In an ideal world, patients would realize that what they feel is not normal and seek help from their primary care physician, therapist or psychiatrist, who would recognize the symptoms and provide proper treatment. We don’t live in an ideal world. Putting symptoms into a search engine is now the first response. That’s when endless lists pop up. For bipolar disorder, it’s easy to find symptoms that are verbatim from the diagnostic manual, complete with medical jargon. But sometimes it’s tough to figure out what they really mean. Mania is hardly a dry, tedious experience, so why should the explanation be?
Mania is characterized by intense euphoria or irritability and high energy. To be diagnosed as a manic episode, you have to experience three of the listed symptoms, or four for irritability. Each of these can be fleshed out extensively, but here’s a simple breakdown:
1 “Inflated self-esteem or grandiosity.”
Grandiosity is an inflamed sense of superiority. You become self-involved, thinking you’re the best and the brightest, even when there isn’t really evidence to back it up. Anger is not uncommon if anyone contradicts you. If psychosis or delusions occur, you might think you’re in a relationship with a famous person or that you are president or a god.
2 “Decreased need for sleep.”
It’s important to note that this does not mean the same thing as insomnia or just not being able to sleep. During a manic episode you may feel fully rested and energetic after only a few hours of sleep. Staying up for days at a time is not uncommon.
3 “More talkative than usual or pressure to keep talking.”
This comes into play if you’re not typically chatty and suddenly finding yourself talking non-stop or striking up conversations with strangers at the grocery store. The pressure to keep talking is your brain telling you that you need to keep speaking even if you don’t know what to say. You may become loud or interrupt frequently. If you’re irritable you may decide it’s a good time to rant at your boss in front of all of your coworkers.
4 “Flight of ideas or subjective experience that thoughts are racing.”
Your thoughts are moving faster than you can process them. You may jump from one idea to another in half a second. When you combine this with being more talkative, you may stop making sense if what you’re saying is trying to keep up with what you’re thinking.
This one is fairly straightforward. Instead of focusing on the task at hand or on the person who is speaking to you, you flip your focus from what’s going on across the room to the mustard stain on the person’s shirt or SQUIRREL!
6 “Increase in goal-directed activity.”
You suddenly decide you’re going to run in a marathon next week when you’ve never even owned a pair of running shoes. Maybe you make plans to build a shed in the backyard when the last thing you built involved Lincoln Logs. It could also be something less extreme like cleaning the entire house and rearranging all of the furniture. You may decide to do all of these things at once yet do nothing to actually reach these goals. Some goals may involve work projects or relationships.
7 “Excessive involvement in activities that have a high potential for painful consequences.”
Typically, this symptom is characterized as “risky behavior,” which is a little vague. Gas station sushi is risky, but the risk is relatively small. When experiencing mania, risk-taking rises to a whole new level. We’re talking spending hundreds or thousands of dollars because you suddenly decided you needed a room full of fish tanks. Maybe your sex drive goes into hyperdrive and you decide to have an affair with several different people. Perhaps you just get in the car and drive until the gas runs out. Then just get out and keep walking. There is no end to the list of ideas that sound fantastic when you’re manic.
These are only a few examples of what can happen during mania. Eventually, it ends, and you have to face the consequences. The best thing to do is keep track of your behavior and call your doctor if anything starts changing.
Photo credit: David Goehring