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When Bipolar Mania Gets Out of Control

For many with bipolar disorder, mania feels dangerously good.
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WebMD Feature

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."

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Bipolar Disorder: Who’s at Risk?

Bipolar disorder, also known as manic depression, is an illness in which a person has periods of high mood and energy and other times of depression. People diagnosed with bipolar disorder usually have one or more major depressive episodes along with one or more manic or mixed episodes. Bipolar mania is a prolonged state (at least one week at a time) of extreme elation or agitation accompanied by excessive energy. Symptoms of the manic "highs" include increased energy, racing thoughts and fast speech,...

Read the Bipolar Disorder: Who’s at Risk? article > >

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 degrees.

  • With bipolar I, there are severe mood swings.
  • With bipolar II and cyclothymic disorder, there are milder versions of the illness.
  • 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."

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