Mania
From Wikipedia, the free encyclopedia
| ICD-10 | F30 |
|---|---|
| ICD-9 | 296.0 Single manic episode, 296.4 Most recent episode manic, 296.6 Most recent episode mixed |
Mania is a severe medical condition characterized by extremely elevated mood, energy, and unusual thought patterns. There are several possible causes for mania, but it is most often associated with bipolar disorder, where episodes of mania may cyclically alternate with episodes of clinical depression. Though the elevated mood and energy level typical of mania could be seen as a benefit, mania generally has many undesirable consequences and has the potential to be very destructive. Classic symptoms include rapid speech, racing thoughts, decreased need for sleep, hypersexuality, euphoria, grandiosity, irritability, and increased interest in goal-directed activities. Mild forms of mania, known as hypomania, cause little or no impairment; more severe forms of mania do cause impairment and may even feature grandiose delusions or hallucinations. Mania and hypomania have also been associated with creativity and artistic talent.[1]
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[edit] Symptoms
Although "severely elevated mood" sounds somewhat desirable and enjoyable, the experience of mania is often quite unpleasant and sometimes disturbing, if not frightening, for the person involved (and those close to them), and may lead to impulsive behavior that may later be regretted. It can also often be complicated by the sufferer's lack of judgment and insight regarding periods of exacerbation of symptoms. Manic patients are frequently grandiose, irritable, belligerent, and frequently deny anything is wrong with them. Because mania frequently encourages high energy and decreased perception of need or ability to sleep, within a few days of a manic cycle, sleep-deprived psychosis may appear, further complicating the ability to think clearly. Racing thoughts and misperceptions lead to frustration and decreased ability to communicate with others.
In addition to decreased need for sleep, other manic symptoms include irritability, anger or rage, delusions, hypersensitivity, hypersexuality, hyper-religiosity, hyperactivity, racing thoughts, talkativeness or rapid speech, and grandiose ideas and plans. In manic and less severe, hypomanic cases, the afflicted person may engage in out of character behaviour such as questionable business transactions, wasteful expenditures of money, risky sexual activity or highly vocal arguments uncharacteristic of previous behaviors. These behaviors increase stress in personal relationships, problems at work and increases the risk of altercations with law enforcement as well as being at high risk of impulsively taking part in activities potentially harmful to self and others.
A mnemonic used to remember the symptoms of mania is DIGFAST: [2]
- D = Distractibility
- I = Indiscretion
- G = Grandiosity
- F = Flight of ideas
- A = Activity increased
- S = Sleep (decreased need for)
- T = Talkativeness (pressured speech)
[edit] Mixed states
Mania can be experienced at the same time as depression, in a mixed state. Dysphoric mania is primarily manic and agitated depression is primarily depressed. This has caused speculation amongst doctors that mania and depression are two independent axes in a bipolar spectrum, rather than opposites.
There is an increased probability of suicide in the mixed state, as depressed individuals who are also manic have the energy needed to commit suicide.
[edit] Treatment
Before beginning treatment for mania, careful differential diagnosis must be performed to rule out non-psychiatric causes.
Acute mania in bipolar disorder is typically treated with mood stabilizers and/or antipsychotic medication. Note that these treatments need to be prescribed and monitored carefully to avoid harmful side-effects such as neuroleptic malignant syndrome with the antipsychotic medications. It may be necessary to temporarily admit the patient involuntarily until the patient is stabilized.
When the symptoms of mania have gone, long-term treatment then focuses on prophylactic treatment to try to stabilize the patient's mood, typically through a combination of pharmacotherapy and psychotherapy.
Lithium is the classic mood stabilizer to prevent further manic and depressive episodes. Anticonvulsants such as valproic acid and carbamazepine are also used for prophylaxis.
[edit] Mania and over the counter prescription drugs
Phenylpropanolamine or (PPA) is a sympathomimetic drug similar in structure to amphetamine which is present in over 130 medications, primarily decongestants, cough/cold remedies, and anorectic agents.
A report on phenylpropanolamine, or P.P.A., from the Dept. of Psychiatry, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. Pharmacopsychiatry 1988 stated:
- We have reviewed 37 cases (published in North America and Europe since 1960) that received diagnoses of acute mania, paranoid schizophrenia, and organic psychosis and that were attributed to PPA product ingestion. Of the 27 North American case reports, more reactions followed the ingestion of combination products than preparations containing PPA alone; more occurred after ingestion of over-the-counter products than those obtained by prescription or on-the-street; and more of the cases followed ingestion of recommended doses rather than overdoses.
- Failure to recognize PPA as an etiological agent in the onset of symptoms usually led to a diagnosis of schizophrenia or mania, lengthy hospitalization, and treatment with substantial doses of neuroleptics or lithium.
PPA is no longer available in any medication in the United States.
[edit] External links
- Visit Bipolar4all written by people who live with BP everyday
- Manic Episode Symptoms
- Mania as a symptom of schizoaffective disorder
[edit] See also
- -mania (suffix)
- Bipolar disorder
- Clinical depression
- Cyclothymia
- Hypomania
- List of songs about mental illness
- Monomania
- Pyromania
- Trichotillomania
[edit] Additional reading
College-level texts on abnormal psychology will contain a section on mania.
[edit] Reference
- ^ Jamison, Kay R. (1996), Touched with Fire: Manic-Depressive Illness and the Artistic Temperament, New York: Free Press, ISBN 0-684-83183-X
- ^ Carlat DJ, The Psychiatric Review of Symptoms: A Screening Tool for Family Physicians, American Academy of Family Physicians, URL: http://www.aafp.org/afp/981101ap/carlat.html, Accessed on: August 13, 2005.
[edit] Other meanings
Some collective mania (craze) can also take place, as individuals have a tendency to lose their own personality inside a crowd (fads, herding, crowd hysteria, stock market bubble, tulip mania).
