What Is Mania?

Mania refers to a state of abnormally and persistently elevated, expansive, or irritable mood, often accompanied by excitement, overactivity, agitation, overoptimism, grandiosity, or impaired judgment. Symptoms of mania can include a sustained period of exaggerated, extreme, and sometimes dangerous behaviors. 

Mania is commonly associated with bipolar disorder, but people without these disorders can also experience mania. When this happens, it means there is another cause or factor contributing to it, such as the effects of a substance or a medical condition.

Symptoms

The symptoms of mania and hypomania, its less severe form, largely overlap, except that hypomania is not accompanied by psychotic symptoms and not severe enough to cause marked impairment in functioning or necessitating hospitalization.

To be classified as mania, symptoms must persist for at least one week, lead to difficulties with functioning, or require hospitalization.

Racing Thoughts

If you feel like your thoughts are racing, repeating, or distracting you, take note. If someone else tells you they can’t keep their thoughts together or that their brain is going miles a minute, take note.

Decreased Need for Sleep

During manic episodes, there is a marked decreased need for sleep. In turn, sleep disturbances can escalate the severity of mania.

If someone you love isn’t sleeping well, it doesn’t necessarily mean that they are experiencing mania, though. There are many reasons someone’s sleep habits may change.

Increased Talkativeness or Fast Speech

While some people naturally speak more frequently or more quickly than others, people with mania only do this during a manic episode. It is a noticeable difference from their regular speech behavior, but others may be able to detect the change more readily. Speaking more loudly than usual is another mania symptom.

Euphoria

As a symptom of mania, euphoria looks like elevated and expansive emotions, including excessive and unreasonable happiness, hopefulness, and excitement. These symptoms, importantly, are not the direct result of consuming substances such as a drug of abuse, a medication, or other treatments.

Euphoria at first may feel like relief if you also experience depression, but the good feelings quickly escalate to uncontrollable and uncomfortable levels.

Increased Energy or Activity 

Increases in goal-oriented activities (social, academic or work, or sexual) and psychomotor activity in the form of agitation is characteristic of manic episodes. This increased energy or activity can also contribute to sleep issues.

Feeling Jumpy or Wired

This may be tied to feelings of anxiety and irritability, increased energy and activity, and feelings of restlessness paired with tirelessness. It can present as repetitive behaviors in some cases.

People may perform these actions—such as finger or foot tapping, hand fidgeting, scribbling, pacing, and multitasking without completing tasks or accomplishing goals—to soothe their tension.

Higher Libido

Increases in sex drive and desire (libido), as well as associated sexual distress, may also be present in manic episodes. While this may seem harmless or even positive on the surface, it can result in risky sexual behaviors or sexual indiscretions.

Engaging in Risky Behaviors

Risky behaviors associated with mania are those that have a high potential for negative or painful outcomes. They may include:

• Spending sprees
• Risky sexual behavior like having unprotected sex
• Risky substance use behavior like sharing needles or taking more than a recommended dose of a drug
• Self-harm

Complications 

Mania is not something to be ignored. Leaving symptoms untreated can be dangerous. Non-bipolar mania doesn’t just happen. If you or someone you love experiences mania, talk to your doctor, who can help with diagnosing the underlying cause to begin the appropriate treatment and reduce the risk of complications.

If a friend or loved one has auditory or visual hallucinations (seeing or hearing something that is not there) or shows paranoia or other delusional behaviors (believing something that isn’t real), contact a mental health professional immediately. These may be serious symptoms of mania.

Mania in Children

Recognizing mania in children requires having an understanding of the child’s baseline moods and behaviors. Even so, the symptoms of mania can be difficult to distinguish from those of attention deficit hyperactivity disorder (ADHD).

Some common mania symptoms in children include:

• Heightened activity levels
• Irritability  
• Poor judgment
• Easily distractible
• Problems with falling or staying asleep

If your child is showing signs of mania or depression, talk to their pediatrician or your family doctor as soon as possible. Moods and behaviors often return to baseline after manic episodes.

Causes

Causes of mania in bipolar disorder are not entirely known, but may include a combination of:

• Family history: If you have a parent or sibling who has experienced mania, you are more likely to experience a manic episode in your lifetime.
• Stress or environmental changes: Events like job loss, breakups, family conflict, financial problems, and illnesses can trigger manic episodes and symptom relapses.
• Brain differences: People with bipolar disorder and other mental illnesses have noticeable brain differences. One 2019 study with 73 participants found that amygdala (involved in memory, emotions, and the fight-or-flight response) activation and connectivity are different in people with bipolar disorder.

Physical conditions that have been associated with mania include:

• Alcohol misuse
• Brain tumor
• Brain injury
• Childbirth (postpartum psychosis)
• Dementia
• Encephalitis
• Lupus
• Medication side effects
• Drug use 
• Sleep deprivation (insomnia)
• Stroke

Diagnosis

You and your doctor will discuss symptoms, including how long episodes typically last. Next, your doctor will order tests—such as a thyroid function test and urinalysis—to rule out other potential contributions to your symptoms.

In order for a manic episode to be diagnosed as part of bipolar disorder, a person must have three of the following symptoms persisting to a significant degree, meaning there has to be a noticeable change in behavior:

• Inflated self-esteem or grandiosity 
• Decreased need for sleep, such as feeling rested only after three hours of sleep
• More talkative than usual or feeling pressured to keep talking
• Flight of ideas or feeling like your thoughts are racing
• Easily distracted by unimportant or irrelevant stimuli 
• Increased activity or agitation
• Excessive involvement in activities that have a high potential for painful consequences 

The mood disturbance has to be so severe that it causes marked impairment in your social or occupational functioning or to necessitate hospitalization to prevent harm to self or others. Also, the mania episode is not the result of a substance- or medication-induced disorder.

Treatment 

Symptoms of mania can be managed with appropriate treatment. Some people may find it easier to manage mania with a combination of medications and psychotherapy.

Medications

The type of medication your doctor prescribes depends on the underlying cause of your mania. Not all medications typically prescribed in mental health settings will be appropriate.

For example, selective serotonin reuptake inhibitors (SSRIs) are antidepressants used for treating depression, but they are used with caution or avoided because they may trigger mania or worsen mood cycling.

Medications that may be prescribed include:

• Mood stabilizers (anticonvulsants or lithium)
• Antipsychotics 
• Sleep aids 
• Benzodiazepines 

Therapy

Psychotherapy focuses on supporting patients in managing their illness and developing healthier coping skills. It can also help patients and their family members better navigate stressful periods and triggers.

Common types of therapy used to treat bipolar disorder and the associated mania include:

• Cognitive behavioral therapy
• Family-based or group therapy
• Dialectical behavior therapy

A review of data from 1995–2013 found that bipolar disorder-specific psychotherapies, when used together with medications, consistently show advantages over medications alone on symptom severity and the risk of relapse.

Lifestyle Changes

You can also make some other positive changes that can help manage mania and bipolar disorder, including:

• Commit to daily exercise
• Eat a more balanced diet that includes regular meals filled with nutrient-rich, colorful fruits and vegetables
• Make sleep a priority by sticking to a set sleep schedule, even on weekends, holidays, and vacations
• Keep a symptoms or feelings journal or log so you can check in with yourself regarding any mood cycling or new risky behaviors
• Practice self-compassion, which means forgiving yourself for reacting to triggers and engaging in self-care activities

Coping

If you experience manic episodes, coping with stressors and reducing overall stress levels can help. Coping with personal stressors is about removing obstacles to help you overcome perceived difficulties.

Strategies may include:

• Asking for help from others like family, friends, neighbors, coworkers, and therapists
• Accessing local support services and agencies or organizations for people with mania or conditions causing mania
• Getting financial assistance or supplementation
• Gaining access to transportation 
• Practicing a sense of humor

Frequently Asked Questions

What is the difference between bipolar and manic depression?

Bipolar disorder was formerly called manic depression or manic-depressive illness. They both describe the mental disorder that causes dramatic mood shifts and changes in energy, activity, and concentration levels.

What does a manic episode look like?

In a manic episode caused by bipolar disorder, a person can experience increased energy, creativity, and feelings of euphoria. It’s common to feel confident, like you can accomplish anything. There may, however, also be irritability and loss of touch with reality.

How do you calm a manic episode?

If you experience mania, you should see a professional for diagnosis and treatment. It’s usually a symptom of a bipolar condition. You can calm a manic episode to some degree by practicing anxiety-reducing techniques like deep breathing and focusing on what you can see, hear, smell, and touch. You can also develop and practice stress-reducing strategies. However, appropriate psychiatric medications are usually required.

What happens when a manic episode ends?

When a manic episode ends, it’s common to feel exhausted, depressed, and even disappointed because the feelings of elevated self-esteem and euphoria that come with the mania are easy to miss. You may feel like your goals are hopeless after your mania passes, but with treatment you can work to stabilize these ups and downs.

Summary

Mania is characterized by feelings of elevated self-esteem, mood, and increased activity. People who have manic episodes may talk fast, need less sleep, and engage in risky behaviors like spending sprees. While it’s one of the main features of bipolar disorder, other conditions can also cause mania. If you have symptoms of mania, reach out to your healthcare provider to help you figure out the underlying cause.

A Word From Verywell

Experiencing mania can be scary, confusing, and isolating, especially if the person experiencing it is understandably worried about sharing their symptoms with others. Know that you are not alone and you can manage your symptoms and stop it from interfering with your life by seeking help and getting treatment.

If you or someone you know needs help with bipolar disorder or the associated signs and symptoms of mania, reach out to your doctor and a mental health professional for help. They will be able to provide a diagnosis and help you develop a treatment plan.