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How Manic Episodes Work With Bipolar Disorder

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Bipolar disorder is an often misunderstood condition that’s poorly portrayed on television. You might have heard someone say “stop acting bipolar” without knowing the meaning of it. According to the Depression and Bipolar Support Alliance (DBSA), bipolar disorder affects approximately 5.7 million adults in the United States, translating to 2.6 percent of the total population over the age of 18. Twenty-five is the median age for the onset of bipolar disorder. However, it can show up in early childhood or as late as your 40s and 50s. 

Bipolar disorder doesn’t discriminate, and it affects an equal number of men and women. The condition is found in all races, ages, social classes, and ethnic groups. More than two-thirds of those with the disorder have at least one close relative with unipolar depression or the illness, meaning it has a heritable component. 

Bipolar disorder is considered the sixth leading cause of disability globally, and the illness results in 9.2 years of reduction in expected life span since one in five individuals with bipolar disorder will complete a suicide attempt. 

Since bipolar disorder is a misunderstood condition, it’s vital to understand how it can affect you. For example, it’s much more complicated than shifting from happy to sad sporadically, and someone with the illness will experience manic episodes that alter their views of reality. Let’s delve into bipolar disorder and get a grasp of how manic episodes work with the disorder.

What Is Bipolar Disorder?

Bipolar disorder, formerly known as manic depression or manic-depressive illness, is a mental health condition that causes unusual shifts in energy, mood, concentration, activity levels, and the ability to carry out daily tasks. 

There are three different types of bipolar disorder, and all three include evident changes in activity levels, energy, and mood. The moods can vary from periods of extreme irritability, elation, or energized behavior (known as manic episodes), to “downs” where the person feels hopeless or indifferent (depressive episodes). Less severe attacks are known as hypomanic. 

Types of Bipolar Disorder

  • Bipolar I Disorder: Defined as manic episodes lasting at least seven days or by manic symptoms severe enough that a person requires immediate hospitalization. In most cases, depressive episodes will occur as well, which last at least two weeks. Bouts of depression with mixed features (having manic symptoms and depressive symptoms at the same time) are possible. Less severe attacks are known as hypomanic. 
  • Bipolar II Disorder: Defined as a pattern of hypomanic and depressive episodes, but not the full-blown manic episodes that are common in Bipolar I Disorder.
  • Cyclothymic Disorder (Also known as Cyclothymia): Cyclothymia is defined by periods of hypomanic symptoms and periods of depressive symptoms that last for at least two years or one year in children and adolescents. However, these symptoms don’t meet the necessary criteria to be considered hypomanic and depressive episodes. 

In some cases, a person might experience symptoms of the condition that don’t match the three categories we’ve discussed above. This is referred to as “other specified and unspecified bipolar and related disorders.”

manic-episode-bipolar-disorder

What Are Mania and Hypomania?

Mania and hypomania are periods of excited and over-active behavior that can significantly impact your daily life. Mania is a more severe form that lasts a week or more, while hypomania is a milder version of mania that lasts for a much shorter time, typically a few days.

Some individuals find mania and hypomania enjoyable because it’s a period where they’re creative and filled with ideas, while others find it highly uncomfortable, unpleasant, or distressing. Artist Kanye West is famously quoted as saying, “I hate being bipolar, it’s awesome,” which speaks to the love/hate relationship individuals with the illness might face.

Mania

Mania typically lasts for a week or more, and it will have a severe adverse impact on your ability to conduct daily activities, which can disrupt or stop them completely. Severe mania has the potential to be serious and usually requires treatment in the hospital. 

The following is is how someone might feel who is going through a manic episode, including:

  • Happiness, euphoria, or a general sense of well-being
  • Agitation and irritability
  • Uncontrollable excitement, such as not getting your words out fast enough
  • A significant increase in sexual energy
  • Getting distracted easily, such as racing thoughts or an inability to concentrate

A person going through a manic episode might behave in the following way:

  • Being very friendly
  • Being more active than they usually are
  • Speaking very quickly, talking a lot, or not making sense to others around them
  • Either sleeping very little or not sleeping at all
  • Acting out of character; saying or doing things that are inappropriate for the situation
  • Acting aggressive or rude
  • Spending money excessively or in a manner that’s not typical for their personality
  • Misusing alcohol or drugs
  • Taking unusual and serious risks with your safety
  • Losing all social inhibitions, similar to how someone might act who’s under the influence of alcohol

After a manic episode, a person may experience the following:

  • Extreme tiredness and needing a lot of rest and sleep
  • Feeling extremely ashamed or unhappy with their behavior
  • Having taken on responsibilities or commitment that are now unmanageable
  • Having very little or no clear memories of what happened during a manic episode

Hypomania

Hypomania lasts less time and is more manageable than mania. However, it can still have a devastating effect on your life and those around you. With hypomania, you might be able to move forward with your daily activities without them being affected as severely as with mania. 

During a hypomanic episode, you may feel like the following:

  • A sense of well-being, euphoria, or extreme happiness
  • Feeling excited to the point you can’t get your words out fast enough
  • An increase in your sexual energy
  • Racing thoughts, unable to concentrate, and getting distracted easily

Your behavior may resemble the following:

  • Speaking very quickly and talking a lot more than normal
  • Being more active than normal
  • Being more friendly than normal
  • Not sleeping very much
  • Taking risks and losing all social inhibitions (e.g., having unprotected sex with strangers, stealing, or driving recklessly)
  • Spending money in excess that you may not have

What To Know About Manic Episodes?

In many cases, people who have bipolar disorder and haven’t been diagnosed by a doctor will turn to drugs or alcohol to “self-medicate.” They don’t understand why they feel this way, and drugs or alcohol numb the pain and help them feel a sense of normalcy. Unfortunately, while this may be a feasible solution in the short term, abusing drugs or alcohol can lead to addiction, which can be fatal. Not to mention, drugs and alcohol can also exacerbate the symptoms of bipolar disorder and lead to bizarre behavior. 

If you’re concerned about a friend or loved one who’s exhibiting bizarre behavior, understanding the symptoms of bipolar disorder and getting a diagnosis early on can help immensely in the long term. 

If you’re someone who’s struggling, you should always be upfront and honest about what you’re experiencing. If you go to treatment for drugs and alcohol to get sober but don’t treat the underlying causes of what contributed to your addiction, you’ll likely relapse when you leave treatment because you didn’t get a co-occurring disorder diagnosis. The same intense symptoms that led to addiction will persist and lead to a devastating cycle of getting help and relapse.

The most common signs of bipolar disorder include the following:

  • Periods of abnormal jumpy or upbeat behavior
  • Unusual talkativeness
  • Distractibility
  • Racing thoughts
  • Decreased need for sleep
  • Severely depressed mood, such as feeling empty, hopeless, or tearful
  • Sleeping too much or insomnia
  • A noticeable loss of interest or feeling no pleasure at all during activities you once found joy in doing.
  • Restlessness or slowed behavior
  • Noticeable and significant weight loss when the person isn’t dieting
  • Weight gain
  • An increase or decrease in appetite (in children, the inability to gain weight normally can be a telltale sign of depression).
  • A loss of energy or fatigue
  • Indecisiveness
  • Feeling worthless or inappropriate guilt.
  • Constantly thinking about, making plans, or attempting suicide.

If you’ve had thoughts or plans to commit suicide, just remember that you’re not alone, and there is always someone willing to listen and offer help. If you need somebody to lean on, please call the National Suicide Prevention Lifeline at (800) 273-8255. Remember, things will get better. If this is an emergency and you’re planning to commit suicide, please call 911 immediately for medical care. 

Sources

National Suicide Prevention Lifeline (N.D.) National Suicide Prevention Lifeline. from https://suicidepreventionlifeline.org/

DBSA (April 2021) Bipolar Disorder Statistics. from https://www.dbsalliance.org/education/bipolar-disorder/bipolar-disorder-statistics/

NIMH (April 2021) Substance Use and Co-Occurring Mental Disorders. from https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health/index.shtml

NIMH (April 2021) Bipolar Disorders. from https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

NIDA (April 2021) Drug Misuse and Addiction. from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction

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