Mania: symptoms, associated disorders and treatment
Many people associate the word mania with the presence of strange and prototypical customs of a person, which he often repeats with relative frequency. However, there are far fewer people who know that the mania concept also has another meaning, which as a general rule is what we refer to when we are talking about psychopathologies.
And is that the mania is also an alteration of the mood , being next to the depression one of the main alterations that comprise of the bipolar upheaval and that like this one supposes a serious alteration, malaise and limitation in the life of the person. It is about this type of emotional state that we are going to talk about throughout this article, defining it and visualizing its basic definition, in what contexts it appears and how it is usually treated.
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Mania and manic episodes
Mania is understood as a psychological alteration characterized by the presence of a state of mind excessively euphoric, expansive and concurrent with a high level of energy . It is a pathological and temporal state that, which can appear in different contexts and that usually appears a form of episodes of a duration of at least a week almost every day and most of the day.
These episodes are characterized by the presence of the aforementioned expansive, euphoric and irritable state of mind, which usually appears together with a high level of restlessness and agitation that manifests itself through hyperactive behavior. Usually the person has the feeling that their thoughts are moving at high speed , not being strange that the thread of the thought is lost before the great affluence of these.
The subject in manic phase also suffers a high level of distraction, having great difficulties of concentration and continuously going from one thing to another. They also appear in this state thoughts and delusions of greatness and genius , considering the subject often invulnerable and with unlimited resources. It is also common for high impulsiveness and aggressiveness to appear, as well as the ability to judge and assess risks, often leading to the performance of acts that may pose a risk to one's health or integrity. They also tend to try to get involved in a large number of projects regardless of their viability.
It is common for fights and conflicts to appear both socially and in the workplace or even in the family and / or couple, as well as large economic expenses (regardless of their economic capacity), hypersexuality (often at risk) and sometimes even consumption of substances that can make your condition worse (for example cocaine).
It is not uncommon also that hallucinations and delusions appear , interpreting reality based on them and reacting aggressively. Finally, it should be noted that often the behavioral changes experienced make it necessary to hospitalize the subject in order to stabilize it.
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The appearance of manic episodes is usually associated with the presence of a bipolar disorder. In fact, one of the most frequent types of bipolar disorder known, bipolar disorder type 1, requires only at least a manic episode not derived from the consumption of toxic or medical diseases in order to be diagnosed, not really needing the appearance of a depressive episode.
But bipolar disorder is not the only context in which an episode or manic behavior can appear. And it is the mania can also appear derived from the effects of the consumption of different drugs or substances, as a result of intoxication. Also some infections and diseases that generate an effect on the brain can also lead to the presence of manic symptoms. Among them may also be some dementias or infections such as encephalitis.
Also, also may appear in other mental disorders , being an example of this some psychotic disorders. Specifically highlights the schizoaffective disorder, which has a subtype called bipolar in which episodes of mania also occur.
In general, mania is a consequence of the presence of a neurochemical or functional alteration of the brain, whether caused by a toxic or drug or by an atypical functioning characteristic of some type of disorder or disease. Occasionally it can also be observed that in some cases manic symptoms may appear in situations of high psychosocial stress.
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The existence of an episode or a manic phase usually has severe repercussions for those who suffer them. At a social level it is frequent as we have seen that there are conflicts or even verbal or physical fights , especially with strangers.
It is also common to have problems with the immediate environment or with the couple such as conflicts, arguments, accusations or infidelities, these problems may have repercussions even after the end of the episode. Also, also it is usual that the environment does not understand the performance of the subject , or that this is due to an alteration of the state of mind alien to his will.
In the workplace, the presence of conflicts is not uncommon, as well as a loss of productivity due to excess energy and distractibility.
At an economic level, it is frequent that they are carried out as we have seen large excesses, often as a result of impulses or to acquire unnecessary products . The risks that can be committed can cause the subject to suffer various mishaps, such as work accidents, falls and injuries, poisonings or substance abuse, transmission of diseases or sexually transmitted infections or unwanted pregnancies. Also on some occasions people in manic phase may even get to perform illegal acts or be involved in criminal activities.
The high level of activation of the subject and their behavioral alterations mean that some type of hospitalization is often necessary in order to stabilize them, generally through pharmacological treatment .
Mania vs hypomania: a matter of degree
The mania is a psychological alteration of emotional character and that can have serious repercussions in the life of the sufferer. However, there is another concept that assumes the existence of virtually identical symptoms and with which it is very easy to confuse mania: hypomania.
As we can deduce by the name, hypomania is a somewhat less extreme version than mania , also appearing an expansive mood, euphoric and with a high level of agitation and energy. The main difference between mania and hypomania is in the intensity with which the symptoms occur.
Although the hypomania supposes a alteration of the perceptible spirit on the part of the surroundings and that can also have repercussions for the subject, the symptoms are less severe and there are usually no delusions or hallucinations. Also, usually do not prevent the subject to have a functionality in their day to day and usually it is not necessary to hospitalization of the patient. Finally, hypomanic episodes have a much shorter duration than manic ones: they usually last between four days and a week.
The treatment of mania
The treatment of manic episodes is usually done from the administration of some type of mood stabilizer , that is, a type of drug that stabilizes the mood. Lithium salts are generally used for this purpose, although there are also other options. In some cases it may be necessary to also apply antipsychotic drugs.
In the event that its appearance is due to intoxication, it will be necessary to treat this fact differentially. The same happens in case of infections, which must be treated in order to reduce or eliminate the symptoms. In disorders such as bipolar or bipolar schizoaffective, depending on the case and especially if there are features that imply a medical emergency (such as the appearance of suicidal behavior) or drugs are not effective it may be advisable the application of electroconvulsive therapy in a hospital .
In addition, it is usual to use psychological therapy (once stabilized at the pharmacological level), in order to detect prodrome or symptoms that warn of the arrival of an episode. Psychoeducation and control of social and circadian rhythms (including sleep and feeding schedules) can also be helpful.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
- Belloch, Sandín and Ramos (2008). Manual of Psychopathology. McGraw-Hill. Madrid.