Manic or Hypomanic Episode
In a Manic or Hypomanic Episode the individual experiences a period of abnormal and persistently elevated, euphoric, expansive or irritable mood. In addition to:
- Self-esteem becoming inflated to the point of the person being grandiose about his or her ideas, intelligence, power, acquaintances, future, etc,
- Feeling rested after only 3-4 hours of sleep with no desire to sleep longer,
- Subjective pressure to keep talking or others commenting that the person is more talkative than usual,
- Thoughts racing or a great many ideas flashing through his or her mind (i.e., flight of ideas),
- More distractible than usual,
- Feeling as though his or her movements are speeded up or that he or she can focus attention better than usual or get more done in a shorter amount of time (i.e., goal-directed),
- Excessively involved in pleasurable activities that have the potential to be dangerous or have painful consequences, such as uncontrolled spending sprees, foolish business ventures, infidelity, or unprotected sexual activity.
A Manic Episode is distinguished from a Hypomanic Episode by the length of time over which the symptoms occur and the extent to which it interferes with the person's normal functioning. In a Hypomanic episode symptoms must last for a minimum of 4 days, whereas to be considered a Manic Episode the symptoms must last at least 1 week. A Hypomanic Episode, by definition, is not severe enough to cause significant impairment in occupational, academic, or social functioning and does not require hospitalization. That said, the symptoms of hypomania must be considered uncharacteristic of the person and, therefore, represent a change in emotional and behavioral functioning. The elevation in mood during a Hypomanic Episode is often less severe than during a Manic Episode, though this is not a diagnostic feature.
A final distinction between the two is that a Hypomanic Episode does not involve Psychotic Features. Psychotic Features are abnormal perceptions (e.g., hearing voices) or odd or unusual beliefs (e.g., paranoia) that are not present when the person is not manic or depressed. Individuals experiencing Psychotic Features should contact a physician as soon as possible as medication is likely required.
Depending on the number and severity of symptoms, a Manic Episode can be considered Mild, Moderate, Severe without Psychotic Features, or Severe with Psychotic Features.
A Mixed Episode is characterized by both depressive and manic symptoms nearly every day for at least 1 week. More specifically, a person must have met criteria for both a Manic Episode and a Major Depressive Episode during this period. Individuals are likely to experience rapid shifts in mood (e.g., sadness, irritability, euphoria), along with other symptoms of mania and major depression. Agitation, insomnia, appetite changes, psychotic features, and suicidal thoughts are commonly experienced. Mixed Episodes are more common among younger individuals and those over 60 years of age.
A number of Physical Conditions can cause symptoms similar to a Manic Episode. Consult with a physician that you trust in order to have a full medical examination prior to concluding that what you are experiencing is mania without any physical basis. This is especially the case when someone remains manic despite receiving appropriate treatment.
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