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."
Treatment for bipolar depression has come a long way from the days (not so long ago) when patients were given sedatives and medications with numerous side effects. Today, mood stabilizing drugs are a mainstay treatment for bipolar disorder. Doctors may prescribe lithium, an antimanic drug, or an antipsychotic drug -- or a combination of both -- in order to alleviate symptoms of depression without triggering a manic episode.
While depression episodes are far more common than manias and have a tremendous...
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.
And yet, that's not true for everyone. There are several types of bipolar
disorder, and all involve episodes of mania and depression -- but to varying
With bipolar I, there are severe mood swings.
With bipolar II and cyclothymic disorder, there are milder versions of the
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
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."
"Insight is not the middle name of mania," says Kay Redfield
Jamison, PhD, professor of psychiatry at Johns Hopkins University School of
Medicine and author of An Unquiet Mind and other books on bipolar
"Most manic episodes are highly unpleasant," Jamison tells WebMD.
"Even people who get euphoric can end up having terrifying experiences.
Some people recognize when it becomes destructive, but certainly not everyone.
That's when the family and the law come in."
Many people begin treatment via a trip to the hospital ER -- often, against
their will. "To be quite honest, if someone were experiencing only the
manias -- even if they recognize things are bad -- it would be difficult to
convince them they need to be on medications," Bearden says.
While depression is difficult for anyone, it's especially traumatic if you
have bipolar disorder, she tells WebMD. "It's such a dramatic change from
the mania. And if the depression becomes very, very severe, people may become
suicidal. That's why a lot of people come for treatment. At that point, people
realize they need to be on medication for the depression -- and to take the
edge off the highs as well."