Manic episodes are a period of extremely elevated mood and are required for a diagnosis of bipolar disorder type 1. Bipolar manic episodes are not just feeling "good" or "high," they are moods that are beyond reason and cause major distress and life impairment. Some of the symptoms of a manic episode include:
- Extreme, grandiose self-esteem; a perceived connection with god; belief in god-like powers
- Extreme elation or irritability
- Spending or gambling sprees, drug use, dramatic increase in sexual behavior
- A rapid stream of ideas thought to be brilliant
- Either behavior with extreme focus on goals or complete distractibility
- Not sleeping, or sleeping very little
(More comprehensive information on bipolar mania.)
This mood must be present for at least one week and not be explainable by drug abuse or any other illness in order to be diagnosed as a manic episode. Manic episodes may be brought on by stressful life events, lack of sleep, drug use, medication changes or nothing at all.
What Do Manic Episodes Feel Like?
Because manic episodes can cause great elation or great irritability, manic episodes can be perceived as pleasant or unpleasant. For some with a grandiose, elated mood, a manic episode is a pleasurable experience. They feel very good about themselves and engage in pleasurable behavior, like spending money or having sex. They believe they are extremely creative and intelligent and can constantly create with no need for sleep. They feel above all others.
For some though, and sometimes within the same manic episode, a person feels extremely irritable with all those around them. They may feel special and brilliant but be extremely annoyed with others for not understanding their genius. Someone in a manic episode may be particularly angry if their goal-directed behavior is interrupted. The longer someone is in a manic episode, the more likely they are to become irritable. This irritability feels uncontrollable and can increase to rage.
In both cases, the person's behavior feels "right," obvious and makes very clear sense, even if it makes no sense to those around the patient or is extremely risky. Those in a bipolar manic episode often endanger themselves because of these behaviors and require emergency intervention. After a manic episode, it may be possible for the patient to see how unrealistic, unreal and out-of-touch with reality they were, but this isn't possible during a manic episode.
What Do Bipolar Manic Episodes Look Like?
The energy felt inside a manic episode is seen on the outside too. People in bipolar manic episodes are often "buzzing" about the room, moving and talking quickly, often going from one idea, or one person, to another. They can be seen laughing and smiling without cause.
Three-quarters of manic episodes involve delusions1 wherein the person truly believes in ideas beyond reason or logic. This is often seen as they brag about impossible abilities, god-like power or creative genius. They may be so sure of their grandiose powers that they demand others follow and obey them, and become enraged, even violent, if they don't. They may defend themselves violently if they feel threatened. Manic episodes may even, very rarely, result in homicide.
Other outward cues of a manic episode include:
- Clothes put on in haste, disheveled
- Unusual clothing that attracts attention
- May be openly combative and aggressive with no tolerance for anyone
- Making bad decisions in all aspects of life; no insight