Mania, also known as manic syndrome, is a state of abnormally elevated arousal, affect, and

energy level, or "a state of heightened overall activation with enhanced affective expression together
with lability of affect."[1] Although mania is often conceived as a "mirror image" to depression, the
heightened mood can be either euphoric or irritable; indeed, as the mania intensifies, irritability can
be more pronounced and result in violence, or anxiety.
The symptoms of mania include heightened mood (either euphoric or irritable); flight of ideas
and pressure of speech; and increased energy, decreased need for sleep, and hyperactivity. They
are most plainly evident in fully developed hypomanicstates; in full-blown mania, however, they
undergo progressively severe exacerbations and become more and more obscured by other signs
and symptoms, such as delusions and fragmentation of behavior.[2]
Mania is a syndrome with multiple causes. Although the vast majority of cases occur in the context
of bipolar disorder, it is a key component of other psychiatric disorders (such as schizoaffective
disorder, bipolar type) and may also occur secondary to various general medical conditions, such
as multiple sclerosis; certain medications may perpetuate a manic state, for example prednisone; or
substances of abuse, such as caffeine, cocaine or anabolic steroids.[citation needed] In the current DSM-5,
hypomanic episodes are separated from the more severe full manic episodes, which, in turn, are
characterized as either mild, moderate, or severe, with specifiers in regard to certain symptomatic
features (e.g. catatonia, psychosis). Mania is divided into three stages: hypomania, or stage I; acute
mania, or stage II; and delirious mania (delirium), or stage III. This "staging" of a manic episode is
very useful from a descriptive and differential diagnostic point of view.
Mania varies in intensity, from mild mania (hypomania) to delirious mania, marked by such
symptoms as disorientation, florid psychosis, incoherence, and catatonia.[3] Standardized tools such
as Altman Self-Rating Mania Scale[4] and Young Mania Rating Scale[5] can be used to measure
severity of manic episodes. Because mania and hypomania have also long been associated
with creativity and artistic talent,[6] it is not always the case that the clearly manic bipolar person
needs or wants medical help; such persons often either retain sufficient self-control to function
normally or are unaware that they have "gone manic" severely enough to be committed or to commit
themselves.[citation needed] Manic persons often can be mistaken for being under the influence of drugs.

Contents

 1Classification

o 1.1Mixed states

o 1.2Hypomania

o 1.3Associated disorders

 2Signs and symptoms

 3Cause

 4Mechanism

 5Diagnosis

 6Treatment
 7Society and culture

 8Etymology

 9See also

 10References

 11Further reading

 12External links

Classification[edit]
Mixed states[edit]
Main article: Mixed affective state
In a mixed affective state, the individual, though meeting the general criteria for
a hypomanic (discussed below) or manic episode, experiences three or more
concurrent depressive symptoms. This has caused some speculation, among clinicians, that mania
and depression, rather than constituting "true" polar opposites, are, rather, two independent axes in
a unipolar—bipolar spectrum.
A mixed affective state, especially with prominent manic symptoms, places the patient at a greater
risk for completed suicide. Depression on its own is a risk factor but, when coupled with an increase
in energy and goal-directed activity, the patient is far more likely to act with violence
on suicidal impulses.

Hypomania[edit]
Main article: Hypomania
Hypomania, which means "less than mania",[7] is a lowered state of mania that does little to impair
function or decrease quality of life.[8] It may, in fact, increase productivity and creativity. In hypomania,
there is less need for sleep and both goal-motivated behaviour and metabolism increase. Some
studies exploring brain metabolism in subjects with hypomania, however, did not find conclusive link
as there are those that reported abnormalities while some failed to detect differences. [9] 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, and hypomania can, if
the prominent mood is irritable rather than euphoric, be a rather unpleasant experience. In addition,
the exaggerated case of hypomania can lead to problems. For instance, positivity for a person could
make him engaging and outgoing, having a positive outlook in life. [10] When exaggerated in
hypomania, such person can display excessive optimism, grandiosity, and poor decision making,
often without regard to the consequences.[10]

Associated disorders[edit]
A single manic episode, in the absence of secondary causes, (i.e., substance use disorder,
pharmacologic, general medical condition) is sufficient to diagnose bipolar I
disorder. Hypomania may be indicative of bipolar II disorder. Manic episodes are often complicated
by delusions and/or hallucinations; should the psychotic features persist for a duration significantly
longer than the episode of mania (two weeks or more), a diagnosis of schizoaffective disorder is
more appropriate. Certain of "obsessive-compulsive spectrum" disorders as well as impulse control
disorders share the name "mania," namely, kleptomania, pyromania, and trichotillomania. Despite
the unfortunate association implied by the name, however, no connection exists between mania
or bipolar disorder and these disorders. B12 deficiency can also cause characteristics of mania and
psychosis.[11]
Hyperthyroidism can produce similar symptoms to those of mania, such as agitation, elevated mood,
increased energy, hyperactivity, sleep disturbances and sometimes, especially in severe cases,
psychosis.[12][13]