There's no denying the exhilaration that mania brings. For many with bipolar disorder, there's a period of denial -- a disbelief that the wonderful surge of energy and euphoria marks a disease that truly needs treatment.
"Mania is a fascinating thing ... it's the brain creating its own hormonal high," says Carrie Bearden, PhD, a clinical neuropsychologist and assistant professor of psychiatry at UCLA. "Most people first become manic in their early 20s, at a time in life when they're not thinking about death, when they feel immortal."
People with bipolar disorder often have cycles of elevated and depressed mood that fit the description of "manic depression." When a person's illness follows this classic pattern, diagnosing bipolar disorder is relatively easy.
But bipolar disorder can be sneaky. Symptoms can defy the expected manic-depressive sequence. Infrequent episodes of mild mania or hypomania can go undetected. Depression can overshadow other aspects of the illness. And substance abuse can cloud the picture.
Indeed, some degree of risky business is the hallmark of mania. Erratic driving and out-of-control spending sprees are common. It's a time when flashy business ideas are borne, torrents of phone calls made.
Mixed bipolar is both mania and depression at the same time -- a dangerous mix of grandiosity, racing thoughts, yet irritable, moody, angry.
People often believe that mania feeds their creativity. The incidence of bipolar disorder is high among poets and writers, Bearden tells WebMD. "A lot of people feel they are most productive during this time. You're up, feeling good, energetic. A lot of patients I've seen, even if they are not in a creative field, pursue some sort of creative endeavor -- writing songs, playing music, writing screenplays."
However, "that simple euphoria doesn't really last," she explains. "It's not like you can hover there. And that's the hardest thing for people to deal with. Frequently it takes people a while to realize that they need to be on medication. It's a trade-off of losing some euphoria to become more stable."
When Bipolar Mania Gets Out of Control
A lot of bad decision-making can happen during the manic phase, Bearden tells WebMD. "It can ruin lives and relationships. There can be extreme irritability. You start yelling at strangers on the street. That's often why they're brought in by police, if they're causing a big disturbance, if they get into a fight in a bar or something like that."