypomania, severe mania, extreme mania, and two forms of mixed mania. Hypomania is a milder form of mania featuring mainly euphoria. Severe mania includes euphoria, grandiosity, high levels of sexual drive, irritability, volatility, psychosis, paranoia, hostility and aggression. Extreme mania, or dysphoric, is characterized by most of the displeasures, hardly any of the possible pleasures of mania. Mixed mania is episodes of both manic and depressive symptoms.

Hypomania is a less severe form of mania. Hypomania may not cause impairment in functioning like mania can. People experiencing a hypomanic episode may actually have increased productivity and goal-directed behavior. Hypomania does not lead to psychotic episodes. Many of the symptoms of mania are present, but to a lesser degree than during a true manic episode.

People with hypomania are generally perceived as being energetic, euphoric, overflowing with new ideas, and sometimes highly confident and charismatic, and unlike full-blown mania, they are sufficiently capable of coherent thought and action to participate in everyday activities. People with frequent episodes of hypomania may dress colorfully and boldly. They are often very social.

In the context of bipolar disorder, a mixed states is a condition during which symptoms of mania or hypomania and symptoms of depression occur simultaneously. During a mixed episode, the person may experience the impulsiveness, insomnia, irritability, and flight of ideas that can be present in a manic episode as well as suicidal thoughts, guilt, feelings of hopelessness, and changes in appetite that are common during depressive episodes. Mixed episodes can be incredibly distressing to the individual. It can lead to panic attacks, substance abuse, and suicide.

Manic episodes in bipolar disorder are typically treated with mood stabilizing medications, therapy, and antipsychotic medication if necessary. It is sometimes necessary to hospitalization until the patient is stabilized on their medication. The mood stabilizing medications can take weeks to effectively control the symptoms. Some people neglect treatment because they like the euphoria that is present during manic episodes. Treatment for manic episodes is important, because bipolar disorder tends to get worse if left untreated.

Next article: Living In Mania

Followed by:

Hypomania And Its Characteristics

Mixed Mania - The Lethal Combination