Mania is an affective disorder with a mood far beyond normal, usually euphoric. While a depressed person tends to be introverted and withdrawn, a manic patient is characterized by strong inner restlessness, sometimes persistent irritability, and loss of inhibitions.
What is mania?
The ancient Greek word mania means rage, madness, or frenzy. From this, the term was derived for the mental disorder of consciousness known as mania. The affected person is in a seemingly never-ending mood high and is often characterized by excessive self-confidence or boundless self-overestimation. In some cases, irritability occurs instead of the mood high. As a result of the illness, those affected often get into conflicts with their environment, as they can no longer consciously avoid them. Mania often occurs in episodes and is bipolar, i.e. with opposing moods. The most common form of mania is called manic depression, in which manic and depressive episodes alternate.
Causes
The causes of mania have not yet been determined with 100% accuracy. However, based on current research and knowledge, it is believed that there are several factors that can trigger a manic episode. On the one hand, a disturbance of the biochemical messengers (neurotransmitters) seems to play a role. Second, alterations in genes have been found in manic patients. Finally, there are often serious experiences, such as the death of a close person, separations, loss or existential fears, which act from the outside and promote the disease. The fact that all these factors have also been demonstrated independently in healthy people, and that there are definitely patients who suffer from mania without external factors, underscores the complexity of the disease and its causes.
Typical symptoms and signs
- Mood swings
- Increased mental and physical activity
- Mood high, good mood, party mood
- High risk behavior
- High emotional excitability
- High social contact and communication skills
- Less fatigue
- High self-esteem
- Irritability
Diagnosis and course
Mania is diagnosed by a consultant psychiatrist based on the symptoms and behavior of the individual. A physical examination is not necessary. Frequently, discussions with the patient are supplemented by discussions with the patient’s relatives. The diagnosis is often made more difficult by the fact that those affected do not see a doctor until very late. They do not perceive their behavior as abnormal or exaggerated and, on the contrary, feel very well and healthy. Typical symptoms of mania include: a constant, unfounded mood high, uncritical behavior towards oneself, loss of inhibitions, strong urge to talk, delusions of grandeur, reduced need for sleep, sometimes hallucinations, strong irritability, strong restlessness, restless doing. Characteristically, all of these behavior patterns extend far beyond what is normal and usually tolerable for other people. In manic depressive patients, phases of mood highs are followed by phases of “catcalling,” listlessness, and sometimes shame because of their previous behavior. Mania occurs from case to case with varying course and symptomatology.
Complications
The complications of mania depend on the condition of the person affected. Thus, the depression that afflicts most sufferers of mania also plays a role. The activities that the sufferer engages in during his manic phases can have serious complications for him and those around him. For example, disinhibited financial behavior often leads to serious imbalances in finances. This can – through borrowing or rather rarely occurring thefts – also affect the manic’s environment. The financial burden in turn leads to a deterioration of the mood during depressive phases. The sexual behavior of the affected person can also cause serious emotional and health damage. Lack of prudence in sexual contact – sometimes indiscriminate – carries a risk of STDs.Lack of sleep and overexertion also often lead to cardiovascular problems, which increase the risk of heart attack and stroke. Affected individuals occasionally tend to neglect hygiene, which can manifest itself in emerging illnesses. In addition, they frequently stress their bodies with alcohol or other substances. Overall, long-term damage from substance abuse occurs significantly more often. Possible criminal acts entail social and personal complications, ranging from legal measures to social isolation. All of these secondary complications also make depressive episodes more severe. The autodestructive behavior of affected individuals is often amplified and may extend to suicide.
When should you see a doctor?
If the affected person shows a sudden behavioral abnormality, he or she needs medical assistance. If there is prodigality, a persistent spending spree, or a very active demeanor, there is an irregularity that needs to be investigated and treated. A high level of activity, a reduced need for sleep or the permanent urge to have to do something are considered signs of an existing disorder. The mood of the affected person is euphoric, the sufferer has no feeling of illness and likewise no insight of a present disorder. As a result, caregivers are urged to contact a physician as soon as possible when symptoms appear so that help can be initiated. Overconfidence, loss of awareness of dangerous situations, and emotionally hurtful behavior indicate a mental irregularity that should be presented to a physician. Since people in a manic phase are considered incapacitated, they require medical attention. If personal performance increases excessively, the thirst for action increases and affected persons show an unfounded immensely good mood, they need a doctor. They have lost their appreciation of reality, as they stand out in inappropriate situations with an elation. If the affected person’s state is perceived as ecstasy or intoxication by people in the close environment, a doctor must be consulted. Mandatory hospitalization is often required.
Treatment and therapy
Mania is treated with medication. Neuroleptics, antiepileptic drugs, and lithium preparations may be used. Combinations of individual drugs are also possible, depending on the severity of the illness, among other factors. The aim of medication is primarily to stabilize the patient’s mood. In the acute manic phases, it is often necessary to treat patients as inpatients in a psychiatric ward. This is especially the case if there are suicidal intentions or if the affected person poses a danger to those around him.
Prevention
Mania is not curable in the conventional sense. Since its causes are not really known, it cannot be prevented. For the person affected, the only option is to “come to terms” with the illness. The high suicide rate among people with manic illnesses shows that for many this life is unbearable. However, those affected do have the chance to lead a relatively regular life without stress. What is important for this is that they face up to the illness, do not discontinue the prescribed drug treatment and seek psychological care to work through past or existing problems.
Aftercare
Aftercare for mania usually goes hand in hand with prevention. After an inpatient stay, it makes sense to continue treatment on an outpatient basis. A psychotherapist supports the patient psychologically and socially, while a psychiatrist works with the patient to decide whether to take medication. Not in every case do people with mania need to take psychotropic drugs permanently. However, in severe cases, they can help establish a biochemical balance in the brain. Doctors prescribe certain agents with the aim of reducing the risk of mania becoming too severe. In psychotherapy, patients learn about their individual causes and triggers for mania. For aftercare, it is crucial to reduce these factors as much as possible to establish a stable living situation.
Here’s what you can do yourself
The options for self-help during a manic episode are very minimal.Since the clinical picture of mania includes a lack of insight into the disease, the patient lacks the necessary awareness of the disease and its occurring symptoms. More likely is a behavior that resembles a megalomania and arrogance towards other people or life. The affected person has the feeling of being immortal and faultless. Even the warnings of people with whom there is a very good relationship of trust are ignored or dismissed as silly. However, in healthy and well-reflected health phases, the sufferer can take some precautions. These include medical care and financial arrangements. Precautions against another manic episode can be taken with a therapist, close relatives, as well as a legal guardian. During a mania, the affected person is considered legally incapacitated. This often leads to legal precautions already being taken after an initial manic episode. In addition, it is helpful if people in the immediate social environment are adequately informed about the illness and its effects. In case of an emergency, a card or a passport with contact details of people who can help, which can be easily seen by third parties, is useful. In this way, a caregiver can be called at any time in the event of a highly euphoric mood.
