Mania

**Mania** is a type of mood.  Mania is usually a symptom of a medical problem or a mental illness.  A person with mania is described as **manic**.

When people are manic, they usually have much more energy than usual.  They often have very strong emotions, and their moods may change very quickly.

The word "mania" comes from the Greek language (_μwordsανία_ means _mania_).  That word comes from _μαίνομαι_ (_mainomai)_, which means "to rage" or "to be furious" (very angry).

Mania is a symptom, not an illness by itself.  Many different things can cause mania.  These things include illegal drugs and brain tumors.  However, most of the time, mania happens in people with bipolar disorder.  Bipolar disorder causes periods of mania that switch off with periods of depression.

Like with other symptoms, mania can be mild (not very bad), severe (very bad), or anywhere in between.  Mild mania is usually called "hypomania."  Very bad mania can cause psychosis, with hallucinations and delusions.

Sometimes people with mania may need to be hospitalized so they do not hurt themselves or other people. Many people with mania and hypomania have special creativity and artistic talents.

## Symptoms

The most common symptoms of mania are:
- A mood that is either euphoric (very happy) or irritable (easily irritated or angered)
- Being very talkative.  This includes talking very quickly (pressured speech) and jumping from one idea to the next very quickly (flight of ideas).
- Having an unusual amount of energy
- Not needing sleep
- Being very hyper

Other symptoms of mania can include:
- Racing thoughts, which can sometimes make it impossible for the person to concentrate on anything other than their thoughts
- Acting impulsively (doing things without thinking them through), like spending a lot of money or having unsafe sex.  People are more likely to put themselves in danger when they are manic.
- Physical symptoms, like sweating, pacing, and losing weight
- Hypersexuality (wanting to have sex much more than usual)
- Delusions, like:
    - Delusions of grandeur: The person believes he is very important - for example, that he knows everything, or is famous, all-powerful, or very wealthy
    - Delusions of potential: The person believes he can do things he cannot really do (for example, believing he can build a house on his own, when he has never built anything before)
    - Delusions of persecution: The person believes other people are "out to get him" and are causing his problems on purpose

### Official diagnosis (DSM-5)

In the United States, a book called _The Diagnostic and Statistical Manual of Mental Disorders_ (DSM), published by the American Psychiatric Association, is used to diagnose mental illnesses.  According to the latest version of the DSM, the DSM-5, a person is having a "manic episode" if all of these things are true:
1. The person's mood has been unusually euphoric or irritable for seven days or more
1. The person's mood changes are not caused by illegal drugs, medicine, or a medical illness
1. The person's mania is:
    1. Causing them obvious problems at work, with family, or friends; OR
    1. Making them psychotic; OR
    1. Making them a danger to self or others
In addition, the person must also have three or more of these symptoms:
1. Inflated self-esteem or grandiosity (the person feels like he is very important and special)
1. Needs only a little sleep to feel rested
1. More talkative than usual; or the person seems like they have to keep talking (pressured speech)
1. Jumping from one idea to another; or the person feels like their thoughts are racing
1. Increase in "goal-directed activity," like taking on big new projects; or "psychomotor agitation" (moving around a lot, unable to sit still)
1. Being easily distracted (the person's attention is drawn too easily to things that are not important)
1. Doing a lot of activities that have a high risk of turning out badly (for example, spending a lot of money; going on sexual adventures)

### Official diagnosis (ICD-10)

The ICD-10 is the World Health Organization's system for classifying health problems.  It describes a manic episode this way:
- The person's mood is euphoric, and can change from being happy and carefree, to "almost uncontrollable excitement"
- The person has an unusual amount of energy and is always doing some kind of activity
- The person seems like they have to keep talking
- The person does not seem to need sleep
- The person cannot pay attention to anything, and gets distracted very easily
- Often, the person feels very important, is much more confident than usual, and has unreasonable ideas about what they can do (for example, they may feel like nothing can stop them from getting what they want)
- The person does not have normal social inhibitions (a sense of what is right and appropriate to do around other people).  This can lead to behavior that is inappropriate, reckless, and unusual for the person.

## Causes

**Mental illness**

Mania is usually a symptom of mental illness, most often bipolar disorder.  A diagnosis of type I bipolar disorder (bipolar I disorder) can be made based on a single manic episode.  This is the most common cause of mania. If a person is hypomanic, they may have type II bipolar disorder or cyclothymia.  If a person has psychosis that lasts longer than their mania, they may have schizoaffective disorder.

**Medical causes**

Mania is usually caused by a mental illness.  However, some medical illnesses can cause symptoms of mania.  Some doctors use the mnemonic E-MANIC to remember the possible medical causes of mania:
- **E**ndocrine: Hyperthyroidism, hypothyroidism, or Cushing's syndrome can cause mania.  (These are all problems with hormones in the body)
- **M**edications: Many different medications can have mania as side effects.  These medications include amphetamines (often used to treat Attention-Deficit Hyperactivity Disorder, or ADHD); antidepressants; corticosteroids; opiate painkillers, and many others.
- **A**buse of alcohol or illegal drugs: Alcohol and many other drugs can cause mania.  These drugs include cocaine, amphetamines, phencyclidine (PCP), lysergic acid diethylamide (LSD), inhalants, opiates, anabolic steroids, and MDMA (Ecstasy).
- **N**eurologic problems: Many different problems with the brain can cause mania.  For example, brain tumors, brain injury, multiple sclerosis, and Huntington's disease can all cause manic symptoms.
- **I**nfection: Infections in the brain can cause mania.  Examples include meningitis, brain infections caused by HIV/AIDS, and neurosyphilis (the last stage of syphilis, when the disease reaches the brain)
- **C**ardiovascular causes and **C**erebrovascular accidents (strokes)

Not having enough vitamin B-12 (vitamin B-12 deficiency) can also cause mania and psychosis.

## Medical treatment

If mania is caused by a medical problem, the best thing to do is to treat that medical problem.

If mania is caused by a mental illness, the best treatment is a combination of medicines and psychotherapy (talking with a therapist or counselor).

Doctors usually treat mania with a combination of mood stabilizers and antipsychotic medicines.  While taking these medicines, the patient should see their doctor regularly to be checked for side effects.

When the symptoms of mania have ended, long-term treatment then focuses on preventative treatment.  The goal of this kind of treatment is to prevent periods of mania or depression from happening.  Very often, this is done using a combination of drugs and psychotherapy.  Medication works best for bipolar disorder, and other mental illnesses, when it is combined with other treatments like psychotherapy.

## Related pages

- Abnormal psychology
- Bipolar disorder
- Clinical depression

### More reading

- _Expert Opin Pharmacother_. 2001 Dec;2(12):1963–73.
- Schizoaffective Disorder. 2007 Sept. Mayo Clinic. Retrieved October 1, 2007.
- Schizoaffective Disorder . 2004 May. All Psych Online: Virtual Psychology Classroom. Retrieved October 2, 2007.
- Increased Amygdala Activation During Mania: A Functional Magnetic Resonance Imaging Study . 2005 June. _The American Journal of Psychiatry_. Retrieved October 2, 2007.
- Psychotic Disorders . 2004 May. All Psych Online: Virtual Psychology Classroom. Retrieved October 2, 2007.
- Increased concentrations and lateral asymmetry of amygdala dopamine in schizophrenia. 1983 Oct. Nature.  Retrieved October 2, 2007.
- Antidepressant-induced mania and cycle acceleration: a controversy revisited . 1995 Aug. _American Journal of Psychiatry_. Retrieved October 2, 2007.
- Risperidone therapy in treatment refractory acute bipolar and schizoaffective mania. 1996 Jan. _Psychopharmacology Bulletin._ Retrieved October 2, 2007.
- Behrman, Andy.  _Electroboy: A Memoir of Mania_, "Preface: Flying High", 2002.

## Other websites

- Bipolar Mania Symptoms
- Depression and Bipolar Support Alliance 
- Manic Episode Symptoms