What Does It Mean To Have A Manic Episode?

Reviewed by Laura Angers, LPC

Published 06/24/2022

Mania, or a manic episode, is just one part of bipolar I disorder, the other being a depressive episode, and it has several distinct symptoms that can be extremely severe. In this article, you will learn about what manic episodes entail and how you can identify them and what can be done to keep them under control.

What Is Mania?

As mentioned in the introduction, manic episodes make up half of Bipolar I disorder, and unlike depressive episodes, mania is what truly defines this type of bipolar disorder - without it, it’s a different form of bipolar disorder or it’s just major depression. So, what is a manic episode exactly?

The manic definition be described as having symptoms such as [1] [2]

  • Feeling elated or extremely happy
  • Unusually high energy
  • A heightened sense of self-importance
  • Having grandiose ideas or plans
  • Racing thoughts
  • Excessive talkativeness
  • Easily distracted
  • Irritability and agitation
  • Impulsiveness and poor decision-making
  • Hypersexuality
  • A decreased need for sleep
  • Poor appetite
  • Delusions
  • Hallucinations
  • Suicidality

As you can see, many of these symptoms are more severe than others, and some of them, particularly the delusions and hallucinations, are indicators of psychosis, which is a symptom that is often associated with schizophrenia, but it’s also often apparent in bipolar disorder as well.

Although a manic state can feel euphoric and overly optimistic at times, these symptoms can be incredibly impairing in various aspects of life, including social relationships and finances.

Manic behavior is also something that is unusual or uncharacteristic of the individual and is something that other people can recognize. It often takes assistance from loved ones to get people with manic episodes and bipolar disorder to get help.

How Long Do Manic Episodes Last?

A manic attack isn't a permanent state of mind, and in bipolar disorder, it will change between depressive episodes and periods of normalcy.

This is known as cycling, and if left untreated, episodes can last weeks or even months, and it can occur multiple times per year.

On average, one study found that manic episodes typically last for around 13 weeks, which is just over three months. [4]

This is a significant amount of time to deal with symptoms of mania and a lot of negative outcomes can occur if treatment isn’t sought out. However, manic and depressive episodes can also change very quickly which is known as rapid cycling. Rapid cycling refers to at least 4 different cycles in a year-long period.

Sometimes, manic and depressive symptoms can overlap as well, causing a mixed episode, and this can make it challenging to diagnose and treat.

Mania vs. Hypomania

When discussing mania, it’s also important to understand a different but related state of mind known as hypomania.

Hypomanic episodes are similar to manic episodes in terms of what symptoms they are experiencing, but they are less severe and don’t have as much impairment as a standard manic episode.

For example, a person might have a decreased need for sleep and still feel energized or they might still have fleeting thoughts but no delusional ideas.

Despite being weaker than manic episodes, hypomania is still of clinical significance and it’s important to be aware of them.

While mania is a sign of bipolar I, hypomania is an indicator of bipolar II, and some people can assume that bipolar II is a less serious or dangerous condition compared to bipolar I.

This may be true in some regard because those with bipolar II never experience a full-blown manic episode, but it also means that they are more likely to struggle with depressive episodes instead. [5]

Major depression, on its own, is a serious mental health condition that requires treatment, and bipolar II uses the same criteria for its depressive episodes such as:

  • A persistent low mood
  • A loss of interest or pleasure in activities
  • Appetite and weight changes
  • Fatigue and lethargy
  • A feeling of worthlessness or hopelessness
  • Difficulty concentrating
  • Suicidal ideation

While hypomania can appear as something positive to others, such as being sociable and being in a great mood, there is always the risk of erratic and impulsive behaviors.

Additionally, it is possible that hypomania can evolve into mania at some point as well, and therefore, it should be dealt with as soon as possible.

How To Treat Manic Episodes?

Bipolar disorder, especially the manic episodes, requires medication as a first-line treatment and this will require the diagnosis and a prescription from a doctor or psychiatrist, and therapy is typically used alongside it to help individuals learn how to cope. Below you will learn about what treatment options are available:

Mood Stabilizers

One of the primary medications that are used to deal with manic episodes are mood stabilizers, and the most widely-used one is lithium carbonate, also simply known as lithium, for short. It’s also one of the oldest psychiatric medications overall, and it still holds strong as one of the most effective options. [3]

However, lithium does come with many possible side effects such as nausea, vomiting, diarrhea, hand tremors, and dizziness, to name a few. [6]

Long term risks can include hypothyroidism and kidney problems, and therefore periodic follow-ups with a doctor or psychiatrist are necessary to make sure you have the proper dosages and that there aren’t high levels of lithium in your body, to prevent these serious issues from occurring due to lithium toxicity.

Like antidepressant medication, it can take weeks for people to see a benefit from mood stabilizers like lithium. If you aren’t seeing results as fast as you like, never increase the dosage on your own without consulting with your doctor or psychiatrist first. Only take what is prescribed to you to minimize these risks.

Antipsychotics

Antipsychotic medications aren’t used exclusively for those who have schizophrenia and related disorders, and research shows that these types of prescription drugs can be effective in treating some of the symptoms of bipolar disorder.

As mentioned earlier in this article, it’s possible to have psychotic symptoms such as delusions and hallucinations, and antipsychotics can help keep these under control.

Antipsychotic medications also have similar side-effects as mood stabilizers; however, weight gain and sexual problems are two additional ones that people should be aware of when taking these. [7]

There are several different kinds of antipsychotics that can be prescribed and this means that people can respond differently to each one.

Anti-anxiety Drugs

Anti-anxiety, such as benzodiazepines can be used to help manage symptoms seen in manic episodes, particularly ones such as irritability, agitation, and sleep issues.

However, because of the potential for misuse and dependency, these are typically used as a short-term solution for certain bipolar disorder symptoms, like the ones mentioned above.

These also work faster than the previous two options and people can notice that they feel calmer and more relaxed typically within 15 to 30mins. However, the benefits will fade within a few hours.

They are most commonly used in conjunction with lithium in the early stages of bipolar I treatment, but not something that should be used for a lifetime.

Psychotherapy

Although medication is essential for the treatment of bipolar disorder, psychotherapy can also be extremely helpful.

The episodes seen in bipolar disorder can be triggered by stress, and people can learn how to cope with life-events that have the potential to trigger an episode.

Therapy can also help strengthen your relationships with those around you, and they can also become involved and learn how they can become more supportive as well.

Cognitive-behavioral therapy (CBT), family-focused therapy (FFT), and Interpersonal And Social Rhythm Therapy, are all examples of therapy that have shown effectiveness in helping people deal with bipolar disorder.

Self-Care

Since the management of bipolar disorder is a lifelong endeavor, there are several different things you can do on your own to help prevent manic episodes.

For example, you can create daily routines for yourself to stay on track, and this also includes trying to keep a consistent sleep schedule.

Having a balanced diet and avoiding caffeine as much as possible as well as staying away from alcohol and illicit drugs will also have a positive effect and it will prevent interactions with your prescribed medications.

Lastly, create realistic goals for yourself and keep track of how you’re feeling each day. You can choose to keep a journal for yourself to help monitor your progress and start to notice patterns in your behavior. [3]

Do You Have Manic Episodes?

If you believe that you or someone you care about is struggling with symptoms of manic episodes, it is recommended that you seek out the help of a doctor or mental health professional immediately who can properly diagnose you.

You can also take this free mania test to determine if you are dealing with these types of episodes and this can help you get started in having a better understanding of it and bipolar disorder.

However, it is not a diagnosis, and as mentioned before, this will require assistance from a professional who can give you a formal assessment and provide you with treatment options.

Conclusion

If you’re having manic episodes, you’re not alone. Although the symptoms are serious, they can be managed, and you can live a normal, productive, and more stable life. It will require your full cooperation and commitment though, and it’s something that will take a lifetime of practice.

References

  1. Mayo Clinic Staff. (2018, January 31). Bipolar disorder. Retrieved from https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955
  2. NHS.uk. (2019, March 14). Bipolar Disorder - Symptoms. Retrieved from https://www.nhs.uk/conditions/bipolar-disorder/symptoms/
  3. Harvard Health Publishing. (2019, March). Bipolar Disorder (Manic Depressive Illness or Manic Depression). Retrieved from https://www.health.harvard.edu/a_to_z/bipolar-disorder-manic-depressive-illness-or-manic-depression-a-to-z
  4. Solomon, D. A., Leon, A. C., Coryell, W. H., Endicott, J., Li, C., Fiedorowicz, J. G., . . . Keller, M. B. (2010). Longitudinal Course of Bipolar I Disorder. Archives of General Psychiatry, 67(4), 339. doi:10.1001/archgenpsychiatry.2010.15

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/210663

  1. Bhandari, S. (2020, April 14). Bipolar II Disorder: Symptoms, Treatments, Causes, and More. Retrieved from https://www.webmd.com/bipolar-disorder/guide/bipolar-2-disorder#1
  2. National Alliance on Mental Illness. (2020). Lithium. Retrieved from https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Lithium
  3. National Institute of Mental Health. (2016, October). Mental Health Medications. Retrieved from https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml