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Manic syndrome
Last reviewed: 07.07.2025

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A lot of people with manic syndrome feel damn good
No one will deny that manic syndrome brings the patient a state of cheerfulness. For many patients, mania is a period of denial - they cannot understand that such a pleasant state of constant energy and euphoria actually requires treatment.
"Mania is a fascinating state... it's a state of hormonal surge that's caused by your own brain," says Kerry Barden, a practicing neuropsychologist. Most sufferers first experience mania in their 20s, when they don't think about death and believe they are immortal.
And, indeed, a certain number of risky undertakings are nothing more than the consequences of mania. During this period, a person is prone to careless driving or uncontrolled, unnecessary spending of large sums of money. This is the period when bright business ideas are born and an uncontrollable flow of phone calls is made.
However, it is impossible to say that such behavior is characteristic of all patients. There are several types of bipolar disorder that have attacks of mania and depression, but all these attacks are different from each other.
- In bipolar disorder of the first degree, mood swings occur in a very severe form.
- In bipolar disorder of the second degree and cyclothymia, these attacks occur in a milder form.
- In mixed bipolar disorder, when manic and depressive episodes can occur simultaneously, there is a dangerous mixture of feelings of superiority and wandering thoughts with irritability, sullenness and anger.
People often believe that mania brings out their creativity. Bipolar mania is very common among poets and writers, says Barden. According to her, most people find that this is when they are at their most productive. You are at your best, you feel great, you feel energized. Most of her patients, even if they are not creative, have discovered their creativity - for example, they have started writing songs, composing music or writing screenplays.
However, "this pleasant state of euphoria does not last forever," explains Barden. "You cannot live in this state forever. And this is the most difficult problem that people with this disorder have to face. More often than not, it takes a certain amount of time for the patient to understand that they really need treatment. They have to sacrifice the state of euphoria in order to return to a normal, familiar life."
When Manic Syndrome Gets Out of Control
During bipolar mania, the patient can make many bad decisions, says Barden. Such decisions can ruin his life or relationships. During mania, the patient becomes extremely irritable. He can start yelling at passersby on the street. That is why such patients with manic syndrome very often end up in police stations, especially if they start a fight in public places.
In most cases, mania is a very unpleasant condition, says Kay Redfield Jamison, a professor of psychiatry and the author of "An Unquiet Mind" and other books on bipolar disorder. Even those patients who are in a state of euphoria eventually find themselves in very unpleasant situations. Sometimes, a manic patient can recognize the moment when mania begins to harm his life, but in most cases, this does not happen. And at that moment, relatives must come to the aid of the patient, otherwise the law will do it.
Many people enter treatment when they arrive in the emergency room - often against their will. In fact, if a manic patient is only experiencing manic episodes - even if they are aware of the negative effects - it will be impossible to convince them to enter treatment voluntarily, Barden says.
Although depression itself is a complex disease, for patients with bipolar disorder, it is several times more difficult. It is very difficult to survive such a sharp change in mood, when the state of euphoria suddenly changes to a depressed mood. And if depression is also severe, then the patient is at risk of committing suicide. This is why most people seek help. At such a moment, they understand that they must do something about depression.
How does manic syndrome manifest itself?
Mania, hypomania and depression are symptoms of bipolar disorder. The sharp mood swings in bipolar disorder do not have a certain sequence. Depression does not always follow mania. The patient can suffer attacks of the same condition several times - for weeks, months or even years - until he suddenly experiences an attack of the opposite condition. Also, the severity of the attack is strictly individual.
Hypomania is a milder form of mania. It is a condition that may or may not develop into a disease. It gives a person quite pleasant sensations. The person feels extremely good and productive. However, in people with bipolar disorder, hypomania can turn into manic syndrome - or suddenly change to a state of deep depression.
State of hypomania and mania
Hypomania: At first, when you feel on top, it is amazing… ideas come to you very quickly… and like a hunter after the brightest star, you wait for an even better idea to appear… Shyness disappears somewhere, things seem extremely interesting. Sensuality takes over you completely, the desire to seduce and be seduced is simply impossible to resist. Your whole being is overwhelmed by an inexplicable feeling of lightness, strength, well-being, omnipotence, euphoria… you can do anything… and suddenly everything changes.
Manic Syndrome: Ideas begin to swarm through your head at a rapid rate, there are too many of them… a feeling of overwhelming confusion replaces clarity… you find it difficult to keep up with such a fast pace… you notice that you have become forgetful. Contagious laughter is no longer funny. Your friends look scared… everything seems to be going against the grain… you become irritable, angry, scared, out of control and feel trapped.
If you experience three or more of the following symptoms of mania most days of the day - nearly every day - for a week, you may have mania:
- An overwhelming feeling of happiness, optimism and delight
- Suddenly the cheerful mood changes to irritability, anger and rudeness
- Restlessness, increased energy and decreased need for sleep
- Fast speech, excessive talkativeness
- Absent-mindedness
- A Leap of Ideas
- Strong sexual desire
- A tendency to make grandiose and impossible plans
- A tendency to make poor judgments and decisions, such as deciding to quit a job
- Inflated self-esteem and pomposity - belief in unrealistic possibilities, intelligence and strength; illusions are possible
- Tendency to engage in life-threatening behavior (e.g., excessive extravagance, sexual promiscuity, alcohol or drug abuse, or reckless business decisions)
Some people with bipolar disorder may enter a psychotic phase, which is expressed in hallucinations. They believe in incredible things and cannot be dissuaded. In some cases, they believe that they have super powers and super strength - they may even consider themselves God-like.
Symptoms of the Depression Phase
The mood swings of bipolar disorder do not occur in a specific order. Depression does not always follow the manic phase. A person may experience one phase several times in a row - for weeks, months or even years before the mood changes. Also, the severity of each phase is strictly individual for each person.
Periods of depression can be very intense. Sadness and anxiety affect every aspect of life - thoughts, feelings, sleep, appetite, health, relationships with loved ones, and the ability to function and work. If depression is left untreated, the patient's condition will only worsen. He will feel as if he cannot cope with this mood.
This state of depression can be described as follows:
Depression: I doubt that I can do anything well. I feel as if my brain has stopped and reached a state where it has become completely useless... I feel as if someone is persecuting me... and there is no hope of changing this situation. People say: "This is temporary, soon you will get better and all these troubles will disappear", but they do not understand how I feel, although they try to convince me otherwise. If I can not feel, move, think and experience, then what is the point of living?
An attack of depression is characterized by five or more of the symptoms listed below, which recur almost every day for two weeks.
Symptoms of depression:
- Sadness, anxiety, irritability
- Loss of strength
- Feelings of guilt, hopelessness and worthlessness
- Loss of interest and complete indifference to once favorite activities
- Inability to concentrate
- Uncontrollable bouts of crying
- It's hard to make a decision
- Increased need for sleep
- Insomnia
- Changes in appetite that cause weight loss or gain
- Thoughts of death or suicide
- Attempts to commit suicide
If a person with manic syndrome also suffers from depression, he may experience illusions about feelings of guilt and worthlessness - for example, false beliefs that a person has become bankrupt or committed a terrible crime.
If this condition is not treated, then attacks of depression may occur more frequently and are more difficult to treat. They can develop into attacks of mania. However, treatment can help prevent this. Taking medications and attending psychotherapy sessions will give the sick person the opportunity to live a full life.
Manic syndrome: what you need to know?
If you are planning an appointment with your doctor regarding bipolar mania, here are 10 questions you should definitely ask your doctor:
- What is happening to me and what triggers manic syndrome?
Bipolar disorder is a physical illness that affects the brain. It may be helpful to learn about the imbalance of brain chemicals that causes mania, what stressful situations can trigger it, and what treatments are available.
- What medications will help me and how do they work?
It is important to know exactly what medications you are taking, how they work, and what to expect from them.
- What side effects may occur and what to do if they occur?
Any medication can cause side effects, including those used to treat bipolar mania. If you have any concerns, you should contact your doctor or psychiatrist.
- What should I do if I forget to take a pill?
To avoid sudden mood swings, it is very important to take medications strictly as prescribed by your doctor.
- What should I do if I start to feel manic?
If you experience a relapse of mania, you may need to change your dose or the drug itself.
- What happens if I stop taking my medication?
Never stop taking your medication without first consulting your doctor.
- Why is psychotherapy important in the treatment of bipolar mania?
Psychotherapy can help you cope with painful relationships and difficult life situations that can trigger an attack of mania.
- Are there other programs that can help treat bipolar disorder?
Going back to work and rebuilding relationships is important in managing bipolar disorder. Social workers, therapists, and counselors can help you with this.
- How often should you visit a doctor?
The more often a patient visits a doctor, the greater his chances of achieving stability more quickly.
- How to contact a doctor in a critical situation?
You should be able to contact your doctor as soon as you need to, especially if your condition is out of control.
Who to contact?
How is manic syndrome treated?
Manic syndrome is a serious illness. But you should remember that you are not alone. More than 2 million people in the United States suffer from this disease. Unlike depression, manic syndrome affects both men and women equally. And although the first attack most often occurs in the 20s, the first symptoms can appear in early childhood.
Although some sufferers may only experience one episode of the disease in their lifetime, it is a lifelong illness. It is usually characterized by episodes of mania - an excessive and irrational state of excitement - and depression, with long periods of normalcy between episodes.
Although doctors still do not clearly understand what causes manic syndrome, they still know much more about this disease than they did 10 years ago. This knowledge has given them the opportunity to choose more effective treatment, although it is unfortunately not yet possible to completely cure this disease.
If you have bipolar disorder and you have three or more of the following symptoms that last nearly every day for a week, you may have manic episodes:
- Increased activity
- There is no need for sleep to feel rested and energized.
- An excessively elevated, inspired mood, reminiscent of a state of euphoria
- Wandering thoughts
- Very fast speech or increased talkativeness; speech is forceful, loud and incomprehensible
- Inflated self-esteem - belief in superpowers, extraordinary mental abilities and strength; delusional ideas may appear
- Reckless behavior (e.g., fast driving, impulsive promiscuous sexual activity, alcohol or drug abuse, making poor business decisions, reckless driving)
- Absent-mindedness
If you have four or more episodes of mania or depression, you have bipolar disorder, which is cyclical.
If you have a manic syndrome, then most likely your doctor will prescribe you an antipsychotic drug, a benzodiazepine and/or lithium to quickly bring the situation under control and relieve increased activity, irritability and hostility.
Your doctor may also prescribe a mood stabilizer. These medications consist of a number of drugs that help control mood swings, prevent them from recurring, and reduce the risk of suicide. They are usually taken for a year or longer and consist of lithium and a certain anticonvulsant, such as Depakote. To keep your manic episodes under control, your doctor may want to monitor you closely and do frequent blood tests.
Often, manic syndrome requires hospitalization of the patient due to the high risk of unpredictable, risky behavior. For people with acute manic syndrome, pregnant women with mania, or those who are unable to control their mood with mood stabilizers, a doctor may prescribe a course of electroconvulsive therapy.
If you are on maintenance therapy and you develop mania during this period, your doctor will either change the dose of your medication or add an antipsychotic to reduce your symptoms.
Non-drug treatments, such as psychotherapy, can help the patient during maintenance therapy and it is recommended to combine its sessions with taking medications.
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