What Happens During A Manic Episode?

GinaMarie Guarino, LMHC

What Happens During A Manic Episode?

Manic episodes are a symptom of bipolar disorder. A manic episode is considered the ‘high’ point on the bipolar spectrum. A manic episode causes a person to become very excitable and irritable. These episodes can last anywhere from a few days to several months.

A patient will feel very energetic and restless during a manic episode. He or she will likely be irritable and talkative. It will often sound like rambling, and it can become so intense that it frightens friends and family. The irritability and talkative or obsessive thoughts often come from racing thoughts that are often nonsensical or grandiose.

A patient who is experiencing a manic episode may set unattainable or unusual goals, express intense enthusiasm and commitment to achieving these goals, and become very agitated if confronted with the erratic and intense behavior, or confusion about the intensity of the unusual or grandiose sense of the ability to attain the goals.

People who are experiencing a manic episode may think people are trying to harm them in some way. They will likely be unable to focus. They will be unreceptive to people trying to help them, and will likely become suspicious of the efforts to help. Someone who is experiencing a manic episode may even become aggressive toward people who express concern for him or her.

A manic episode will affect a patient’s sleep cycle. He or she will sleep very little. The patient experiencing a manic episode may even go for entire days without sleeping. This little need for sleep, erratic behavior and high energy despite the sleep deprivation can make friends and loved ones assume that the manic patient is under the influence of drugs.

A manic episode can cause a patient to make poor decisions. Some examples are actually using drugs, engaging in promiscuous or dangerous behavior, or picking fights with people. This is because during a manic episode a patient will feel invincible. They will likely have a sense of exaggerated confidence. They may even believe they have abilities to engage in these activities with no risk of being hurt. This often causes tension with the manic patient and concerned loved ones, along with innocent bystanders.

During a manic episode a patient can experience psychotic symptoms, like:

  • Hallucinations. Seeing or hearing things that are not there or do not exist. Symptoms of hallucinations include having imagined sensations throughout the body. Some examples are voices telling you unsettling things or seeing shadows or people who are not actually there. Hallucinations can also cause people to smell things that are not real or feel things that are not there.
  • Delusions. False or imagined perceptions of reality. Signs of delusions include paranoid behavior. Delusions also include grandiose beliefs in self. Delusions can cause the beliefs of being betrayed by people close to them, that someone is trying to stalk them, capture them, or harm them.

Sometimes patients with bipolar disorder will not experience mania. They may instead experience episodes hypomania. “Hypomania” means the symptoms of ‘mania’ are not as severe as the typical manic state. Patients who experience hypomania likely have a bipolar II diagnosis. Both mania and hypomania have the potential to be dangerous to the patient and people around them. That is why it is important to seek medical or psychiatric intervention if a patient is experiencing a manic episode.

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