In the case of mania, those affected are in an exaggerated mood and hardly sleep. You start 1,000 things without finishing them. They often spend a lot of money and are very sexually active. They don't feel sick. Why manically ill people can be a great burden for those around them.
Mania is a mental illness from the field of affective disorders, i.e. a disorder of the emotional experience.
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Mania is mostly a phase
Mania usually occurs in phases. For no real reason, those affected feel extremely elated, restless and overactive. They talk a lot and quickly, constantly develop new plans that they then forget, and hardly sleep. In such phases, those affected often spend more money than their budget allows, and therefore cause high debts. At the same time, many sufferers have great sexual desire during a manic phase and feel extremely attractive.
Usually the mania alternates with depression. Sufferers fluctuate between the overly elation of mania and the listlessness of depression. The clinical picture is called bipolar disorder (previously: manic-depressive illness). About three percent of all Europeans experience a mania in their lifetime. Hypomania is a milder form of mania with less noticeable symptoms.
Possible causes of mania
It is unclear exactly why some people develop mania. Apparently a genetic predisposition plays a role. But the social environment and life experiences are also decisive. Some factors increase the risk of developing mania:
- Substance abuse (such as ecstasy, cocaine, alcohol, and amphetamines)
- Increased incidence of mood disorders in the family
- Frequent mood swings
- Early development of depression
- Taking depressants
- The interaction of various diseases and their treatment in very old, frail people
Experts disagree on whether ADHD increases the risk of developing mania in childhood.
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Symptoms: This happens in a manic phase
Those affected do not feel sick in a manic phase, on the contrary. They experience an extremely high mood, are very excited and overestimate themselves immensely (megalomania). This often leads to the fact that those affected no longer recognize risks and thus put themselves in danger. Some people even believe they can fly off a bridge or a roof.
Manic people often lose the sense of closeness and distance, feel extremely attractive and get social problems as a result. Since the libido is increased, many of those affected are very sexually active. Sick people cannot sit still for a minute. They behave restlessly and hardly need any sleep. When someone contradicts them, they quickly become aggressive.
At the height of a mania, those affected can develop delusional ideas. They speak quickly and incomprehensibly and often become very excited. This can also express itself through violence. If the mania is particularly pronounced, psychotic symptoms may appear:
- Thought disorders
- Delusions
- Hallucinations (hearing, seeing, or feeling something that is not there)
However, these symptoms are shorter in mania than in other mental illnesses. When the manic phase is over, those affected recognize their previous wrongdoing. They are terribly ashamed of it and try to repair the damage by apologizing or making amends.
Very often, mania or bipolar disorder is associated with anxiety or obsessive-compulsive disorder, substance abuse, personality disorder, eating disorder, or difficulty controlling impulses. At the same time, people with a mania suffer more than average from heart disease, migraines or type 2 diabetes mellitus.
However, since most people do not feel that they are sick, they avoid seeing a doctor. As a result, it often takes many years to diagnose the disease and get help. In many cases, they do not perceive their illness as such until they have amassed large debts, have lost their job or partner, or relatives are discussing judicial care.
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Mania: diagnosis with various tests
First, the doctor will have the problems described to you in a detailed discussion. He uses tests to check how much the patient can concentrate, how good attention and memory skills are. There are also standardized tests for the ability to socialize.
At the same time, the doctor must rule out that the symptoms are caused by other illnesses, such as epilepsy, multiple sclerosis or HIV infection. Thyroid disease can also lead to an overly elevated mood. Therefore, the doctor has a differential blood count done, including the values for TSH (thyroid hormones) and CRP (proteins that are increased in inflammation).
The following values are also important:
Imaging procedures such as MRI or CT as well as an EEG can rule out other organic causes of mania.
In order to be able to assess the disease as reliably as possible, the doctor asks the person affected to keep a mood diary. Every evening he should write down how he feels, how well he slept, what he did that day, whether he took any medication and whether something stressed him. This can be done either on paper or via an app on the computer or smartphone. At the same time, the affected person should learn to assess himself better and to react early to the first signs of illness.
Treat mania with medication and psychotherapy
To treat mania, the doctor usually combines medication with psychotherapy. Light therapy or electroconvulsion therapy (ECT) can also be used. In the short term, it is important to get the acute symptoms under control. Above all, the sick person should be able to cope with everyday life and communicate with others without problems. The long-term goal is to prevent further manic attacks. These goals are defined in detail jointly by the doctor and the patient. It is important that the sick develop trust in their doctor.
Relatives or close caregivers are often included in the treatment. Depending on the severity of the symptoms and the social environment, treatment can be inpatient in a psychiatric facility, partial inpatient (i.e. only during the day) or outpatient on individual appointments. Self-help groups can often help in the long term. Artistic therapies, sport or occupational therapy offer sick people the opportunity to gain new experiences and build self-confidence.
The following drugs are used:
- Antidepressants
- Neuroleptics
- lithium
- Anti-epileptic drugs
However, some of the drugs have side effects such as weight changes or changes in the blood count or hormonal balance. Functional restrictions of the kidneys or heart problems can also occur. Close medical supervision is therefore necessary.
Psychotherapy is about understanding the disease and learning and ways of reacting to symptoms at an early stage. At the same time, a fixed daily structure helps those affected, for example through a daily and weekly plan. Relaxation techniques can help you stay calm in stressful situations and reduce stress. Many of those affected feel positive about fixed rules such as: wait 24 hours before buying.
How long does a mania last?
A mania usually develops slowly over several days and lasts for different lengths of time. How quickly a patient reacts to the treatment and whether the phases are only moderated or stopped entirely depends on many factors. The sooner someone seeks help, the better the chances of recovery. The environment also plays an important role: If a sick person is caught and supported by an understanding environment, this gives them stability. Other psychological or physical illnesses make therapy more difficult.
Those who suffer from mania are at high risk of relapse. The risk of relapse is particularly high when the different phases of bipolar disorder follow one another quickly. Even if the disease occurs very early, for example at a young age, the risk of a chronic course increases. If stressful events occur, this can reduce the chances of recovery. Some sick people suffer from manic phases again and again for the rest of their lives. Others lead a symptom-free life after therapy.
Mania: this is how you can prevent it
A regular lifestyle with enough sleep and plenty of exercise helps prevent mental illness. Children whose parents suffer from mental illness should be included in treatment. Because the risk of developing a mental illness themselves is great.
Anyone who sleeps very poorly over a long period of time in their youth should also get help. Excessive anxiety can be a sign of mental illness. Parents can have a lot of positive effects by being affectionate and appreciative. It also helps children and adolescents to talk about feelings and thereby learn to deal with different feelings.