Manic Episode
A manic episode is a distinct period of abnormally elevated or irritable mood and increased energy causing marked impairment, hospital need or psychosis.
Key takeaways
- Reduced need for sleep without fatigue, pressured speech, grandiosity and risky decisions distinguish mania from ordinary happiness.
- Substances, corticosteroids, thyroid disease and neurological illness can cause a manic syndrome and need assessment.
- Acute treatment prioritises safety and sleep, while longer-term planning addresses bipolar relapse prevention.
The listings below are not appropriate for unsupervised use; acute mania requires urgent psychiatric and physical evaluation.
Assessing severity and cause
Clinicians evaluate immediate harm, spending, driving, sexual risk, aggression, psychosis and ability to eat or drink. Collateral history is valuable because insight is often reduced. Toxicology, thyroid and other tests are selected from the presentation.
Acute and maintenance treatment
Antipsychotics, lithium or valproate have acute roles depending on severity, pregnancy potential and organ health. Sedating medicine may be used briefly for agitation. Antidepressants are reviewed because they can contribute to switching. After recovery, sleep routine, adherence and early-warning signs reduce recurrence.
When to seek urgent care
Get emergency help for immediate risk to self or others, psychosis, severe agitation, inability to sleep for several nights with escalating behaviour, refusal of essential fluids or dangerous driving and spending.