Mania (manic episode)
En español: lee sobre esta manía en Fobias.org.
You may be reading this because you, or someone you love, has been sleeping very little but feeling full of energy, talking fast, starting big plans or spending money that is not there. From the inside it can feel wonderful, or it can feel tense and irritable. Often the people around you notice the change before you do.
In medicine, mania has a specific meaning. It is a mood episode that needs proper medical care. This page explains what it is, how to spot it and where to get help in the UK.
What it is
A manic episode is a period when your mood is very high or very irritable, with far more energy and activity than usual and much less need for sleep. Mind describes hypomania and mania as periods of over-active, high energy behaviour. Mania is the more severe form and typically lasts a week or more unless treatment shortens it. It can disrupt or stop daily life, and severe mania often needs hospital treatment.
Mania is a recognised condition, not a habit or a quirk. It is the defining feature of bipolar disorder (a doctor may call it bipolar 1 when there has been a full manic episode), and it can also happen with postpartum psychosis or schizoaffective disorder. Some people have hallucinations or delusions, such as believing things that are not true. With treatment, many people with bipolar disorder live stable, full lives.
How it differs from a phobia
A phobia is a fear that makes you avoid something. Mania is different: it is not a fear at all, but a change in mood, energy and thinking that pushes you to do more, faster, often without your usual brakes. Elsewhere on this site the word mania is used for habits and urges, but here it has its medical meaning.
Read more about manias and phobias
Common signs
- Needing far less sleep without feeling tired
- Feeling very happy, excited or unusually irritable
- Racing thoughts that jump from one idea to another
- Talking fast and being hard to interrupt
- Spending a lot of money on impulse
- Feeling untouchable or far more confident than usual
- Behaviour that is out of character
When it tends to show up
- After several nights of poor sleep
- During times of heavy stress or pressure
- After a bereavement, break-up or money worries
- In the weeks after having a baby
- After alcohol or recreational drugs
- After long-haul travel or shift work
- Late at night, staying busy instead of resting
- Online, with spending, messages or posts that do not stop
Symptoms
In your body
- Little need for sleep
- Restlessness and lots of physical energy
- Fast speech
- Skipping meals because you are busy
- Increased sexual energy
In your mind
- Euphoria or a strong sense of wellbeing
- Racing thoughts
- Being very easily distracted
- Raised confidence or self-esteem
- Feeling you understand things others cannot
- In severe cases, hearing or believing things that are not real
What you might do
- Starting many projects at once
- Overspending or making big money decisions
- Taking serious risks you normally would not
- Losing your usual social inhibitions
- Getting angry when asked to slow down
- Calling or messaging lots of people at all hours
What causes it
The exact cause of bipolar disorder is not known. You are more likely to develop it if a parent, brother or sister has it, and childhood trauma, stressful life events and recreational drugs such as cannabis and cocaine may raise the risk. Common triggers for an episode include stress, poor sleep and being very busy, although sometimes there is no clear trigger. Because symptoms like mania can also come from some medicines, substances or physical illness, a doctor needs to assess them.
How it can affect your life
During an episode many people feel good, even better than ever, which is why it can be hard to accept that something is wrong. The effects often show afterwards: debts, problems at work, strained relationships or risky situations. Mind notes that people may feel shame, find they have taken on commitments they cannot manage, have gaps in memory or feel exhausted. In bipolar disorder a period of low mood can follow. Families often feel frightened and confused. With treatment and a good plan, many people reduce the impact of future episodes.
Treatment
In the UK, your GP is the usual first step. They can refer you to a psychiatrist, who will work with you on a treatment plan. Treatment for bipolar disorder usually includes medicines to help stabilise mood and talking therapy such as CBT. If doctors are worried about your safety or someone else’s, you may need a hospital stay or support at home from a crisis team.
Any decision about medication, including starting, stopping or changing a dose, is made with your doctor. Hypnotherapy is not a suitable treatment for mania.
Things that can help day to day
- Keep every appointment with your GP or mental health team
- Take medication as prescribed and talk to your doctor before any change
- Keep regular times for sleeping and waking
- Avoid alcohol, recreational drugs and lots of caffeine
- Write a crisis plan with someone you trust: who to call and what to do
- For relatives: stay calm, do not argue, and encourage contact with the care team
When to get help
See your GP as soon as you can if you notice signs of mania in yourself or someone close to you. If you already have a care team, contact them at the first warning signs. Bipolar UK and Mind offer information and support for you and your family.
If someone has gone days without sleep, is putting themselves in danger, seems to have lost touch with reality, cannot look after themselves or has thoughts of harming themselves or others, call 999 or go to A and E. For urgent mental health advice, call NHS 111 and choose the mental health option. If you are also feeling very low, talk to your GP or call Samaritans free on 116 123.
See also: Hypomania · Megalomania (grandiosity)
Common questions
What is the difference between mania and hypomania?
Both involve a high or irritable mood, more energy and less need for sleep. Hypomania is milder and usually lasts a few days, and people can often keep up with daily life. Mania is more severe, typically lasts a week or more, can stop daily life and may need hospital care.
Does mania always mean bipolar disorder?
Not always. It is the central feature of bipolar disorder, but it can also happen with postpartum psychosis or schizoaffective disorder, and similar symptoms can come from some substances, medicines or physical illness. Only a doctor can assess what is going on.
How can I help someone during a manic episode?
Stay calm, avoid arguing about their ideas and gently encourage them to contact their GP or care team. If they have not slept for days, are taking serious risks or seem out of touch with reality, call 999 or go to A and E.
Can hypnotherapy help with mania?
No. Hypnotherapy is not a suitable treatment for mania, and it should not be used during an episode or when someone holds fixed beliefs that are not true. The right help is a GP and a mental health team or psychiatrist.
Further reading: NHS: Bipolar disorder, symptoms · NHS: Bipolar disorder, treatment · NHS: Bipolar disorder, causes · Mind: About hypomania and mania · NHS: Where to get urgent help for mental health