What Constitutes a Manic Episode?
Most people understand bipolar disorder as a mood disorder with two primary symptoms: manic episodes and depressive episodes. While there are different bipolar diagnoses, each experiences mania, and depression to varying degrees. The intensity and severity of the emotional highs and lows you experience with bipolar disorder will vary based on your specific diagnosis. Despite the often negative stigma linked to bipolar disorder, many individuals with it have contributed significantly to history, literature, politics, and entertainment.
Bipolar disorder is not widespread in the American population. Recent data suggest that the lifetime prevalence of a bipolar disorder in the United States is approximately 1% for bipolar 1. About 3% of US adults receive a bipolar disorder (of any time) diagnosis each year. For most cases, the typical age of onset for bipolar disorder symptoms is 25 years of age. However, a recent study by Harvard University Medical School suggests those ages 18-29 had the highest rates of bipolar disorder.
Understanding Bipolar Disorder
Bipolar disorder is a diagnosable mental health condition. People with bipolar disorder experience extreme alterations or shifts in mood. Most cases of bipolar disorder are diagnosed when one reaches their early to mid-twenties. However, some diagnoses may occur during early childhood and the teen years as well. There is no cure for bipolar disorder; however, mental health treatment at a treatment center like The Meadowglade can minimize the impact of symptoms.
There are three primary types of bipolar disorder. The type of bipolar disorder one has will depend on the kind of symptoms they experienced and their severity. A mental health provider will work with you to evaluate your symptoms and better understand your bipolar diagnosis. Because everyone can experience emotional lulls or emotional highs, it is essential to consider whether the mood swings associated with bipolar disorder disrupt or significantly interfere with your day-to-day life or the lives of family and loved ones.
Bipolar I disorder is characterized by the appearance of at least one manic episode. Someone with bipolar I may experience hypomanic or major depressive episodes before and after they experience a manic episode. This type of bipolar disorder affects both genders equally.
The symptoms of bipolar II are slightly different than those of bipolar I. Someone with bipolar II will have one major depressive episode that lasts a minimum of two weeks. They will also experience an episode of hypomania that lasts a few days. The primary difference between mania and hypomania is symptom duration. While mania lasts for at least one week, hypomania lasts three to four days. Although thought to be more common in women, this type of bipolar affects both men and women.
Someone with cyclothymia will experience episodes of hypomania and depression. The duration and severity of symptoms are much less than that of bipolar I or bipolar II disorder. Most people with cyclothymia only experience a month or two at a time when their moods are stable. Also, someone with untreated cyclothymia may experience worsening symptoms that can evolve into bipolar I or bipolar II with time.
Understanding Bipolar Disorder Symptoms
Bipolar disorder, regardless of type, is characterized by three primary symptoms occurring at various levels of severity and for varying durations. Someone with bipolar disorder will have depression and some form of mania, either hypomania or a traditional manic episode.
Mania or a manic episode occurs when you experience a period of overwhelming and intense emotional highs. During a manic episode, you may experience many emotions, including euphoria, excitement, and impulsivity. You may also have excessive energy, which can impact your ability to sleep or rest. During manic episodes, someone with bipolar disorder may also engage in undesirable or harmful behaviors such as spending sprees, unprotected sexual encounters, or substance use. Manic episodes may last for several days or weeks.
Hypomania is a symptom typically unique to bipolar II disorder. Hypomania is similar to mania as it involves emotional highs; however, the symptoms and emotional highs are not as notable or severe. Also, unlike manic episodes, hypomania may not result in difficulties at work, school, or social relationships. Someone with hypomania will still notice alterations in their mood, yet their alterations are not as significant as those experienced during a manic episode.
Depressive episodes are the exact opposite of manic episodes or even hypomania. During a depressive episode, feelings of hopelessness, lack of interest in hobbies, deep sadness, and lack of energy are common. Other challenges such as excessive sleep, self-harm, and suicidal thoughts also happen. Depressive episodes related to bipolar disorder will last around two weeks.
What is a Manic Episode?
A manic episode, or mania, is a symptom associated with bipolar I disorder. As mentioned above, the intensity and severity of a manic episode will vary slightly from person to person, even though they all share the same underlying diagnosis. The current edition of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), lists several diagnostic criteria that mental health providers can use to assess the presence and severity of manic episodes. They use these criteria when evaluating patients who seek help for their bipolar symptoms at a treatment center like The Meadowglade.
For mental health professionals to classify a period of elevated mood as a manic episode, your symptoms must meet several criteria. Additionally, your manic symptoms must last for at least one week. The only exception to the one-week duration is if someone experiencing mania is hospitalized for their symptoms (during a manic episode). In these cases, successful treatment during their hospital stay may reduce the duration of mania. When someone experiences a manic episode, their behavior differs from their “normal” baseline. A typical example would be someone who is naturally energetic or “up” most of the time. During a manic episode, the same person would have an uncontrollable, perhaps unmanageable amount of energy.
Other common symptoms that frequently occur during manic episodes include problems concentrating, inability to sleep, elevated self-esteem, racing thoughts, being abnormally social or talkative, and engaging in risky behaviors or poor financial decisions.
Although some people make light of manic episodes, it is important to note that they can be dangerous and risky for many reasons. Often, someone experiencing a manic episode cannot safely comprehend their actions but believes they are entirely in control of their behaviors and decisions.
Unfortunately, in many cases, they are not. In the most severe instances, a person experiencing a manic episode may experience psychosis or a “loss of touch with reality.” During a manic episode, many people struggle to attend to their usual obligations, including work, social, and school requirements.
Learning to Safely Manage Manic Episodes
Not everyone who lives with bipolar disorder is able to predict the onset of a manic episode. While some can recognize their symptoms, others either cannot or choose not to acknowledge the onset of mania for various reasons. If you have bipolar disorder and struggle with frequent episodes of mania, there are things you can do to prepare for a manic episode.
First, it is important to avoid triggers. If you have bipolar disorder, you likely understand that certain things can be triggering or, at the very least, increase the frequency of manic episodes. One of the best ways to manage manic symptoms is to avoid the things (people, places, events, activities, etc.) that will make it worse. It is essential to get enough sleep, maintain a healthy diet and avoid turning to drugs or alcohol (and other mood-altering substances) to control your symptoms. Self-medicating to cope can lead to the opposite effects – worsening and long-lasting mania.
It is also essential to follow your doctor’s orders regarding therapy and mental health medications. If you have prescriptions to help manage your bipolar symptoms, it is vital to take your medications on a regular schedule. It would be best to work with your medical or mental health provider to develop a list of medications that can assist when you experience sudden (acute) mania symptoms. While medications are not effective for everyone, some may help meet your specific needs, including preventing future manic episodes (mood stabilizer) and reducing manic symptoms quicker (antipsychotics).
Finally, seek help when you need to. If you experience symptoms you recognize as the beginnings of a manic episode, contact your mental health provider or our team at The Meadowglade immediately. Also, if you have a family member who understands what your manic symptoms are, make arrangements with them to contact your treatment providers if you cannot. Planning ahead will help ensure you receive the help and support your need as soon as possible. In some cases, manic episodes may be so severe they inhibit your ability to make decisions on your own. To ensure you receive the care you need and want during times of crisis, you may want to consider writing your wishes down and providing this information to a trusted loved one. Delegating someone you trust to make decisions for you during an emergency can provide for safe and adequate access to quick treatment in a moment of crisis.
If you have bipolar disorder and manic episodes are part of your symptoms, it is important to work with your treatment team and mental health providers to learn how to manage your symptoms safely. Remember, it is not possible to prevent mania, and it can be challenging to determine the length of time that may pass between manic episodes. Therefore, seeking help for your bipolar symptoms and learning more about therapy, prevention, coping, and symptom management can be highly beneficial for you and your family. If you would like to learn more about The Meadowglade and our programs, contact our admissions team for information about our comprehensive bipolar treatment programs.