A discrete period lasting a week or more during which a person experiences mania, an abnormally elevated, cheerful, or euphoric mood.
A person experiencing a manic episode shows persistent and often inappropriate enthusiasm which may involve taking on new projects for which he or she is ill suited. It might also involve engaging strangers in detailed conversations, acting without concern for consequences of one's actions, or increased sexual activities. Less commonly, a person may be abnormally irritable during a manic episode. On average, the episodes begin before age 25. This means that some individuals experience their first episode while in their teens and others during middle age.
Psychiatrists use five criteria to identify someone in the midst of this type of mood episode. First, the period of abnormal behavior must persist for at least one week unless the person is admitted to a hospital. Typically, the episodes last from a few weeks to a few months. Second, the diagnosisrequires three additional symptoms if the mood change results in expansive behavior, or four if it results in unnatural irritability. These symptoms include an unwarranted sense of self-importance, a tendency to be easily distracted, a decreased need for sleep, a rapid flow of ideas with one replacing another before the first is acted upon, an inability to sit still or increased activity directed at achieving some goal, an irrepressible need to talk, and finally, a devotion to some activity the patient finds pleasurable but could be harmful. The third criterion is that the symptoms do not qualify the patient for a diagnosis of mixed episode. Fourth, the patient can not function normally at home or at work, or shows signs of psychosis. The fifth and last criterion is that the cause of the episode can not be attributed to side effects from any drug abuse, medication, medical treatment, or medical condition.
Many of these symptoms are also present in a hypomanic episode. A hypomanic episode is similar to a manic episode, but the symptoms may be experienced to a lesser extent. The main differences between a manic and hypomanic episode are the following:
- A hypomanic episode may only last four days, whereas a manic episode, by definition, lasts one week.
- In a manic episode, psychotic features (hallucinationsand delusions) may be present, but in a hypomanic episode, they cannot be.
- A manic episode significantly impairs the affected person's functions, but a hypomanic episode does not.
Both of these kinds of episodes may be seen in patients with bipolar disorder.
Dean A. Haycock, Ph.D.