How to Deal With Mania and Manic Episodes

Medically Reviewed by Zilpah Sheikh, MD on February 24, 2024
Written by Charlotte Huff, Shawna Seed
11 min read

Mania is condition that produces extremes – mood, energy, activity, and behavior. Your highly elevated mood and activity are noticeable to other people and a switch from your usual demeanor. 

 If your doctor has diagnosed bipolar disorder, you may know what mania feels like. To be diagnosed, you must have had at least one episode of mania or its milder form, hypomania. 

During these stretches, you may feel fabulous, with lots of energy and an "up" mood. But in the case of bipolar disorder, those feelings are a symptom of mental illness. So it’s important to recognize the early signs that mania is developing.

What is a manic episode?

A manic episode is a stretch of time when you have one or more symptoms of mania. An episode typically lasts for a week or longer, unless treatment cuts it short.

Experts aren't 100% sure what causes mania, and the reasons for it may vary among people. Some of the causes and risk factors are: 

  • A family history of bipolar disorder
  • A chemical imbalance in your brain 
  • Mental illness, such seasonal affective disorder, postpartum psychosis, or schizoaffective disorder
  • Conditions such as brain injury, brain tumors, stroke, encephalitis, or lupus
  • Prescription medication such as antidepressants
  • Use of recreational drugs and alcohol 
  • Stressful life changes such as moving, changing jobs, or the death of a loved one 
  • A history of trauma or abuse 
  • Lack of sleep or changes in your sleep patterns

Each person's triggers for a manic episode are different. Some common triggers are: 

  • Stimulating environments with bright lights, loud noise, or lots of people 
  • Major life changes such as marriage, divorce, or a new job
  • A lack of sleep 
  • Using alcohol or recreational drugs 

Researchers have divided manic episodes into different types. 

Acute mania

This is the manic phase of a mental health condition called bipolar I disorder. When you have bipolar I, you swing between major highs and lows that affect your energy, mood, and thinking. You can have bipolar I even if your bouts of depression are limited.

Unipolar mania

This is a rare condition. When you have it, you'll have only the "up" elements that come with bipolar disorder, such as excitement, a high energy level, and euphoria. 

Hypomania

This is a less severe version of mania that lasts for a shorter period of time.

Delirious mania

When you have this type, you have the high energy level and euphoria of mania, but you'll also have symptoms of delirium. Those include confusion, disorientation about time and place, and an altered sense of reality.

 

Just because you’re extra-energetic and in a good mood doesn’t mean you’re starting a manic episode. But be aware of patterns, such as when:

  • You feel you’re on top of your life, even if it’s not really going well.
  • You have anxiety that can’t be explained by a stressful event, such as an upcoming exam.
  • Your thoughts race and you're cranky.
  • You're sleeping less and not taking good care of yourself.
  • You talk too much or faster than usual.
  • Your sex drive is revved up.
  • You turn more often to alcohol or drugs or do other risky things like drive dangerously.
  • You get completely absorbed in an activity to the point of obsession.
  • You're easily distracted by things that aren't important. 
  • You're moving without purpose – pacing or fidgeting. 
  • You go on spending sprees or are otherwise reckless with money.

What does a manic episode look like?

If you're having a manic episode, you might appear to be more friendly and talkative than usual. You might say or do things that are inappropriate or out of character for you. You might spend money recklessly or take risks with your personal safety that you wouldn't usually. Your behavior might come off as rude or aggressive. You might lack social inhibitions. You might talk a lot, and quickly, and say things that don't make sense to others. You might not sleep, or sleep very little. You might misuse alcohol or recreational drugs. 

How long does a manic episode last?

The early signs of a manic episode – called prodromal symptoms – can last weeks or even months. A manic episode that's caused by bipolar disorder can last as long as 6 months. If you get treatment, the episode will be shorter. Your symptoms might clear up within 3 months.

After a Manic Episode

Once a manic episode ends, you might have a variety of reactions to it. You may: 

  • Feel happy about the episode 
  • Be embarrassed about the episode 
  • Not have clear memories of what happened 
  • Be very tired and need a lot of sleep 
  • Feel overwhelmed by projects you agreed to during your episode 
  • Feel depressed, especially if you have bipolar I disorder 

Once you're in a full-blown manic state, you may not think you need help or be willing to accept it. That's why the best way to deal with mania is to address it early on.

If you think you're heading into a manic stretch, first get in touch with your doctor. They may need to change your medication dose or recommend that you try another one.

Take your medicine exactly as your doctor prescribes, even if you don’t think you need it. Tell your doctor about any supplements or herbs you’re taking. They may cause worrisome side effects.

Your doctor may compare your symptoms against a checklist from the American Psychiatric Association to determine whether you're having mania: 

  • You have an elevated mood and energy level that's lasted more than a week, and you feel that way for most of the day, every day. 
  • You have shown at least three symptoms, or four, if your mood is cranky.
  • Your mood change is severe enough that it can cause problems at work, school, or in your social life. You may need treatment in a hospital if you have hallucinations or delusions, or if there's a risk you'll harm yourself or someone else. 
  • Your mood change can't be explained by another medical issue, prescription medication, or drug abuse.

 

A combination of things can help with mania. 

Medications for mania 

Your doctor might prescribe an antipsychotic drug. Those include:

  • Aripiprazole (Abilify)
  • Lurasidone (Latuda)
  • Olanzapine (Zyprexa)
  • Quetiapine (Seroquel)
  • Risperidone (Risperdal)

Your doctor might add a mood stabilizer. You're more likely to need a mood stabilizer if your mania is part of a mood disorder like bipolar I. Those drugs include: 

  • Carbamazepine (Tegretol)
  • Lithium
  • Valproate (Depakote)

Your doctor might also prescribe an antidepressant. 

Therapy and counseling

Different types of therapy can help manage your mania. Types you might try include: 

  • Psychotherapy, where you meet with a mental health professional to help identify your mania triggers and talk about your condition
  • Cognitive behavioral therapy (CBT), which can help you adjust perceptions about yourself and others 
  • Family therapy, which can help your loved ones understand your condition and learn helpful behaviors 

Other mania treatments

In rare cases, doctors recommend electroconvulsive therapy (ECT). When you have ECT, electrical current is applied to your brain. 

If you feel as though you're unsafe, you can go to an emergency room or call an ambulance for help.

During a manic episode, you might take actions that have long-term effects on your well-being. Examples include reckless sexual behaviors (which carry the risk of sexually transmitted illnesses) or unwise financial decisions. You may become aggressive, damaging property or hurting yourself or someone else. 

Mania can affect your ability to work. One study found that people who'd had a manic episode had high levels of unemployment afterward, even though their symptoms had improved.

Your reputation may suffer; people who don't understand your condition may talk negatively about you and distance themselves.

If you're worried you might be headed into a manic episode, you can take concrete steps to reduce the risk. They include: 

  • Review what's happening in your life and your stress level. See if you can dial back your commitments a bit. If you slow down now, you may avoid having to take more time off later because your symptoms got worse.
  • See a counselor or therapist. If you aren’t already in therapy, find someone who treats people with bipolar disorder. They can help you learn ways to identify and cope with troubling thoughts, emotions, or behavior.
  • Look for ways to relax. When you talk with others, focus on listening. Carve out time to read, listen to your favorite music, or watch a show.
  • Get enough sleep. You need at least 6 hours a night.
  • Watch out for caffeine. Steer clear not only of caffeine in beverages, like sodas and energy drinks, but in over-the-counter medications.
  • Stay away from drugs and alcohol. They can affect your mood and may interact with medications you’re taking.
  • Above all, don’t postpone seeking help so you can continue to ride the manic “high.” The higher your manic episode rises, the further your mood may tumble after it ends.

Talk to your doctor or therapist about what you should do when you're already in a manic state. And plan ahead. You might ask trusted friends or relatives to call your doctor if they notice signs of mania.

Here are some practical ways to protect yourself while you're in a manic episode:

  • Keep up your normal routine. As much as possible, try to maintain a stable daily schedule. This includes your sleep, eating, and exercise patterns.
  • Guard your finances. Limit how much cash you carry. Consider temporarily giving your credit cards to someone you trust to avoid impulse purchases.
  • Delay big decisions. Don't make any major changes before you talk to someone, such as a mental health professional or a relative. At the least, give yourself time to reflect before you take action.
  • Bypass risky situations. This isn’t the right time to begin a new relationship or sort through a conflict with a friend.

Self-care tips

You can take steps to help manage your condition long-term. They include: 

  • Understand what triggers a manic episode so you can limit the impact.
  • Try to establish a sleep and exercise routine and stick to it.
  • Take your medication at the same time every day.
  • Track your moods using a journal or mood diary.
  • Talk to friends and loved ones you trust about your condition. Let them know what helps – and what doesn't.
  • When your mood is stable, set up an action plan with friends or loved ones for when you have a manic episode

Start by talking to your friend or loved one who has manic episodes. Ask questions about how they feel, and what is and is not helpful to them. 

Try to learn their warning signs and triggers, so that you can help spot a manic episode early on. But don't assume every good mood is evidence of an episode. 

When your friend is not in the middle of an episode, make a plan for how you might help them during one. Ideas might include: 

  • Encouraging them stick to a routine, whether that's sleeping, eating, or exercising 
  • They might agree that you should offer a second opinion on plans that seem grandiose, or when they're taking on too much.
  • With their permission, you could help manage their money during an episode. 
  • Develop a plan for a crisis in case they become so unwell that they need treatment in a hospital. 

Your friend or loved one might see, hear, or believe things that don't seem real. If that happens, don't challenge them. Focus on staying calm. Let them know you understand what they're experiencing is real to them, even if it isn't to you.

If you're worried about them, speak up. Be ready to set boundaries and step away if their behavior becomes rude or aggressive, or if they want you to take part in something you don't think is safe. 

After an episode, your friend or loved one may be embarrassed about it. Be supportive. Offer your help dealing with fallout, if they want it. You also could offer to help them get support.

Seek out support for yourself, too. Talk to someone about how the manic episodes affect you. 

Once you feel better, keep up your healthy habits. That includes exercise, which can improve both mood and sleep. Build up your toolbox of strategies to make future episodes less intense:

  • Look at what boosts your stress level. Lots of things in your life, whether it’s your job or a person you deal with, may affect your mood.
  • Think about what may have been early signs of previous episodes. Was missing sleep for a few nights an early signal? Tell loved ones about those signs so they can watch out for them, too.
  • Track your mood each day. When you keep a daily mood diary, you and your doctor or therapist can look for patterns. How do medication, sleep patterns, and life events affect how you feel?
  • Once your mood is stable, reflect on how mania affects you in good and bad ways. Write down those thoughts. Then you can remind yourself of the downside when you're tempted to ignore the early signs of mania.
  • Stick to your routines with sleeping, eating, and taking your medication. 
  • Avoid people and situations that might encourage you to make risky choices, such as abusing alcohol or drugs.

Mania is a condition that can happen as part of a mental health issue, especially bipolar disorder. During a manic episode, you might feel euphoric and have extremely high energy. You might tackle numerous projects at once or become obsessively focused on something. Your mood change will be obvious to the people around you. Mania can be managed with medication and therapy. You can take steps on your own to help deal with your condition, including learning about your triggers and avoiding them, making a crisis plan ahead of time, and sticking to a routine. 

What are the four symptoms of mania?

Mania has many symptoms. Among them are: 

  • Feeling very up, euphoric, or elated 
  • Feeling jumpy or more active than usual 
  • Not needing sleep 
  • Having so many thoughts, you have trouble expressing them all 
  • Feeling very important, talented, or powerful 
  • Feeling especially cranky

What are the types of mania?

The main types of mania are acute mania, hypomania, and delirious mania. A fourth type, unipolar mania, is rare.

Am I going through a manic episode?

It can be hard to gauge whether you're manic when you're in the middle of an episode. It's good to learn your triggers and warning signs so that you have a better sense of when your mood is changing. Talking to trusted friends or family members ahead of time can be helpful; together, you can work out a plan for how to spot and handle an episode. If you think you're having a manic episode, call your doctor. You also can talk to someone close to you about it. If you think you're in danger of harming yourself, seek help right away. In the U.S., you can dial 988 for the Suicide and Crisis Lifeline.