mania

Mania: description

A mania is a mental disorder in which the emotional world, the emotional experience and the emotional expression are disturbed (affective disorder). Concerned individuals live in phases in an intense but unfounded elation, accompanied by an overly good mood and an increased self-esteem that is well above the normal average. A mania usually occurs in phases, the symptomatic period refer to physicians as a manic episode. In the phases between two episodes sufferers show no signs of mania.

During a manic episode, affected individuals are particularly powerful, energetic, and euphoric. Many things are started and quickly stopped, business is done, contracts are closed. For those affected, it is impossible to sit still for a while and do nothing. They often overestimate their own strength, their own attractiveness and their own financial resources and can inadvertently inflict great harm on themselves or their fellow human beings.

After a manic episode, sufferers are often overwhelmed by feelings of guilt and shame and try to undo what they did during mania.

It is very difficult for outsiders to deal with a mania. Those affected often show unrestrained, unfamiliar disinhibition, are easily irritated and do and say many things that are fundamentally inconsistent with their moral beliefs.

The causes of mania are not fully understood. It is probably favored by several factors. It is assumed that certain triggering events, such as lasting changes in the lives of those affected, can trigger manic phases in the case of a specific hereditary disposition. A mania can occur suddenly without triggering factors.

Every 100th German suffers from an affective disorder, but pure mania accounts for only about five percent of it. It is generally assumed that the number of unreported cases of mania is high – not all mania are diagnosed. This is partly because many sufferers show only mild symptoms that do not seriously affect their everyday and professional lives. On the other hand, many people are ashamed to visit a doctor with symptoms of a mental illness.

Mania in childhood and adolescence are rare. For most sufferers, the first manic episode sets in until the age of 25.

Other forms of mania

An attenuated form of mania, in which mood swings are still well above normal, is called hypomania. The risk of developing mania from hypomania is low.

Not always a hypomania is in need of treatment. If those affected and their immediate environment are not fundamentally affected by the symptoms of hypomania, no therapy is necessary.

Conditions similar to hypomania are also commonly reported by persons suffering from sleep deprivation, such as people on night or shift duty.

The mania can also be combined with the symptoms of schizophrenia (schizoaffective psychosis).

Mania: symptoms

The most significant symptom of a mania is an exaggerated and unusually intense but mostly unfounded exhilaration that suddenly occurs and can last for several days. This exhilaration is accompanied by the following symptoms:

• strong inner excitement
• excessive activity
• strong restlessness
• increased efficiency and creativity
• Unreasonably increased self-esteem
• loss of reality
• significantly reduced sleep requirement
• Lack of distance when dealing with other people
• disinhibition
• diminished respect
• reduced danger perception
• lack of sensitivity to the needs and feelings of others
• sometimes neglect of food intake and personal hygiene

jumpiness

For outsiders, it is often difficult to keep up with the thoughts and actions of those involved. Their inner unrest is transferred to their actions and their conversations with others. It is difficult to have a normal conversation with a man. Manicists jump from one topic to another with their thoughts and never stay with one thing for long. In addition, in a mania symptoms such as strong Rededrang (Logorrohe) and a slurred, indistinct language. It may be that manicans talk so fast that listeners are not able to understand anything at all.

Typical of the mania is also that countless things are started at once, but nothing is completed. With great enthusiasm, sufferers can take on a new task from one second to the next and forget them within a few minutes. To sit still for a long time or to do nothing for a few minutes is almost impossible for them.

disinhibition

A disinhibition can occur in a mania in different areas of daily life. Almost all manic patients become distant and begin randomly addressing strangers, handing out gifts to strangers or inviting an entire pub for a drink.

In a mania, there is also often a disinhibition in the sexual area and an increased sexual desire (libido). Sexual disinhibition does not only take place with regard to one’s own partner, but also with regard to strangers. Concerned persons often overestimate their own attractiveness during an episode.

Furthermore, mania can lead to an excessive spending spree; Transactions are made on a large scale or contracts are made, often exceeding one’s own financial resources.

delusions

In some people with mania, in addition to these common symptoms, some less common delusions appear. Most commonly it comes to the so-called megalomania. The transition between megalomania and exaggerated self-esteem is fluid. Manias with psychotic symptoms also have delusions that can be defended for several weeks as a reality, even in periods when mania has subsided. In very rare cases hallucinations or nightmares occur.

Quick change of mood

Decisive during a manic phase is that elation can turn irritable within seconds, for example, when something does not work the way people have imagined or when they hear objections from friends or acquaintances.

suicidal thoughts

In some cases of mania, the loss of reality can be so pronounced that sufferers develop suicidal thoughts. Especially at such a stage inpatient treatment in psychiatry is necessary. But it is also dangerous that many sufferers in the acute phase as a result of total self-esteem develop the feeling that they could fly. Due to the diminished ability to correctly recognize dangers, those affected can, for example, seriously endanger themselves and others in road traffic.

Behavior after a manic phase

As long as a manic phase persists, sufferers are not receptive to the indication that they are in a morbid phase. If this is addressed by acquaintances or the family, patients react with irritation and lack of understanding. Often violent disagreements and insults of related or strangers are the result. Only when the period of exhilaration has subsided will those affected become aware of what they have done and how they have behaved. Above all, the disinhibition often leads to actions that are in stark contradiction to the usual principles of those affected. The states of elation are so often characterized by serious self-blame and a deep sense of guilt.

After a mania, those affected usually try to undo what they did during the manic phase and apologize to those involved.

Manic-depressive disorder, in which phases of exaggerated exhilaration alternate with periods of depression, is one of the most common forms of mania.

Symptoms of hypomania

In a hypomania, the symptoms of a mania in a weakened form. Classic signs are above average good mood, increased self-esteem, increased activity, increased risk-taking and increased sociability. In contrast to mania, hypomania causes pronounced states of fatigue. Affected people often sleep overly long. Even the appetite can change. Affected persons of hypomania eat either much more or less than normal.

Mania: causes and risk factors

The exact causes of mania are still not fully understood. At present, the cause of mania is mainly suspected to be interference with messenger substances (transmitters) in the brain. The neurotransmitters in the brain are responsible for the transmission of nerve impulses. In a mania, an imbalance of these transmitters is present in most cases; the transmitters dopamine and norepinephrine are present in higher concentrations than in a healthy human.

So far, researchers have been able to identify several genes that might be responsible for the development of bipolar disorder, such as mania. However, these genes are also altered in many healthy people, so they can not be the sole cause of mania. Even with a change in these genes, other factors must be added to develop a mania.

In many cases, a manic episode is preceded by changes or significant events in the lives of the individuals or close relatives. These can be events like:

• job change
• unemployment
• End of a relationship
• divorce
• bereavement
• move

But it can also come to a mania without a triggering event.

Mania: examinations and diagnosis

In the rarest cases, the symptoms of mania are perceived by sufferers themselves. Manic phases are perceived as liberating and enriching. During a manic episode, most of the illness is missing. In the symptom-free time, the victims often plague and embarrassment feelings, but recognizing the disease as such, the most very difficult.

Although mania is a manifest and serious condition, it can not be diagnosed with physical exams or clinical tests. A diagnosis of mania can only be made by talking to a family doctor or psychiatrist over a long period of time, and by thoroughly interviewing the person concerned and his relatives. Usually it is relatives who initiate these discussions. Diagnosis can help if people who are suspected of having a mania have a feeling diary or mood calendar.

In every human, the symptoms of a mania show different degrees. Very pronounced symptoms make it easier for the attending physician to make a diagnosis. It is especially difficult when the symptoms differ only slightly from the basic personality of the person concerned.

On average, about ten years pass before the correct diagnosis is made; In difficult cases, it can take up to 15 years.

Mania: treatment

The treatment of mania is usually composed of two building blocks, the drug treatment and a psycho or behavioral therapy.

Medication

To alleviate the acute symptoms of mania and to prevent new manic episodes, medications such as lithium supplements, antiepileptic drugs or atypical antipsychotics are administered. They influence the transmitter activity in the brain and relieve the symptoms. Sedatives can also be given in the acute phase of mania. They dampen the restlessness and increased unrest of those affected and allow them, for example, to sleep again.

For the long-term therapy of a mania and above all to avoid a relapse (recurrence) patients should be treated even in the symptom-free time with lithium salts, such as lithium carbonate.

psychotherapy

Accompanying the drug treatment should be done in mania psycho or behavioral therapy. Patients can learn to recognize the first signs of a manic episode, to avoid stimulating stimuli during a mania and to deal properly with an acute illness phase.

Those affected should above all learn to maintain a normal daily routine and to follow their normal activities in a structured way – such as a normal sleep rhythm. In this way, the symptoms can be reduced during an acute episode, and the environment makes dealing with those affected easier. Scientists also suggest that consequent psychotherapy can prevent many manic episodes in the long term.

involuntary commitment

A mania can show symptoms that are so severe that dealing with the affected person is no longer possible. In extreme cases, a forced admission to a psychiatric facility may be necessary. Prerequisite is an acute intrinsic or third-party hazard, which must be confirmed by a judge in accordance with the provisions of the country-specific law. A compulsory briefing serves above all to ensure that foreign persons are not endangered and that the person concerned is shielded himself from stimulating stimuli from the environment.

The admission may be followed by a compulsory treatment, but it must also be approved by the judge and, depending on the institution, supervised by a second doctor.

hypomania

Whether a hypomania must be treated depends on how often individual hypomanic phases occur and how much the affected person is affected by them in their professional and everyday lives. Sporadic hypomanic phases that do not seriously affect social and professional life need not be treated. However, if sufferers or relatives suffer greatly from the symptoms of a hypomanic episode and the person is ill-informed, treatment can be provided by psychotherapy or psychotropic drugs.

Minors with mania

When treating mania in children and adolescents, it should be noted that some of the drugs used in adults do not show the same efficacy in these age groups.

Mania: disease course and prognosis

As with other diseases, mania also applies: the sooner the right therapy is started, the better the prognosis.

According to scientific studies, life expectancy in mania is reduced by one to two percent. Effectively, however, the affected individuals lose a lot of life that they could otherwise use elsewhere.

After a first episode of illness, the probability of a second episode is about 95 percent. A relapse can be prevented with a suitable drug therapy (recurrence prophylaxis).

In Germany usually takes about ten years to final diagnosis. During this time, many patients experience serious problems that can affect their personal and professional lives and aggravate mania. Relatives and friends often turn away because they no longer know how to deal with the sufferer. Often, partnerships break up or sufferers are dismissed from their jobs. In many cases, affected persons overestimate their material resources during a maniacal episode and plunge themselves and their families into heavy debts.

So if you notice any symptoms of mania with yourself or a loved one, be sure to seek medical attention as quickly as possible – with a consistent treatment mania can be quite cause a trouble-free life!