A manic episode is a type of mood disorder, characterized by an elevation of mood. Patients often feel a sense of euphoria, and it is this type of mania that is most classically associated with manic episodes. However, a manic patient can also feel irritable and agitated. In addition, manic patients exhibit a number of associated symptoms: inflated self-esteem or grandiosity, decreased sleep requirement, flight of ideas, distractibility, increased activity level, psychomotor agitation and/or excessive involvement in pleasurable but risky activities. Their thoughts are, at the least, rapid. There is often a loosening of associations, and, in the extreme, patients can be psychotic.
A typical manic patient might appear well groomed, possibly displaying a dramatic change in appearance (e.g. a drastic change in wardrobe, make-up, or hairstyle). The manic patient will probably be very talkative and may initially appear more clever or entertaining; however, conversation will become tangential with puzzling jumps from one subject to another. Often a manic patient has an inflated sense of self-confidence and feels invincible. This often leads the patient to take on unrealizable projects, engage in risky sexual activities, spend too much money, and get in trouble with the law. After the manic episode has passed, the manic patient will often come to regret actions carried out during the episode.
For the mood disorders, DSM-IV describes several types of episodes. These episodes are not disorders in themselves, but descriptions of discrete syndromes, which can form the building blocks of actual disorders.
For a Manic Episode, DSM-IV lists the following criteria:
- The symptoms must last for at least one week (or any duration if hospitalization is necessary)
- Three or more of the following symptoms (at least 4 if the mood is only irritable):
- decreased need for sleep
- pressured speech
- racing thoughts or flight of ideas
- increased activity or agitation
- increased engagement in pleasurable but risky activities
- The symptoms cause impairment in social or occupational functioning.
- The symptoms are not secondary (the direct result of a substance or general medical condition)