Understanding the Symptoms of Bipolar Mania

Recognizing the 8 Signs of a Manic Episode

Mania and hypomania are phases of bipolar disorder characterized by elevated "highs" in mood and behavior that are in stark contrast to the depressive "lows" of the emotional cycle.

Mania is a facet of type I bipolar disorder in which the mood state is abnormally heightened and accompanied by hyperactivity and a reduced need for sleep. By contrast, hypomania (often described as "mania-light") is a type II bipolar disorder which neither has the range nor severity of symptoms that classic mania has.

If left untreated, bipolar mania can spin out the control and affect your ability to function on a daily basis. Recognizing the symptoms is the first step toward seeking the appropriate treatment and care.

Symptoms

The appearance of one or two symptoms of mania doesn't necessarily mean that you have bipolar disorder. There may be other explanations for your sudden change in mood, including an emotional trauma, a brain injury, a drug reaction, or an undiagnosed anxiety disorder.

Broadly speaking, bipolar mania can be characterized by some or all of the following features:

  • Mood changes
  • Sudden changes in energy and activity
  • Speech disruptions
  • Impaired judgment
  • Changes in thought patterns
  • Development of psychosis

You wouldn't necessarily have all of these features to be diagnosed as manic or hypomanic. Instead, your doctor would review your symptoms and see if they meet the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) issued by the American Psychiatric Association.

If you are experiencing manic symptoms that are impairing your ability to function, find a mental health professional in your area able to diagnose your symptoms and offer treatment, if needed. You can ask your family doctor for a referral or contact the National Alliance on Mental Illness (NAMI) hotline at 800-950-NAMI from Monday to Friday, 10:00 a.m. to 6:00 p.m. Eastern Time.

Diagnosis

According to the DMS, bipolar mania can be diagnosed if you experience at least three of the following symptoms for no less than a week:

  • Reduced need for sleep
  • Increased rate of speech
  • Flight of ideas
  • Being easily distracted
  • High self-esteem
  • An increased interest in goal-oriented activities
  • Psychomotor agitation (such as pacing or hand-wringing)
  • An increased pursuit of risky or dangerous activities

To better understand the nature of these symptoms, you would need to explore the root behaviors that characterize bipolar mania.

Mood Changes

Mood changes are characterized by a sudden burst of activity, often described as being as being outsized or larger than life. These change would be long-lasting rather than transient and be uncharacteristic of your natural mood state.

Symptoms may include:

  • Extreme excitability
  • An expansive mood
  • Grandiosity and imperiousness
  • Sudden shifts to extreme irritability, hostility, or even anger

Changes in Energy

It is one thing to have a sudden rush of energy; it is an another when the energy is relentless, prolonged, and overwhelming. As with mood changes, the sudden upshot of energy would not be considered normal and can switch off as quickly as it was switched on.

Symptoms may include:

  • A decreased need for sleep with little apparent fatigue
  • A sudden increase in goal-oriented activities (such as a project that needs to be done to the exclusion of other activities)
  • Restlessness and an inability to remain still
  • Persistent and often purposeless movement

Speech Disruptions

Speech disruptions are probably the easiest way to recognize a manic episode. A person may be described as having a "motor mouth" and be difficult or even impossible to interrupt.

Speech disruptions may include:

  • Rapid, pressured speech (as if you cannot get enough words in)
  • Incoherent speech (often described as rambling and persistent)
  • Clang associations (a serious condition in which words that sound similar are grouped together even if they don’t make any sense)

Impaired Judgment

Impaired judgment can often be missed by casual observers who may dismiss the behavior as either a momentary lapse or a sudden burst of generosity, passion, daring, or goodwill. At times, the behavior may be risky, hurtful, or even dangerous.

Example include:

  • Inappropriate humor and brash behavior
  • Extreme impulsiveness (including gambling and risk-taking)
  • An apparent lack of insight into the consequences of an action
  • Reckless and extravagant spending (including the lavishing of gifts on friends, casual acquaintances, and even strangers)
  • Hypersexuality and sexually provocative behaviors

Changes in Thought Patterns

Changes in thought patterns are easily spotted by those with whom the person has regular interactions. They may manifest as a sudden burst of creative insight or appear fractured and nonsensical.

Example include:

  • Enhanced creativity or inventiveness (often perceived as a "breakthrough" or an epiphany)
  • Flight of ideas (a rapid succession of thoughts that shoot from one idea to the next)
  • Racing thoughts (a rapid stream of thought, often repetitive)
  • An increased focus on religion or religious activity
  • Disorientation or disjointed thinking

Psychosis

Psychosis is a severe manifestation of bipolar disorder which can affect people in a manic or depressive mood state. Psychosis is defined as a break from reality which typically requires medical treatment and hospitalization. It is not a feature one would expect to see in a hypomanic phase.

Symptoms may include:

  • Hallucinations (hearing, seeing, smelling, touching, or feeling things that are not real)
  • Delusions (believing things that are not real)
  • Paranoia (fearing things that are not real)

The symptoms of psychosis tend to match the mood state. If it occurs during a manic phase, you may believe you have special powers and engage in reckless behaviors. If bipolar psychosis occurs during a depressive episode, you may believe that someone is out to harm you.

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