## Definition
- A distinct period of **abnormally elevated, expansive, or irritable mood** with **increased energy or goal-directed activity**.
- Severe enough to cause significant impairment in social, occupational, or other important areas of functioning.
- May necessitate **hospitalization** or involve **psychotic features**.
## Core Features
- Duration: **At least 7 consecutive days** (or any duration if hospitalization is required).
- Marked deviation from typical behavior and functioning.
- Symptoms observable and disruptive.
## Common Symptoms
- Inflated self-esteem or **grandiosity**
- Decreased need for sleep (feeling rested after 2-3 hours)
- Excessive talkativeness, pressured speech
- Racing thoughts, flight of ideas
- Distractibility
- Increased goal-directed activities (social, sexual, work-related) or purposeless activity (pacing, hand-wringing)
- Excessive involvement in risky activities (spending sprees, sexual indiscretions, foolish investments)
## Psychotic Features (Possible)
- **Delusions** (grandeur, persecution)
- **Hallucinations** (less common than in psychotic disorders)
- **Disorganized thinking**
## Distinction from [[Hypomania]]
| Feature | Mania | Hypomania |
| ----------------- | -------------------------- | ---------------- |
| Duration | 7+ days or hospitalization | 4+ days |
| Severity | Severe, impairing | Mild/moderate |
| Psychosis | Possible | Absent |
| Functional Impact | Significant impairment | Minimal/moderate |
| Hospitalization | Often required | Rare |
## Role in Diagnosis
- Required for diagnosing [[Bipolar Disorder|Bipolar I Disorder]]
- Not necessary for [[Bipolar Disorder|Bipolar II Disorder]] (which requires [[Hypomania]])
- Can occur with or without prior [[Depression]]
## Risks
- Financial, legal, and relational damage due to impulsivity
- Aggression or risky behavior leading to harm
- Vulnerability to burnout, exhaustion, and crash into severe [[Depression]]
## Treatment
- **Mood Stabilizers**: [[Lithium]], [[Valproate]], [[Carbamazepine]]
- **Atypical Antipsychotics**: e.g., [[Olanzapine]], [[Risperidone]]
- **Benzodiazepines** (short-term for agitation)
- Hospitalization when safety is compromised
- Long-term [[psychotherapy]] for insight and management
## Related Concepts
- [[Hypomania]]
- [[Bipolar Disorder|Bipolar I Disorder]]
- [[Psychosis]]
- [[Impulse Control]]
- [[Emotional Dysregulation]]
## Notable Quotes
- "Mania feels like having a rocket engine strapped to your chest—with no off switch."
## References
- American Psychiatric Association. (2013). _DSM-5: Diagnostic and Statistical Manual of Mental Disorders_.
- Goodwin, F. K., & Jamison, K. R. (2007). _Manic-Depressive Illness: Bipolar Disorders and Recurrent [[Depression]]_.