anger mistaken for maniaFrom Kate:

On a recent admission to hospital I felt more anger than mania. I felt angry over an involuntary admission. As I vented my feelings of anger, they were perceived as symptomatic of a manic episode. Where does that “fine line” exist? Please tell.

We expect that situations like these occur more often than most professionals would like to admit. Although therapists often point out that “Nobody can make you angry,” sometimes people have very good reason to feel angry, and an involuntary admission certainly qualifies as one of these reasons.

Unfortunately, any expression of that anger is likely to be perceived as a symptom of mania. It’s like being suspected of a violent crime you didn’t commit. The more vehemently you protest, the more your captors suspect you of being a violent person capable of committing such a crime.

Anger and mania are not the same thing. Period. Anger is an emotional response that occurs in response to a trigger, and people are more or less able to regulate themselves in response to feelings of anger. People in a manic episode may be irritable and more easily angered, and they often struggle with regulating their angry responses. But just being angry is not a manic symptom per se.  Someone may feel angry with or without mania.

Unfortunately, the conditions surrounding an involuntary admission are never ideal, nor are the people making the decisions. Like all people, they’re not perfect. In the highly charged emotions around a possible involuntary admission, anger may be perceived as threatening and perceived as evidence of a “risk of harm to others.” This is a key phrase in determining whether someone qualifies for involuntary admission.

If someone is unable to regulate the response and appears to be aggressive or threatening, that may well be a reason that the psychiatrist or ER staff pursues the admission.

Unfortunately, we have no ideal solution. The best we can do is open the floor to discussion and increase awareness of these imperfect situations. If you’ve experienced an involuntary admission to a hospital or psychiatric treatment center, justified or not, or managed to avoid one, please share your experience.

How did it make you feel at the time? How did you respond? Do you think you or others could have handled the situation differently for a better outcome? If so, what could/should you or they have done?