Mania
Defination
Mania is a drastic change in a person’s behavior that affects their
day-to-day functioning and lasts for one week or longer trusted
source . People may experience altered moods, thought patterns,
and energy levels.
People can experience mania on its own, or it may be part of a
mental health condition, such as:

bipolar disorder
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schizoaffective disorder
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substance induced mania

bipolar disorder secondary to another medical condition
Some people may enjoy the experience of mania, while others may
find it causes them discomfort or distress.
In some cases, mania symptoms can be severe, such as psychosis
or hallucinations, and will require hospitalization.
Symptoms
Symptoms of mania, or a manic episode, are behaviors that are an
extreme change from a person’s usual behaviors, and last for one week
or longer.
People may have some of the symptoms of mania, such as high energy
or talking quickly, but if that is normal behavior for them, it is probably
not a manic episode.
Symptoms of mania can include:

extreme high energy

a reduced need for sleep

euphoric feelings, such as extreme happiness, excitement, or
feeling “high”

feeling invincible

racing thoughts

speaking very fast

unusual behavior compared to a person’s normal behaviors

being easily distracted or irritated

impulsiveness

grandiosity

increased goal-directed actions

intense anxiety

psychosis, which is a detachment from reality

an increase in reckless behaviors, such as increased drug use,
unprotected sex, or excessive spending

delusions, such as paranoia

hallucinations
Severe symptoms of mania can be serious, and people may require
treatment in hospital.
Once a manic episode has passed, people may experience any of the
following:

shame or unhappiness about their behavior

commitment to responsibilities or tasks they now feel unable to
manage

little to no memory of what happened during the manic phase

fatigue
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needing plenty of rest and sleep
If people have mania due to a mental health condition, such as bipolar
disorder, they may experience a depressive episode after mania.
Diagnosis
To diagnose mania, a doctor may carry out a number of tests to check
for any underlying causes, and to rule out any other conditions. Tests
may include:

a complete blood count

complete metabolic panel

thyroid panel

urine drug screening under brain imaging tests, such as CT or
MRI scans, particularly in people the age of 13 or over the age of
60 trusted source
Causes
There is currently no known cause for mania, or bipolar I disorder.
Causes may involve a combination of genetics, psychological, and
social factors.
Research trusted source has found a definite link between genetics and
mania. In a study of twins, there was a 40% chance of one twin having
mania if the other twin also had mania. Certain genes may also play a
part in whether people have bipolar I disorder or schizophrenia.
There is also anecdotal evidence that social factors and stressful or
traumatic life events can play a part in causing manic episodes, as well
as affecting their frequency.
Environmental factors that may cause mania include:

high stress levels

lack of sleep, or changes to sleep patterns

recreational drug or alcohol use

changes in the seasons, as springtime may make the occurrence
of mania more common for some people

major life changes, such as moving or divorce

childbirth, which may cause postpartum psychosis

grief or bereavement

trauma or abuse

difficult circumstances, such as money problems, housing issues,
or loneliness

side effect of certain medications, such as some antidepressants

side effect of a physical or neurological condition, such as lupus,
dementia, stroke, or brain injury
Treatments
People can see their doctor to discuss a treatment plan for mania.
Treatment options may include:
Medication
People may take antipsychotic medications to treat mania. These
include:

haloperidol

risperidone

olanzapine

quetiapine
If people also have a mood disorder, they may take a drug to help
stabilize their mood, such as:

carbamazepine

lithium

valproate
If people are pregnant, or planning to become pregnant, they can talk to
their doctor about the safety of taking medication for mania. Taking
valproate during pregnancy can Increase the chances of a baby having
birth defects or learning disabilities.
Other treatment options available to people living with mania include:

Therapy: If people experience mania due to a mental health
condition, such as bipolar disorder, they may benefit from talking
therapy or counselling.

Community support: If mania is affecting people’s ability to carry
out everyday tasks, people may benefit from social support, such
as a social worker.

Emergency help: If people have severe symptoms, or a manic
episode is continuing for a long period, people may need
immediate medical treatment in a hospital. People can go to their
nearest emergency room or call 911.

Electroconvulsive therapy: In rare cases, electroconvulsive
therapy (ECT) may be an option if mania becomes lifethreatening, or for people who have bipolar disorder which does
not respond to other treatments. ECT passes controlled currents
of electricity through the brain to cause a brief seizure in order to
affect certain chemicals and neurons within the brain.

making a plan to help manage a manic episode better, such as
avoiding certain situations that may worsen symptoms, getting to
sleep early, and postponing any major decisions

sticking to a routine, and setting an alarm if it helps people
remember to take medication consistently

making time for relaxation and activities that reduce stress

planning and managing finances to help reduce any financial
concerns

planning for an emergency, and having any important contact
numbers close to hand

maintaining physical health by eating a nutritious diet, as well as
getting regular exercise and plenty of sleep

talking to family and friends about how mania feels, and how they
may help with any self-care plans or reminders

finding a support group locally or online to connect with people
going through similar experiences
Nursing management of a patient with bipolar disorder include the
following:
Nursing Management




History. Taking a history with a client in a manic phase often proves
difficult; obtaining data in several short sessions, as well as talking to
family members, may be necessary.
General appearance and motor behavior. Client with mania
experience psychomotor agitation and seem to be in perpetual
motion; sitting still is difficult; this continual movement has many
ramifications; clients can be exhausted or injure themselves.
Mood and affect. Mania is reflected in periods of euphoria,
exuberant activity, grandiosity, and false sense of well being.
Thought process and content. Cognitive ability or thinking is
confused and jumbled with thoughts racing one after another, which
is often referred to as flight of ideas; clients cannot connect
concepts, and they jump from one subject to another.
Nursing Care Planning and Goals

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
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

Client will no longer exhibit potentially injurious movements after 24
hours with administration with administration of tranquilizing
medications.
Client will experience no physical injury.
Client’s agitation will be maintained at manageable level with the
administration of tranquilizing medications during first week of
treatment.
Client will not harm self or others.
Client will consume sufficient finger foods and between-meal snacks
to meet recommended daily allowances of nutrients.
Within one week, client will be able to recognize and verbalize when
thinking is non-reality based.
Client will be able to recognize and verbalize when he or she is
interpreting the environment inaccurately.