Mania: symptoms, associated disorders and treatment

There are mood disorders that can be pathological, as in the case of mania.

Many people associate the word mania with the presence of strange and prototypical habits of a person, who tends to repeat them with relative frequency. However, many fewer people know that the concept of mania also has another meaning, which as a general rule is what we refer to when we are talking about psychopathologies.

And the fact is that mania is also an alteration of the state of the mood.being, together with depression, one of the main alterations that are part of the bipolar disorder and that, as well as this one, supposes a serious alteration, discomfort and limitation in the life of the person. It is about this type of emotional state that we are going to talk about throughout this article, defining it and visualizing its basic definition, in what contexts it appears and how it is usually treated.

• Article related: "Bipolar disorder: 10 characteristics and curiosities that you did not know".

Mania and manic episodes

It is understood by mania a psychological alteration characterized by the presence of a state of humor excessively euphoric, expansive and concurrent with an elevated level of energy.. It is a pathological and temporary state that can appear in various contexts and usually appears in the form of episodes lasting at least a week almost every day and most of the day.

These episodes are characterized by the presence of the aforementioned expansive, euphoric and irritable mood, which usually appears together with a high level of restlessness and agitation manifested by hyperactive behavior. Generally the person has the sensation that his thoughts pass at great speed, not being rare that he losesIt is not uncommon to lose the train of thought due to the great influx of thoughts.

The subject in manic phase also suffers from a high level of distractibility, having great difficulties of concentration and passing continuously from one thing to another. Also appearing in this state are thoughts and delusions of grandeur. thoughts and delusions of greatness and genius, the subject often considering himself invincible.The subject often considers himself/herself invulnerable and with unlimited resources. It is also common to find a high level of impulsivity and aggressiveness, as well as a diminished capacity for judgment and risk assessment, often leading to acts that may pose a risk to their own health or integrity. They also tend to try to get involved in a large number of projects regardless of their viability.

It is common for fights and conflicts to appear both socially and at work or even in the family and / or partner, as well as large financial expenditures (regardless of their economic capacity), hypersexuality (often taking risks) and sometimes even consumption of substances that can worsen their condition (eg cocaine).

It is not uncommon for hallucinations and delusions to appear.interpreting reality based on them and reacting aggressively. Finally, it should be noted that often the behavioral alterations experienced make it necessary to hospitalize the subject in order to stabilize him/her.

Contexts of onset

The onset of manic episodes is usually associated with the presence of bipolar disorder. In fact, one of the most common known types of bipolar disorder, bipolar disorder type 1, requires only a minimum of at least a manic episode not derived from substance abuse or medical illness in order to be diagnosed. to be diagnosed, and does not actually require the occurrence of a depressive episode.

But bipolar disorder is not the only context in which a manic episode or behavior may appear. And it is mania can also appear derived from the effects of the consumption of different drugs or substances, as a product of an intoxication. Likewise, some infections and diseases that have an effect on the brain can also lead to the presence of manic symptoms. Among them may also be some dementias or infections such as encephalitis.

In addition, it can also can also appear in other mental disordersAn example of this is some psychotic disorders. Specifically, schizoaffective disorder stands out, which has a subtype called bipolar in which manic episodes also occur.

In general, mania is a consequence of the presence of a neurochemical or functional alteration of the brain, whether it is caused by a toxic substance or drug, or by an atypical functioning due to some type of disorder or disease. Occasionally it can also be observed that in some cases manic symptoms may appear in situations of high psychosocial stress.

Consequences

The existence of a manic episode or phase usually has severe repercussions for those who suffer from it. At the social level it is frequent as we have seen conflicts or even verbal or physical fights, especially with strangers.especially with strangers.

It is also common to have problems with the close environment or with the partner such as conflicts, arguments, accusations or infidelities, and these problems may have repercussions even after the episode is over. In addition, it is also it is also common that the environment does not understand the subject's actionsor that this is due to an alteration of the state of mind beyond his or her control.

At work, the presence of conflicts is not infrequent, as well as a loss of productivity due to excess energy and distractibility.

At the economic level it is frequent that, as we have seen, great excesses are made, often as a often as a result of impulses or to purchase unnecessary products.. The risks they may commit can cause the subject to suffer various mishaps, such as accidents at work, falls and trauma, intoxication or substance abuse, infection of diseases or sexually transmitted infections or unwanted pregnancies. Also, sometimes people in a manic phase may even carry out illegal acts or become involved in criminal activities.

The high level of activation of the subject and his or her behavioral alterations often require some type of hospitalization in order to stabilize him or her, usually through pharmacological treatment.

Mania vs. hypomania: a question of degree

Mania is a psychological alteration of an emotional nature that can have serious repercussions in the life of the person who suffers from it. However, there is another concept that involves the existence of practically identical symptoms and with which it is very easy to confuse mania: hypomania.

As we can deduce from the name, hypomania is a somewhat less extreme version of mania.It is also a state of expansive, euphoric mood, with a high level of agitation and energy. The main difference between mania and hypomania is in the intensity with which the symptoms occur.

While hypomania involves a mood disturbance that is perceptible to the environment and may also have repercussions for the subject, the symptoms are less severe and delusions and hallucinations do not usually appear. In addition, they usually do not prevent the subject from functioning in daily life and hospitalization is not usually necessary. Finally, hypomanic episodes have a much shorter duration than manic episodes: they usually last between four days and one week.

Treatment of mania

The treatment of manic episodes is usually based on the administration of some type of eutimizantthat is to say a type of drug that allows to stabilize the state of mind. Lithium salts are generally used for this purpose, although there are also other options. In some cases it may also be necessary to apply antipsychotic drugs.

In the case that its appearance is due to intoxication, it will be necessary to treat this fact in a differential way. The same occurs in case of infections, which should be treated in order to reduce or eliminate the symptomatology. In disorders such as bipolar or schizoaffective bipolar disorders, depending on the case and especially if there are characteristics that represent a medical emergency (such as the appearance of suicidal behavior) or the drugs are not effective, it may be advisable to the application of electroconvulsive therapy in a hospital..

In addition, psychological therapy is often used (once the patient is pharmacologically stabilized), in order to detect prodromes or symptoms that warn of the onset of an episode. Psychoeducation and control of social and circadian rhythms (including sleep and eating schedules) may also be helpful.

Bibliographic references:

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.
• Belloch, Sandín and Ramos (2008). Manual de Psicopatología. McGraw-Hill. Madrid.