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3.3 What is Mania?


This article is from the Bipolar Disorder FAQ, by barry@webveranda.com (Barry Campbell) with numerous contributions by others.

3.3 What is Mania?

Criteria for Manic Episode (DSM-IV, p. 332)

A. A distinct period of abnormally and persistently elevated, expansive, or
irritable mood, lasting at least 1 week (or any duration if hospitalization is

B. During the period of mood disturbance, three (or more) of the following
symptoms have persisted (four if the mood is only irritable) and have been
present to a significant degree:

(1) inflated self-esteem or grandiosity

(2) decreased need for sleep (e.g., feels rested after only 3 hours of sleep)

(3) more talkative than usual or pressure to keep talking

(4) flight of ideas or subjective experience that thoughts are racing

(5) distractibility (i.e., attention too easily drawn to unimportant or
irrelevant external stimuli)

(6) increase in goal-directed activity (either socially, at work or school, or
sexually) or psychomotor agitation

(7) excessive involvement in pleasurable activities that have a high potential
for painful consequences (e.g., engaging in unrestrained buying sprees, sexual
indiscretions, or foolish business investments)

C. The symptoms do not meet criteria for a Mixed Episode.

D. The mood disturbance is sufficiently severe to cause marked impairment in
occupational functioning or in usual social activities or relationships with
others, or to necessitate hospitalization to prevent harm to self or others,
or there are psychotic features.

E. The symptoms are not due to the direct physiological effects of a substance
(e.g., a drug of abuse, a medication, or other treatments) or a general
medical condition (e.g., hyperthyroidism).

Note: Manic-like episodes that are clearly caused by somatic antidepressant
treatment (e.g., medication, electroconvulsive therapy, light therapy) should
not count toward a diagnosis of Bipolar I Disorder.

Again, the APA gives us a good starting point for studying mania, but the
language is awfully clinical. Here's a plain-English version, with some

* Decreased need for sleep.

* Restlessness.

* Feeling full of energy.

* Distractibility (what was that?)

* Increased talkativeness (or increased typeativeness)

* Creative thinking.

* Increase in activities.

* Feelings of elation.

* Laughing inappropriately

* Inappropriate humor.

* Speeded up thinking.

* Rapid, pressured speech, that you can teach, eating a
peach, while on a beach.

* Impaired judgment

* Increased religious thinking or beliefs.

* Feelings of exhilaration.

* Racing thoughts, which can't be taught, and can't be
bought, although they ought, you might get caught.

* Irritability (dammit, there it is again!)

* Excitability.

* Inappropriate behaviors.

* Impulsive behaviors.

* Increased sexuality (also known as "platoon-of-Marines-on-
shore-leave syndrome")... or

* "clang associations" (the association of words based on
their sound, a possible reason so many poets are
bipolar, also why we have pun fun)

* _decreased_ interest in sex, or any other interpersonal
relationships, due to obsessive interest in some other
subject or activity

* Inflated self-esteem (so prove I'm NOT the world's leading

* Financial extravagance.

* Grandiose thinking.

* Heightened perceptions.

* Bizarre hallucinations.

* Disorientation.

* Disjointed thinking.

* Incoherent speech.

* Paranoia, delusions of being persecuted.

* Violent behavior, hostility

* Severe insomnia

* Profound weight loss

* Exhaustion


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