Bipolar Beat

How Long Can a Manic Episode Last?

By Candida Fink MD
October 17, 2008

Loved ones often wonder how long a manic episode can last if it remains untreated. Generally speaking, an episode can last several weeks to several months. A visitor to the Bipolar Blog posted a comment indicating that her husband was experiencing a manic episode that lasted eight months and was still ongoing.

Eight months is certainly over the normal limit. Something usually happens before then to end the episode - the person receives treatment (possibly through a hospital stay), the episode simply ends, or the person becomes physically exhausted.

If an episode lasts more than a few months, it generally indicates that something else could be fueling it, such as the following:

  • Drugs 
  • Alcohol
  • Surreptitious antidepressants (sounds weird I know - but possible)
  • Something related to physical illness

 


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9 Comments to
“How Long Can a Manic Episode Last?”

I went through a period of hypo mania for 5 mos. I slept 2-3 hours a night & had so much energy & enthusiasm & felt so good. I had confidence & felt high self esteem (which is unusual for me). I actually felt like I had adrenaline rushes coursing through my body. It felt like a drug was tingling all my nerve-endings–hard to explain. I did not report it to my doctor as I did not realize it was so dangerous. I have bipolar 1 & had been stable for 5 years previous to this on a cocktail of 5 medications.

SUDDENLY I crashed & did an overdose. My husband found me & took me to the ER. That was 2 1/2 years ago & I still haven’t recovered from the experience emotionally. I am so scared that I could do something like that. I had suicide attempts in the past (1st one at 15), but after my 1st child at 22 promised myself I would not do that as my mother committed suicide (she was bipolar also) & I knew how devastating that is on a child. So despite STRONG urges to do so over the years I have restrained myself until that episode 2 1/2 years ago.

My daughter is 31 now & I am 54 so I was shocked that I had broken my vow after all these years. Since that overdose my doc has listed my dx as mixed–moderate & has been adjusting my meds & wants to add Seroquel to help me to sleep (sleeping a little better; maybe 4 sometimes 5 hours a night despite taking some sedating meds), but I am resisting taking more meds.

I am also doing individual therapy & DBT (which is helping immensely). But is it possible to be in a mixed state for so long (2 1/2 YEARS)??

Hi Suzanne -
The depressive episodes are typically much longer than the manic or hypomanic ones. And a mixed state by definition is a full depressive episode - so likely to last longer than mania.
Hang in there - you are doing so much to help yourself - i think DBT is a terrific treatment option. And remember that it was not you who chose to break your promise not to hurt yourself - it was your illness. Try to be gentle on yourself - because you are doing battle with this might enemy - but you have been winning the war even though that battle was so overwhelming.

Thank you for your kind words. It means a lot to hear that breaking that important vow was not a result of my weakness of character. Sometimes I just wonder if I am doing all this to myself; am I somehow causing these feeling to occur through my negative thinking? Am I just following what my mother modeled for me (she committed suicide when I was 15) because I am too weak to break the patterns? All these thoughts swirl around after a relapse.

Thanks for your response.

How does one measure whether the symptoms are severe, chronic, diabilitating?
I know–If it is distressing and interfers with your job, school, or relationships.
Well, what if you don’t have a job, go to school or have a relationship? Or, what if you do have them and you aren’t fired, kicked out of school, or your relationship doesn’t bail? What if you, yourself decide to quit all of the above? So, how do you know if you quit because of bipolar or because you are a lazy coward????

Hello,
My sig other. Has been displaying classic signs of mania for the last 2 months. The thing is he also has end stage liver disease and was hospitalized in October for it and for his extreme mood swings. His liver specialist put him on Trazadone, because he said he couldn’t sleep and his pcp had him on gabapentin for pain. His liver specialist said he had hepatic encepalapathy and left it at that. But I am seeing all the signs of manic depression and they don’t fit with the first diagnosis. I have called 911 on him twice, the first was because he said the message light on our cable box was a camera and was taking pictures of what was going on in the house and he called his brother and said he was there dad and that he was going to get him because he stole money from the estate after their dad died (needless to say his brother also called the cops and got a restraining order), the second time was yesterday as he called his ex in Fl at 5 am and told her to call 911 for him. He wanted me to as well and when I finally did (after talking to his ex)he was furious with me but calm with the police and said I was the one who needed the help (I am bi-polar too but am pretty stable right now just slightly depressed from the stress of all this but I am getting help). I don’t know where to turn anymore and am afraid to leave him alone as I don’t know what he will do. He spends money like it is water and thinks he is God and that God sent him here to finish what Jesus didn’t get done. He also thinks he is John Lennon and Darwin. Can anyone give me info on what I can do. His sister just puts her head in the sand so to speak and his ex is trying to help but has her own family in Florida to take care of. What can I do? I am at my wits end and it seems like no one really listens.

Lisa - I know exactly what you mean - I have asked the same question. For me it amounts to this, “how on earth can I tell which parts of my life are real and which are fuelled by bipolar disorder?!” xx

My wife’s manic episodes are never that long, although it’s so hard to tell because she goes into mixed states, where she’s manic and depressed at the same time. They are hell on me. Those states can last for a couple of months. The true manic states, though, they burn out quickly for her… a couple of weeks at most.

My wife is severely bi polar and she also has HIV, if it matters I do not have either condition. We lived together in Argentina until I simply could not take the situation any longer. I feel terribly guilty for leaving however the situation was quite severe and I believe dangerous. I have been gone 3 months. She has been on different medications for at least 10 years mainly benzodiazapines also she took Zoloft for about 18 months. She self medicates has never followed her dosage guidelines in Argentina you can get these medications without a prescription. My Mother in Law is a psychologist and arranged for delivery of the medications with no prescription. My wife also stops taking her HIV medication often because she gets sick from them. I spent the last 3 years handling every domestic responsibility trying to get her to take the meds she needed and stop with those she did not. It did not work. I have tried to be supportive from a distance but now I am “intruding” on her life she seems to be on a manic episode drinking and some other things and is quite aggressive towards keeping me at a distance. She has never been on a structured treatment program. Just meds. I Love my wife do not want to divorce I know she Loves me but seems to be avoiding anything that is emotional right now. This is so hard I am worried deeply for her. What can I should I do?

Hi all,
Huge Sigh :/ Please Bare with me. Hard Times!

my husband and I have been together for nearly 7 years. For the most part, it’s been h*ll. (and yes, I feel guilty for saying it).
Husband has been suffering with emotional issues from childhood. He began consuming himself in Alcohol at an early age.
Moving on:
After nearing divorce and talking to his mother he decided to go for help, 3 years ago. Diagnosis~Bi polar manic. He was put on Zoloft which turned him into an even bigger Angry Monster. Currently on lamictal since August. I began to recognize the onset of a Manic/Mean Phase in September. Unforntunately, I recall the specific day-Sept 21.
He got physical and I sent him packing. Well, actually I packed his things for him~all the while, feeling numb.”this isn’t right, I love him but he’s mean, cruel, he can’t help it, etc…”
After a week he came to me apologizing/cring and said things would be different-he moved back in.
I *think* this affects him more than myself.
Each episode worsens slightly. This is by far the worst yet :/ In his eyes, I can not do or say anything RIGHT… SO CONFRONTATIONAL :/ !! lose - lose situation. I won’t discount how he must feel. As much as I love him I am not sure I can hang on much longer :/
There’s so much more: the first 5 years of our relationship he led what I refer to as a double life.
We began going to church regularly in 2004/2005,had a son in 2006, all the while husband was watching porn on internet, calling sex lines from cell,joined an online dating site, frequenting a Peep show where the girls strip and the man does “you know what to himself”. sorry (tmi)
How I found out: he went through $5,000.00 cash in a week and had absolutely nothing to show for it and a female called his cell! Initially he contacted her “phone sex” sorry again, tmi.
All the while, *WE* were taking Ministry classes at church.
Enough for now- I feel nausea

*L* in Ohio

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Candida Fink, M.D. and Joe Kraynak are authors of Bipolar Disorder for Dummies. Pick up the book today!
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