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Causes and treatment of Mania

Geeta Mohan
Causes and treatment of Mania

• Mania, also known as manic syndrome, is a state

of abnormally elevated arousal, affect, and energy
level, or a state of heightened overall activation
with enhanced affective expression together with
liability of affect.
• Although mania is often conceived as a "mirror
image" to depression, the heightened mood can be
either euphoric or irritable, as the mania
intensifies, irritability can be more pronounced and
result in violence or anxiety.
Causes of Mania

• Mania is a syndrome of multiple causes. Although the vast

majority of cases occur in the context of bipolar disorder, it is a
key component of other psychiatric disorders (as schizoaffective
disorder, bipolar type) and may also occur secondary to various
general medical conditions, as multiple sclerosis; certain
medications or certain substances of abuse, as cocaine or
anabolic steroids.
• In current nomenclature, hypomanic episodes are separated from
the more severe full manic episodes, which, in turn, are
characterized as either mild, moderate, or severe, with specifiers
with regard to certain symptomatic features
(e.g. catatonia, psychosis).
• Catatonic depression is characterized by severe depression with
additional symptoms like the inability to move and lack of
response to stimuli
• Psychosis is an abnormal condition of the mind that results in
difficulties determining what is real and what is not. Symptoms
may include false beliefs (delusions) and seeing or hearing things
that others do not see or hear (hallucinations)

• The symptoms of mania include heightened mood

(either euphoric or irritable); flight of ideas
and pressure of speech; and increased energy,
decreased need for sleep, and hyperactivity. They are
most plainly evident in fully developed hypomanic
states; in full-blown mania, however, they undergo
progressively severe exacerbations (the process of making
a problem, bad situation, or negative feeling worse) and become
more and more obscured by other signs and
symptoms, such as delusions and fragmentation of

Mania may be divided into three types :

.Hypomania or stage I
• Acute mania or stage II;
• Delirious mania or stage III.
This "staging" of a manic episode is, in particular,
very useful from a descriptive and differential
diagnostic point of view.
Causes of Mania

Possible causes of hypomania or mania include:

• High levels of stress.
• Changes in sleep patterns or lack of sleep.
• Use of stimulants such as drugs or alcohol.
• Seasonal changes – some people are more likely to experience
hypomania and mania in spring.
• Significant change in your life – moving house or going through
a divorce, for example
• Childbirth ( postpartum psychosis )
• Substance abuse
Causes of Mania

• Loss or bereavement
• Violence, trauma or abuse
• Difficult life conditions – unemployment, poverty, social
deprivation or homelessness
• As a side-effect of medication
• As a side effect of a physical illness or neurological
• Family history – if you have a family member who
experiences bipolar moods, you are more likely to
experience mania or hypomania
• Brain chemistry – there is some evidence to suggest
that the function of the nerves in the brain could play a
role, although this has not been definitively proven
Causes and treatment of Mania

• Before beginning treatment for mania, careful differential

diagnosis must be performed to rule out secondary causes.
• The acute treatment of a manic episode of bipolar disorder involves
the utilization of either a mood stabilizer (valproate, lithium, or
carbamazepine) or an atypical antipsychotic.
Although hypomanic episodes may respond to a mood stabilizer
alone, full-blown episodes are treated with an atypical
antipsychotic (often in conjunction with a mood stabilizer, as these
tend to produce the most rapid improvement)
• When the manic behaviours have gone, long-term treatment then
focuses on prophylactic treatment to try to stabilize the patient's
mood, typically through a combination
of pharmacotherapy and psychotherapy. The likelihood of having a
relapse is very high for those who have experienced two or more
episodes of mania or depression. While medication for bipolar
disorder is important to manage symptoms of mania and depression,
studies show relying on medications alone is not the most effective
method of treatment. Medication is most effective when used in
combination with other bipolar disorder treatments,
including psychotherapy, self-help coping strategies, and healthy
lifestyle choices.

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