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This article is an expansion of a section entitled Mania from within the main article Bipolar disorder. For the classical mythological figures named Mania, see Mania (mythology). Mania may refer to two different mythological figures In Greek mythology, Mania was the Personification of Insanity.
For other uses, see Manic (disambiguation).
Manic episode
Classification and external resources
ICD-10 F30
ICD-9 296.0 Single manic episode, 296.4 Most recent episode manic, 296.6 Most recent episode mixed


Mania (from Greek μανία[1] and that from μαίνομαι - mainomai, "to rage, to be furious") is a severe medical condition characterized by extremely elevated mood, energy, unusual thought patterns and sometimes psychosis. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. Greek (el ελληνική γλώσσα or simply el ελληνικά — "Hellenic" is an Indo-European language, spoken today by 15-22 million people mainly Psychosis (from the Greek ψυχή "psyche" for mind or soul and -οσις "-osis" for abnormal condition with adjective psychotic There are several possible causes for mania, but it is most often associated with bipolar disorder, where episodes of mania may cyclically alternate with episodes of clinical depression. Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression These cycles may relate to diurnal rhythms and environmental stressors. Mania varies in intensity, from mild mania (known as hypomania) to full-blown mania with psychotic features (hallucinations and delusions). This article is an expansion of a section entitled '''Hypomania''' from within the main article Bipolar disorder. A hallucination, in the broadest sense is a Perception in the absence of a stimulus. A delusion is commonly defined as a fixed False Belief and is used in everyday language to describe a belief that is either false fanciful or derived from Deception

Manic patients may need to be hospitalized to protect themselves and others. Mania and hypomania have also been associated with creativity and artistic talent. Mental illness and Creativity are popularly considered to be related particularly in the case of Bipolar disorder. [2]

Contents

Symptoms

Symptoms of mania include rapid speech, racing thoughts, decreased need for sleep, hypersexuality, euphoria, impulsiveness, grandiosity, and increased interest in goal-directed activities. Pressure of speech is a tendency to speak rapidly and frenziedly as if motivated by an urgency not apparent to the listener Hypersexuality is the desire to engage in Human sexual behavior at a level high enough to be considered clinically significant Euphoria is a medically recognized emotional state related to Pleasure and Happiness. [3] Mild forms of mania, known as hypomania, cause little or no impairment, but most people who suffer from prolonged hypomania due to bipolar disorder develop full mania. This article is an expansion of a section entitled '''Hypomania''' from within the main article Bipolar disorder.

Another symptom of mania is racing thoughts during which the sufferer is excessively distracted by unimportant stimuli. [4] This negative experience creates an inability to function and an absentmindedness where the manic individual's thoughts totally preoccupy him or her, making him or her unable to keep track of time or be aware of anything besides the neurological pattern of thoughts.

Manic symptoms include irritability, anger or rage, delusions, hypersensitivity, hypersexuality, hyper-religiosity, hyperactivity, impulsiveness, racing thoughts, talkativeness, pressure to keep talking or rapid speech, and grandiose ideas and plans, decreased need for sleep (e. Irritation or exacerbation, in Biology and Physiology, is a state of Inflammation or painful reaction to Allergy or cell-lining damage A delusion is commonly defined as a fixed False Belief and is used in everyday language to describe a belief that is either false fanciful or derived from Deception Hypersexuality is the desire to engage in Human sexual behavior at a level high enough to be considered clinically significant Religiosity, in its broadest sense is a comprehensive Sociological term used to refer to the numerous aspects of religious activity dedication and Belief (religious Hyperactivity can be described as a physical state in which a person is abnormally and easily excitable or exuberant g. feels rested after 3 or 4 hours of sleep). In manic and hypomanic cases, the afflicted person may engage in out of character behavior such as questionable business transactions, wasteful expenditures of money, risky sexual activity, abnormal social interaction, or highly vocal arguments uncharacteristic of previous behaviors. These behaviors increase stress in personal relationships, problems at work and increases the risk of altercations with law enforcement as well as being at high risk of impulsively taking part in activities potentially harmful to self and others.

Although "severely elevated mood" sounds somewhat desirable and enjoyable, the experience of mania is often quite unpleasant and sometimes disturbing, if not frightening, for the person involved (and those close to them), and may lead to impulsive behavior that may later be regretted. It can also often be complicated by the sufferer's lack of judgment and insight regarding periods of exacerbation of symptoms. Manic patients are frequently grandiose, obsessive, impulsive, irritable, belligerent, and frequently deny anything is wrong with them. Because mania frequently encourages high energy and decreased perception of need or ability to sleep, within a few days of a manic cycle, sleep-deprived psychosis may appear, further complicating the ability to think clearly. Psychosis (from the Greek ψυχή "psyche" for mind or soul and -οσις "-osis" for abnormal condition with adjective psychotic Racing thoughts and misperceptions lead to frustration and decreased ability to communicate with others.

There are different "stages" or "states" of mania. For example, a minor state may involve increased creativity, wit, gregariousness, and ambition. However, a more serious state of mania may involve lack of good judgment, lack of ability to focus, and even psychosis. Psychosis (from the Greek ψυχή "psyche" for mind or soul and -οσις "-osis" for abnormal condition with adjective psychotic The victim of mania may feel elated; however, he/she may also feel irritable, frustrated, and may experience derealization. Derealization ( DR) is an alteration in the perception or experience of the external world so that it seems strange or unreal

A mnemonic used to remember the symptoms of mania is DIGFAST:[5]

Mixed states

Main article: Mixed episode

Mania can be experienced at the same time as depression, in a mixed episode. A mnemonic device (nəˈmɒnɪk is a Memory aid Commonly met mnemonics are often verbal something such as a very short poem or a special word used to help a person remember This article is an expansion of a section entitled '''Mixed state''' from the main article Bipolar disorder In the context of Mental This article is an expansion of a section entitled '''Mixed state''' from the main article Bipolar disorder In the context of Mental Dysphoric mania is primarily manic and agitated depression is primarily depressed. This article is an expansion of a section entitled '''Mixed state''' from the main article Bipolar disorder In the context of Mental This article is an expansion of a section entitled '''Mixed state''' from the main article Bipolar disorder In the context of Mental This has caused speculation amongst doctors that mania and depression are two independent axes in a bipolar spectrum, rather than opposites. The Bipolar spectrum refers to a category of Mood disorders that feature abnormally elevated mood

There is an increased probability of suicide in the mixed state, as depressed individuals who are also manic have the energy needed to commit the act and the thoughts of depression that would lead them initially to suicide.

Hypomania

Main article: Hypomania

Hypomania is a lowered state of mania that does little to impair function or decrease quality of life according. This article is an expansion of a section entitled '''Hypomania''' from within the main article Bipolar disorder. In hypomania there is less need for sleep, goal motivated behavior and increased metabolism. Though the elevated mood and energy level typical of hypomania could be seen as a benefit, mania itself generally has many undesirable consequences including suicidal tendencies.

Associated disorders

A single manic episode is sufficient to diagnose Bipolar I Disorder. Hypomania may be indicative of Bipolar II Disorder or Cyclothymia. Bipolar II Disorder is a Bipolar spectrum disorder that is characterized by at least one Hypomanic episode and at least one Major depressive episode; with Cyclothymia (pronounced /ˌsaɪkləˈθaɪmiə ˌsɪklə-/ is a Mood disorder. However, if prominent psychotic symptoms are present for a duration significantly longer than the mood episode, a diagnosis of Schizoaffective Disorder is more appropriate. Psychosis (from the Greek ψυχή "psyche" for mind or soul and -οσις "-osis" for abnormal condition with adjective psychotic Schizoaffective disorder is a Psychiatric Diagnosis of neurobiological illness.

Medical treatment

Before beginning treatment for mania, careful differential diagnosis must be performed to rule out non-psychiatric causes. A differential diagnosis (sometimes abbreviated DDx, ddx

Acute mania in bipolar disorder is typically treated with mood stabilizers and/or antipsychotic medication. This article refers to the medication For other uses see Stabilizer. Antipsychotics are a group of Psychoactive drugs commonly but not exclusively used to treat Psychosis, which is typified by Schizophrenia. Note that these treatments need to be prescribed and monitored carefully to avoid harmful side-effects such as neuroleptic malignant syndrome with the antipsychotic medications. Neuroleptic malignant syndrome (NMS is a life-threatening neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs. It may be necessary to temporarily admit the patient involuntarily until the patient is stabilized. Antipsychotics and mood stabilizers help stabilize mood of those with mania or depression. Antipsychotics are a group of Psychoactive drugs commonly but not exclusively used to treat Psychosis, which is typified by Schizophrenia. This article refers to the medication For other uses see Stabilizer. They work by blocking the receptor for the neurotransmitter dopamine and allowing serotonin to still work, but in diminished capacity. Dopamine is a Hormone and Neurotransmitter occurring in a wide variety of animals including both vertebrates and invertebrates Serotonin (ˌsɛrəˈtoʊnən ( 5-hydroxytryptamine, or 5-HT) is a Monoamine Neurotransmitter synthesized in serotonergic Neurons

When the symptoms of mania have gone, long-term treatment then focuses on prophylactic treatment to try to stabilize the patient's mood, typically through a combination of pharmacotherapy and psychotherapy. Prophylaxis ( Greek "προφυλάσσω" to guard or prevent beforehand) is any medical or Public health procedure whose purpose Medication, also referred to as medicine, can be loosely defined as any substance intended for use in the diagnosis cure mitigation treatment or prevention of disease Psychotherapy is an Interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living

Lithium is the classic mood stabilizer to prevent further manic and depressive episodes. Lithium in pharmacology refers to use of the Lithium Ion, Li+ as a drug Anticonvulsants such as valproic acid and carbamazepine are also used for prophylaxis. Valproic acid ( VPA) is a Chemical compound that has found clinical use as an Anticonvulsant and mood-stabilizing drug, primarily in Carbamazepine ("CBZ" is an Anticonvulsant and mood stabilizing drug used primarily in the treatment of Epilepsy and Bipolar disorder Prophylaxis ( Greek "προφυλάσσω" to guard or prevent beforehand) is any medical or Public health procedure whose purpose More recent drug solutions include lamotrigine. Lamotrigine (marketed as Lamictal (ləˈmɪktəl by GlaxoSmithKline, called Lamictin in South Africa, he למוג'ין ( Lamogine

Psychopharmacology

The biological mechanism by which mania occurs is not yet known. One hypothesised cause of mania (among others), is that the amount of the neurotransmitter serotonin in the temporal lobe may be excessively high. See Chemical synapse for an introduction to concepts and terminology used in this article Serotonin (ˌsɛrəˈtoʊnən ( 5-hydroxytryptamine, or 5-HT) is a Monoamine Neurotransmitter synthesized in serotonergic Neurons The temporal lobes are parts of the cerebrum that are involved in speech, Memory, and Hearing. This is likely to be only part of the puzzle. Dopamine, norepinephrine, glutamate and gamma-aminobutyric acid also appear to play important roles. Dopamine is a Hormone and Neurotransmitter occurring in a wide variety of animals including both vertebrates and invertebrates Norepinephrine ( INN) (abbreviated norepi or NE) or noradrenaline ( BAN) (abbreviated NA or NAd) is a Glutamic acid (abbreviated as Glu or E) is one of the 20 Alpha Amino acids It is not among the human Essential amino acids Its Gamma-aminobutyric acid (GABA is the chief inhibitory Neurotransmitter in the Mammalian Central nervous system. The temporal lobe is involved in speech, listening, reading, word association and contains the amygdala, the almond shaped emotional center for the brain. The la amygdalae ( Latin, also la corpus amygdaloideum, singular la amygdala, from Greek el αμυγδαλή grc-Latn amygdalē, 'almond' The left amygdala is more active in women who are manic and the orbitofrontal cortex is less active (2005). The orbitofrontal cortex (OFC is a region of association cortex of the Human brain involved in cognitive processes such as Decision-making. Emotional stimulation creates the ability for life events to be stored more vividly in the memory. In women, the amygdala becomes similar to one of a manic woman during sex combined with menstruation.

Bipolar disorder is different for men than it is for women. Mania affects the hypothalamus and the pituitary-adrenal-axis by causing it to secrete hormones in different amounts, that accounts for hypersexuality, changes in metabolism, and misdiagnosis as hormonal imbalance. The hypothalamus links the Nervous system to the Endocrine system via the Pituitary gland (hypophysis Hypersexuality is the desire to engage in Human sexual behavior at a level high enough to be considered clinically significant Metabolism is the set of Chemical reactions that occur in living Organisms in order to maintain Life. Because the hormone problem stems from a neurological problem hormone therapy isn't the best solution. Hormones (from Greek ὁρμή - "impetus" are chemicals released by cells that affect cells in other parts of the body Hormone therapy, or hormonal therapy is the use of Hormones in medical treatment If serotonin levels are stable, hormones secreted by the pituitary gland will stabilize. The pituitary gland, or hypophysis, is an Endocrine gland about the size of a Pea. Bipolar disorder is similar to a thought disorder combined with hypothyroidism and hyperthyroidism. In Psychiatry, thought disorder or formal thought disorder is a term used to describe a pattern of disordered language use that is presumed to reflect disordered thinking Hypothyroidism is the disease state in humans and animals caused by insufficient production of Thyroid hormone by the Thyroid gland. Hyperthyroidism is the term for overactive tissue within the Thyroid gland resulting in overproduction and thus an excess of circulating free thyroid hormones Thyroxine

In the study done by Brentwood VA Medical Center in Los Angeles, California, antidepressants were taken during mania. An antidepressant is a Psychiatric medication used for alleviating major depression or Dysthymia ('milder' depression One third of bipolar patients developed antidepressant induced mania from their healthy state and one fourth developed antidepressant induced rapid cycling from their healthy state. For those with type II bipolar disorder, antidepressants decrease the gaps between the depression and mania (1995). Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression

Mania and over the counter drugs

Phenylpropanolamine (PPA) is a sympathomimetic drug similar in structure to amphetamine which was formerly present in over 130 medications, primarily decongestants, cough/cold remedies, and anorectic agents. Phenylpropanolamine (PPA is a drug ingredient of the Phenethylamine family used as a Decongestant in prescription and nonprescription (over the counter

A report on PPA, from the Dept. of Psychiatry, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. Pharmacopsychiatry 1988 stated:

We have reviewed 37 cases (published in North America and Europe since 1960) that received diagnoses of acute mania, paranoid schizophrenia, and organic psychosis and that were attributed to PPA product ingestion. Schizophrenia ( from the Greek roots schizein (σχίζειν "to split" and phrēn Of the 27 North American case reports, more reactions followed the ingestion of combination products than preparations containing PPA alone; more occurred after ingestion of over-the-counter products than those obtained by prescription or on-the-street; and more of the cases followed ingestion of recommended doses rather than overdoses.
Failure to recognize PPA as an etiological agent in the onset of symptoms usually led to a diagnosis of schizophrenia or mania, lengthy hospitalization, and treatment with substantial doses of neuroleptics or lithium. Schizophrenia ( from the Greek roots schizein (σχίζειν "to split" and phrēn Antipsychotics are a group of Psychoactive drugs commonly but not exclusively used to treat Psychosis, which is typified by Schizophrenia.

PPA is no longer available in any medication in the United States as of the year 2000.

Personal accounts

In Electroboy: A Memoir of Mania by Andy Behrman, he describes his experience of mania as "the most perfect prescription glasses with which to see the world. Andy Behrman was born 1962 and is an American writer of non-fiction as well as a mental health advocate and national speaker who maintains a website at www . . life appears in front of you like an oversized movie screen" (2002). Behrman indicates early in his memoir that he sees himself not as a person suffering from an uncontrollable disabling illness, but as a director of the movie that is his vivid and emotionally alive life. "When I'm manic, I'm so awake and alert, that my eyelashes fluttering on the pillow sound like thunder" (2002).

Also the most severe ase was attributed to a young female of Jess Earley.

See also

Caveat: See "Symptoms" above. In Psychiatry, monomania (from Greek monos, one and mania, Mania) is a type of Paranoia in which the patient has only one idea Pyromania is an impulse to deliberately start fires to relieve tension and typically includes gratification or relief afterward Social manias are mass movements which periodically sweep through Society, sometimes on a world wide basis Trichotillomania (TTM or "trich" as it is commonly known is an impulse control disorder or form of Self-injury characterized by the repeated urge The Young Mania Rating Scale (abbreviated YMRS) is an eleven-item multiple-choice diagnostic questionnaire which Psychiatrists use to measure the severity

References

  1. ^ Mania, Henry George Liddell, Robert Scott, A Greek-English Lexicon, at Perseus
  2. ^ Jamison, Kay R. (1996), Touched with Fire: Manic-Depressive Illness and the Artistic Temperament, New York: Free Press, ISBN 0-684-83183-X
  3. ^ DSM-IV
  4. ^ Lakshmi N. Kay Redfield Jamison (born June 22, 1946) is an American clinical psychologist and writer who is one of the foremost experts on Bipolar disorder Touched with Fire Manic-Depressive Illness and the Artistic Temperament is a Book by the American Psychologist Kay Redfield Jamison that examines Free Press is an American publisher and Imprint of Simon & Schuster that has been in business for over fifty years The Diagnostic and Statistical Manual of Mental Disorders' ( DSM) is published by the American Psychiatric Association Ytham, Vivek Kusumakar, Stanley P. Kutchar. (2002). Bipolar Disorder: A Clinician's Guide to Biological Treatments, page 3.
  5. ^ Carlat DJ, The Psychiatric Review of Symptoms: A Screening Tool for Family Physicians, American Academy of Family Physicians, URL: http://www.aafp.org/afp/981101ap/carlat.html, Accessed on: August 13, 2005. Events 3114 BC - According to the Lounsbury correlation the start of the Maya calendar. Year 2005 ( MMV) was a Common year starting on Saturday (link displays full calendar of the Gregorian calendar.

External links


Dictionary

mania

-noun

  1. Violent derangement of mind; madness; insanity.
  2. Excessive or unreasonable desire; insane passion affecting one or many people; fanaticism
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