Manic Episodes with Bipolar Disorder

  Manic episodes are a key clinical feature of Bipolar I and are often accompanied by other signs of bipolar including a denial that anything is wrong.

  Manic episodes are characterized by a distinct period of elevated, expansive or irritable mood lasting at least 1 week including at least 3 of the symptoms below and 4 where the mood is only irritable.

1. Inflated self-esteem or grandiosity- unrealistic beliefs in one's abilities and powers.
2. Decreased need for sleep
3. More talkative than usual or feeling a need to keep talking
4. Flight of ideas, racing thoughts
5. Distractibility
6. Enhanced goal-directed activity or psychomotor agitation
7. Excessive involvement in pleasurable activities that have a high potential for painful consequences like increased sexual drive, abuse of drugs, particularly cocaine, alcohol, and sleeping medications.

  Psychotic features like grandiose delusions or auditory hallucinations may occur with manic episodes. Psychotic periods are characterized by the loss of contact with reality.

  Hallucinations are associated with the senses so the individual sees, hears, tastes, smells or feels something non existent e.g. they might feel they are being touched, or hear voices talking to them or about them when there is no one else around to do so. Often these false perceptions are negative in nature like a foul smell, critical voices, seeing unpleasant characters.

  Delusions on the other hand are false ideas which may originate from misinterpreting a situation. They may be convinced that someone is stealing their money or that they have special powers of wealth or control etc.
With mania the delusions are often of grandiosity reflecting the prevailing extreme elevated mood state.