Features
The classifications of mania vary in intensity. Mild mania or hypomania is a manic condition in which quality of life and function are slightly impaired. There is elevated energy level or raging mood, which can be beneficial for the affected person since these features result to goal-motivated behavior. Full-blown mania also features a higher energy level and elevated mood than mania, coupled with psychotic features such as hallucinations, aggression, catatonic behavior, delusions of grandeur, suspiciousness and self-neglect. Mixed state or dysphoric mania includes mania with some episodes of depression, but not as cyclical as bipolar disorder. These features of mania are affected by changes in environmental stressor, diurnal rhythms and sleep cycle. The magnitude of manic episodes is measured through standardized tools like Young Mania Rating Scale and Altman Self-Rating Mania Scale.
Many individuals with mania and hypomania showcase artistic talent and do not always need or want medical help because of two reasons. These people may be extremely unaware of their manic episodes.
Symptoms
The American Psychiatric Association defines a manic episode as a period of 7 or more days in which there is irritable, open electable and effusive mood in an unusual, continuous manner that is not caused by medical illness or medication. To be verified as a manic episode, it must satisfy either one of these three conditions:
1. Causes apparent hardships in social relationships, activities or at work
2. Requires hospital admission
3. Causes the person to suffer psychosis
Mania is characterized by consistent and abnormal high level of self-esteem, pressured speech, frequent talking/blabbering, flight of ideas, racing thoughts and diminished need of sleep. A mixed episode of mania happens when the person has concurrent depression.
Biological Basis
Several research studies show that mania is caused by the excessive levels of serotonin in the temporal lobe. Increase in the amount of other neurotransmitters such as dopamine, glutamate, norepinephrine and GABA are also suspected to contribute in manic episodes. In females, imaging studies reveal increased levels of activity in the left amygdala and decreased activity in orbitofrontal cortex. However, these findings are not yet confirmed as the real biological mechanisms of mania.
Treatment
Treatment of mania includes the administration of antipsychotic medication and mood stabilizers such as lithium. Psychotherapy and counselling are also crucial parts of the management for mania.
