Can You Hurt People During Mania? Does A Person With Bipolar Disorder Know Right From Wrong?

Medically reviewed by Karen Foster
Updated February 29, 2024by BetterHelp Editorial Team
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Bipolar disorder is a mood disorder commonly characterized by extreme highs and lows in mood and behavior. During “high” periods, a person with bipolar disorder may experience mania or hypomania, which can prompt impulsive behaviors that sometimes include dangerous or unhealthy decisions. 

Some people with bipolar disorder may try to cover up impulsive behaviors through lying, and at times it may seem that they are unaware that they have lied. If you have witnessed this behavior in someone you love, you may experience frustration and wonder if they are purposely lying to you. To understand bipolar disorder symptoms, it can be helpful to look at the diagnostic criteria and different types of bipolar treatments available. 

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Bipolar disorder may make it difficult to find stability

Understanding bipolar disorder

Bipolar disorder is a mood disorder that affects as many as 2.8% of adults in the United States each year. People with bipolar disorder may experience mood cycles between mania or hypomania and depression. 

When a person experiences mania, they can experience excess energy, struggle to sleep, and have racing thoughts. They may experience delusions, paranoia, and a sense of superiority over others. Mania can be exhausting and cause someone to believe they are near invincible. During a manic period, a person might engage in problematic behaviors like impulsive spending, gambling, substance use, and high-risk sexual activity.

Hypomania is a less severe form of mania that doesn’t involve paranoia or severe delusions but can involve increased impulsive behaviors like those above. In addition, hypomania is often accompanied by an energetic mood, a lack of sleep, and a belief that one is “cured” or doesn’t need mental health treatment any longer. 

Following mania or hypomania, a person with bipolar disorder may experience a low period of depression, during which they may lack energy, neglect self-care, struggle with personal hygiene, and find it challenging to carry themselves through the day. In some cases, people with bipolar disorder experience suicidal thoughts during a depressive episode. 

If you are experiencing suicidal thoughts or urges, call the 988 Suicide & Crisis Lifeline at 988 or text 988 to talk to a crisis provider over SMS. They are available 24/7 to offer support. 988 also offers an online chat for those with an internet connection.

Types of bipolar disorder

There are two subtypes of bipolar disorder, each of which can produce different symptoms. 

Bipolar I disorder 

People with bipolar I disorder experience manic episodes, severe forms of hypomania. These episodes may precede depressive episodes, but not everyone with bipolar I disorder has depressive episodes. Mania involves extreme highs, lack of sleep, delusions of grandeur, and difficulty connecting with reality. 

Bipolar II disorder 

Bipolar II disorder is categorized by depressive episodes alternating with hypomanic episodes. Hypomania often lasts three to seven days, while mania in bipolar I disorder lasts at least a week. Hypomania may not involve the more severe symptoms of mania, such as extreme delusions, paranoia, or psychosis. In addition, it is often less severe. However, hypomania is not “positive” and can cause challenges in functioning, risk-taking behaviors, and sleep deprivation. 

Cyclothymic disorder

People who experience some symptoms of mania, depression, or hypomania but do not meet the criteria for bipolar I disorder or bipolar II disorder may be diagnosed with cyclothymic disorder, which involves more rapid mood shifts. 

How do people with bipolar disorder act during a manic episode?

When a person with bipolar disorder experiences a manic episode, they may experience racing thoughts, act impulsively, and have a sense of grandiosity. As a result, they may lie or make exaggerated statements about themselves to impress others. If they engage in substance use, their judgment may be impaired. During a manic episode, especially when other factors come into play, individuals may find it difficult to rely on the same sense of morality they typically uphold. 

Because of these behavior patterns, the consequences of untreated mania can include damaging or losing relationships, jeopardizing one’s employment or housing opportunities, or experiencing legal challenges. However, this doesn’t necessarily mean that people with bipolar disorder don’t have morals or don’t know when they’re making a mistake.  

Mania may not entirely alter one’s sense of reality but can seem all-consuming to the individual in the moment. One’s mood and sense of self-importance may be so high that harm or offense caused to others doesn’t seem as significant as it would otherwise. The individual may be kind, empathetic, and gentle when not experiencing an episode but may completely forget their promises, commitments, and desires when manic. 

Experiencing bipolar disorder does not mean you can’t tell right from wrong, but its symptoms can temporarily make it harder to let your sense of morality guide your actions. If you have a loved one with bipolar disorder, understanding that their actions may stem from a symptom out of their control may be helpful when choosing how to proceed. Working together to process what a manic episode might mean and how to respond to it can be a way to be supportive without excusing certain behaviors. 

Do people with bipolar disorder lie? 

Lying can occur alongside mania in bipolar disorder because mania often causes individuals to struggle to understand morality, commitment, and the consequences of actions. Someone with mania may lie because they struggle to remember the consequences of doing so or don’t think it’s a significant problem when they are experiencing high energy and a sense of self-entitlement.

Despite the frequency of lying in this condition, it is not an official or primary symptom of bipolar disorder. Lying is a behavioral challenge and can often be treated through professional support methods like therapy. Some people with bipolar disorder may lie because they believe the lie at the moment. For example, delusions can cause an individual to believe they are someone they aren’t or want what they wouldn’t want outside of a manic episode, which can cause them to communicate this information to others. 

Can lying and impulsivity be treated? 

One way to treat impulsivity and lying is to contact a licensed mental health professional, such as a therapist. A therapist is trained in treating these and other symptoms, and they can help you understand and manage your behaviors within a nonjudgmental environment. Bipolar disorder is a mood disorder that affects millions of people every year. If you have bipolar disorder, you didn’t do anything to “cause” it, and having a mood disorder is not your fault.

Some situations may be improved through understanding. If you have experienced adverse consequences from impulsive behaviors during mania, addressing the root of those concerns may help you reconcile with others. Therapy can also help you understand what might spark your manic or depressive episodes, allowing you to prepare for and recognize them when they arise.

Some people experiencing severe mania may require crisis intervention services, such as inpatient mental healthcare. If you’re experiencing significant delusions, cannot sleep for days, and have psychosis, you might benefit from talking to an inpatient program about your options. If you have a therapist, work with them to develop a crisis plan in cases of severe mania where you might lose your judgment abilities. 

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Types of therapy for bipolar disorder

A few therapeutic modalities have been proven successful in treating symptoms of bipolar disorder, including the following. 

Cognitive behavioral therapy (CBT) 

Several types of mental health treatment can be effective in treating bipolar disorder. One of the most common is cognitive-behavioral therapy (CBT), often conducted in one-on-one sessions with a therapist. In CBT, a person is guided to confront and reframe maladaptive thoughts and beliefs. CBT offers clients a place to talk about what they’re going through, establish coping strategies with their therapist, work through cognitive distortions, and increase their ability to navigate their emotions. 

If you pursue CBT, a therapist might ask you to participate in keeping thought records and recognizing cognitive distortions, such as black-and-white thinking that reduces situations or people to “all good” or “all bad.” This method is designed to help you identify and adjust these ways of thinking to clarify your thoughts and actions.

Dialectical behavioral therapy (DBT)

Dialectical behavioral therapy (DBT) is another popular line of treatment for several mental health disorders. DBT was initially developed for people with borderline personality disorder (BPD), historically marked as treatment-resistant. When mental health professionals began implementing DBT, they realized it was also effective for people with bipolar disorder and other conditions that cause intense emotions. 

This treatment method focuses on four different areas of life: 

  • Interpersonal skills

  • Emotional regulation 

  • Distress tolerance

  • Mindfulness

A person with bipolar disorder may struggle with their diagnosis. Employing the concept of radical acceptance taught by DBT, learning to understand symptoms, engaging in positive behaviors, and promoting healthy thought processes can be done in DBT to help them cope with this condition and its symptoms. 

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Bipolar disorder may make it difficult to find stability

Alternative treatment options 

If you have bipolar disorder or suspect you may be experiencing its symptoms, you are not alone. Support is available as you work to make positive changes in your mind, home, relationships, and workplace. According to the National Advisory Mental Health Council, the treatment success rate for bipolar disorder may be as high as 80%. Whether you have been diagnosed with bipolar disorder, suspect that you may have this condition, or are experiencing behaviors and thoughts that disrupt your life, a licensed therapist can provide you with resources, strategies, and support to gain greater control over your life. 

However, some people with bipolar disorder may experience barriers to in-person therapy. In these cases, online therapy through platforms like BetterHelp offers accessibility to sessions. If you find impulse control and managing a schedule challenging, the flexibility of online therapy may be a significant perk. It allows you to work with a skilled counselor from home. In addition, you can choose between phone, video, or live chat sessions, allowing you control over how you get support. 

In addition to being convenient, online therapy has the potential to make a significant difference in your symptoms. One review of online therapy for bipolar disorder found that 95% of clients experienced increased quality of life after treatment, with results similar to in-person therapy.  

Takeaway

Bipolar disorder and its symptoms, including manic episodes, may make it challenging for some people to act according to their moral code. Although the occurrence of a manic episode cannot be controlled, the behaviors and decisions an individual makes during their episodes can be worked on with support. Consider contacting a licensed therapist online or in your area for further guidance.
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