Often begins with a pleasurable sense of heightened energy, creativity, and social ease. Can quickly escalate out of control into a full-blown manic episode. People with mania typically lack insight, deny anything is wrong, and angrily blame anyone who points out a problem. Symptoms are present for at least one week, to the point where the person has trouble functioning in a normal way:
- Feeling unusually "high", euphoric or irritable (or appearing this way to those who know you well)
Plus at least four (and often almost all) of the following:
- Needing little sleep yet having great amounts of energy
- Talking so fast others can't follow your thinking (motor-mouth)
- Having racing thoughts
- Being so easily distracted your attention zips between many topics in just a few minutes
- Having an inflated feeling of power, greatness or importance
- Doing reckless things such as spending too much money, inappropriate sexual activity, making foolish business investments.
In severe cases, there may be psychotic symptoms such as hallucinations or delusions.
2. Hypomanic episode. Hypomania is a milder form with similar, but less severe symptoms and less impairment. You may have an elevated mood, feel better than usual, and be more productive. These episodes often feel good to the extent people stop their medication to get a “high”. However, there is a severe price to pay - either escalating to mania or crashing to depression.
- Feeling sad, blue, down in the dumps or losing interest in things you normally enjoy
Plus at least four of the following:
- Trouble sleeping or sleeping too much
- Loss of appetite or eating too much
- Problems concentrating or making decisions
- Feeling slowed down or too agitated to sit still
- Feeling worthless, guilty or having very low self-esteem
- Loss of energy or feeling tired all the time
- Thoughts of suicide or death.
Severe depressions may also include hallucinations or delusions.
4. Mixed Episode. Perhaps the most disabling are those episodes with symptoms of both mania and depression at the same time or swinging frequently during the day. You are excitable or agitated as in mania, but also feel irritable and depressed, rather than on top of the world.