Here's How to Know if You or Someone Else Is Having a Manic Episode (2024)

The terms "mania" and "manic episode" describe a state of mind characterized by high energy, excitement, and euphoria over a sustained period of time, typically followed by feelings of depression. It's an extreme change in mood and thinking that can interfere with school, work, or home life.

Mania is also a main feature of bipolar disorder, which used to be known as manic depression. "Mania is the linchpin; you can't have a diagnosis of bipolar disorder without mania," Ken Duckworth, MD, chief medical officer at the National Alliance on Mental Illness (NAMI), told Health.

Here's everything you need to know about mania, including all the signs, what a manic episode feels like, how it's linked to bipolar disorder, and how it can be treated.

Signs and symptoms of mania include having high energy, being talkative and talking fast, having racing thoughts, being easily distracted, engaging in risky behavior, and not getting enough sleep. These characteristics of a manic episode typically last for one week or more, according to StatPearls, the medical database of the National Institutes of Health (NIH).

Mania is a "natural" state, per StatPearls. This means that mania occurs on its own; it's not caused by other factors like medical conditions, or drug or alcohol use.

Mania can feel so good that people often don't think anything is wrong. But, family members or other people close to the person experiencing a manic episode may notice the changes in behavior. Also, mania can often be followed by depression—and because these phases don't feel near as good, a person is more apt to seek help from a healthcare provider during a depressive episode.

Whether you are experiencing these symptoms yourself or someone you know is, it's important to recognize them when they occur. Here are the main signs of a manic phase in detail.

High Energy or an "Expansive" Mood

The energetic highs that accompany mania may make you more active than usual, says MedlinePlus, an online health information service from the NIH. You may suddenly have a big idea that's goal-directed but unrealistic, such as starting a business on a whim with all your family's life savings, said Dr. Duckworth.

Fast-Talking

People with mania may be extremely talkative—and it's more than just speaking quickly. "It's almost as if they can't get the words out fast enough. It's called pressure of speech," Michael Roeske, PsyD, licensed clinical psychologist with Newport Academy and adjunct professor with the University of San Francisco told Health. For someone talking to a person in a manic episode, "you feel it—it almost presses you against the wall," said Roeske.

Lack of Sleep

With all of that energy and activity during a manic period, sleeping may stop or the person may run on very little sleep. "People with mania often don't need any sleep at all," said Roeske.

Distraction

Racing thoughts may lead you to become easily distracted and start "multitasking on steroids," said Roeske. This might also look like taking on numerous complex tasks and not doing them to completion.

Risky Behavior

Spending reckless amounts of cash during a manic episode is not uncommon. "I've had patients who have bought three or four vehicles in a weekend," said Roeske.

Unprotected sex, gambling, or a drug or alcohol binge may also occur, Daniel Winarick, PhD, a licensed clinical psychologist in New York City, told Health. Because of this tendency to seek out risky behavior, "mania is serious and dangerous," explained Winarick. "A person can potentially do something to hurt themselves or someone else."

Psychosis

Severe manic episodes may also involve psychosis, which includes having hallucinations or delusions, according to NAMI. For example, people may have grandiose delusions, where they believe they are spies, government officials, or secret agents without having a background in any of these areas, or they may have delusions of paranoia, where they feel they are being stalked or targeted, says StatPearls.

Mania vs. Hypomania

Mania and hypomania are both characterized by sudden mood swings that make a person feel super energetic, wired, and euphoric and then depressed. However, hypomania is less extreme than mania. Both can lead to issues functioning at work and in your personal life, but hypomania episodes are less likely to cause noticeable problems. And they won't last as long. A period of hypomania lasts for four days, instead of a week, according to StatPearls.

Bipolar I disorder is a mental health condition where there are shifts between high moods (or mania) and low moods (or depression), according to MedlinePlus. Genetics or family history, stress, and differences in brain function may all play a role in the development of bipolar disorder (and, therefore, mania).

An estimated 2.8% of adults in the US have bipolar disorder, split equally among men and women, per the National Institute of Mental Health (NIMH). And about 4% of the population will experience bipolar disorder at some point in their life. Bipolar I disorder typically starts around age 25, as per StatPearls, and symptoms usually show up earlier in life in males than in females.

For mania to be diagnosed, this elevated and energetic mood and behavior has to happen most of the day and last for at least one week, according to The American Journal of Psychiatry. "To be diagnosed with bipolar disorder, a person must have experienced at least one episode of mania or hypomania," according to NAMI. "To determine what type of bipolar disorder a person has, mental health care professionals assess the pattern of symptoms and how impaired the person is during their most severe episodes."

The Warning Signs of a Manic Episode

If you've already been diagnosed with bipolar disorder, know your own warning signs of mania, said Dr. Duckworth. For example, you (or someone you're with) may start:

• Driving faster than usual
• Having agitated mannerisms
• Singing a certain song or using certain phrases (will be entirely unique to the individual)

"One thing we've learned is that people have predictable episodes of mania. If you can recognize patterns and allow people in your life to give you feedback without activating your own defensiveness, then you can participate in collaborative problem-solving," said Dr. Duckworth.

Also, realize that early manic episodes can be "seductive," said Dr. Duckworth. "Some people prefer it because they feel that they're more open, funnier, and interesting. The experience can be reinforcing in the beginning," said Dr. Duckworth. However, mania can also lead to extreme agitation or irritability, which ultimately won't feel good.

Medication

During a manic episode, a person is a danger to themself. The risky behavior can lead to losing your job or being kicked out of school, arrested, or hospitalized in a psychiatric emergency room, said Winarick. It's also important to know that for bipolar disorder, in general, the risk of suicide is 10 to 30 times higher than in the general population, according to research published in Medicina in 2019.

The first line of treatment might involve using an atypical antipsychotic to stop mania. A long-term mood stabilizer (like lithium) will then be prescribed to help prevent the recurrence of mania, said Roeske.

One challenge in treating bipolar disorder is that antidepressants may be used in the treatment of depression. However, "antidepressant use is a known risk for mania," said Dr. Duckworth. These medications may activate a manic episode if not used carefully under close supervision and alongside other medications such as mood stabilizers.

If you have a family history of bipolar disorder, then taking an antidepressant alone is a risk. Dr. Duckworth pointed out that clinicians have also seen mania triggered by other therapies for depression, such as light therapy for the seasonal affective disorder (SAD). In this case, proper diagnosis and understanding of family history is critical in mental illness treatment, whether it's for depression or bipolar disorder.

Therapy and Lifestyle Changes

While medication is needed to treat bipolar disorder and prevent manic episodes, psychotherapy and lifestyle modifications are also critical.

"One of the advantages we have is that lifestyle makes a big difference," said Dr. Duckworth. This is both about the general structure of your life and your daily habits. Sleep is one of the most important things you need to manage bipolar disorder—and it may also be one of the first disruptions that mania is developing. Practicing good sleep hygiene and having a consistent sleep and wake time that allows for a full night's sleep will help. Minimize stress, too, which can result in or exacerbate manic episodes.

Your psychotherapist can help you become more organized and accomplish tasks, assist you with medication compliance, get healthy habits in place, and develop self-awareness to pinpoint your early warning signs of mania, added Winarick.

Though about 83% of people with bipolar disorder deal with serious impairment because of their illness, according to the NIMH, many people learn to live with the mania caused by bipolar disorder without significant disruption to their lives, said Roeske.

A Quick Review

The highs of a manic episode can be very energetic periods with lots of activity, a flood of thoughts, and little sleep. Yet, these extreme highs can be followed by low lows, or depressive periods. The harmful effects of mania include engaging in risky behaviors that can harm reputations or careers, or, worse, endanger lives.

If you or someone you know has mania, make sure to get appropriate care. With proper treatment, whether mediations, therapy, or a combination of both, people with mania can overcome the dangers and lead fulfilling lives.