What Happens In The Manic Phase Of Bipolar Disorder?

Updated August 28, 2020

Medically Reviewed By: Aaron Dutil

Are you or someone you know affected by mood swings that seem extreme or “out of the ordinary”?  Do those changes in mood affect your ability to stay focused or complete tasks?  While occasional changes in mood are normal, when those changes occur often, or without obvious reason, they may be a reason for concern. For some, these could be signs of a mental health disorder known as bipolar disorder. Because not everyone who has bipolar disorder has been properly diagnosed or is receiving treatment, it is important to understand the symptoms and know when to seek help.

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What Is Bipolar Disorder?

Bipolar disorder is a mental health condition that causes unusual shifts in energy, mood, concentration, and the ability to perform activities of daily living.  These shifts in mood, referred to as episodes, include emotional highs (mania or hypomania) and lows (i.e. depression).    The National Institute of Mental Health reports that approximately 2.6 percent of the adult population in the United States is affected by bipolar disorder.

Risk Factors for Developing Bipolar Disorder

The exact cause of bipolar disorder remains unknown among mental health professionals.  Scientists believe that there is a genetic component that may cause the disorder to run in some families.   However, while people are genetically predisposed to be at risk of developing bipolar disorder, not everyone who has a family member with the disorder will experience it.  Environmental factors such as gender, stress, and alcohol or substance abuse are also thought to be contributing factors to the development of bipolar disorder.

Family Tendencies

If you have a first-degree relative with bipolar disorder, such as a parent or sibling, you may be at higher risk for developing the disorder.  For many people, the first symptoms tend to There is not appear during teenage years or early adulthood.  Although bipolar disorder can be diagnosed at any age, the typical age of onset is 25.

Gender

While men and women are equally affected by bipolar disorder, there are some symptoms that are more specific to each gender.  For example, women are more likely to experience rapid cycling mood episodes.  Additionally, they are more likely to experience mixed and depressive episodes compared to men with the disorder.  Men, on the other hand, may exhibit bipolar disorder symptoms such as anger, hostility, or aggression.

Rapid cycling is the term used to describe changes in mood cycles where the affected person experiences four or more episodes of mania or depression within a 12-month period.   This rapid change in mood cycles is often described by the person as feeling like they are on a rollercoaster ride of emotions.  Emotions may move from high to low and back again over a period of hours or days.  During a rapid-cycling episode, the individual may feel dangerously out of control.  Rapid cycling has been associated with a higher incidence among those who have not been adequately treated for the disorder.

Stress

People who live in a high-stress environment or have a high-stress job may be more likely to experience bipolar disorder.  Other factors, such as physical or sexual abuse (especially in the early developmental stages of life), or the death of a parent or other traumatic events are also believed to increase the risk of bipolar disorder later in life.

Alcohol or Substance Abuse

Although alcohol and other substances do not cause bipolar disorder, their use can hasten the onset of symptoms and make the associated mood episodes worse.

Diagnosing Bipolar Disorder

There was a time when bipolar disorder was confused with other mental health disorders such as schizophrenia or unipolar depression.  Today, however, clinicians have a greater understanding of the illness and can identify signs and symptoms of bipolar disorder and, in most cases, can effectively and safely treat it.  Proper diagnosis and treatment can help people with bipolar disorder lead active and healthy lives.

There is not a medical diagnostic test, such as blood work or x-rays, to help with the diagnosis of bipolar disorder.  However, making an appointment with your primary care provider is an important first step.  Your health care provider can perform a physical exam and may order medical tests that will rule out other medical conditions that have similar symptoms.  If other conditions are not found, a referral to a mental health professional may be given to help with diagnosis.

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Bipolar Phases

Highs and lows associated with emotion are usually temporary for most people.  People with bipolar disorder, however, experience more dramatic changes in mood.  These shifts are often referred to as bipolar phases or bipolar episodes.  Mood swings related to bipolar disorder shift from periods of mania to periods of depression.  These episodes are described as manic, hypomanic, or depressive states, depending on the individual’s mood or behavior.  Bipolar mood swings may happen at any time, without warning, and may last for long periods of time.

Mania is characterized by the excitement that manifests as mental and physical hyperactivity, the elevation of mood, and disorganized behavior.  Hypomania is a less severe form of mania.  During episodes of hypomania, mood and energy levels are heightened, but they are not “out of control.”  The depressive symptoms associated with bipolar disorder are very similar to those of other major depressive episodes.  Individuals may experience significant sadness, hopelessness, irritability, and changes in appetite, sleep patterns, or weight.

Understanding Manic Episodes of Bipolar Disorder

The way bipolar disorder symptoms manifest, the duration of symptoms, and the overall effect on a person may vary greatly from person to person.  The manic symptoms of bipolar disorder may be especially difficult for some people to understand as people may react differently during these episodes.  For example, when manic episodes occur, one person may experience mania or hypomania episodes with feelings of frustration or irritability while another may exhibit a decreased need for sleep, accelerated thinking, or hyperactivity.

When manic symptoms of bipolar disorder emerge, it’s not uncommon for one to experience feelings of creativity, heightened energy, or euphoria.  Some people may feel they are destined for greatness or are invincible.

While the overall feeling of increased energy and euphoria may feel good at first, manic episodes can cause a spiral in emotions.  For instance, during this phase, some people engage in dangerous or inappropriate behavior.  They may become sexually promiscuous, gamble, or go on spending sprees.  Some people are easily angered, may start fights or lash out at others, or blame those who criticize their behavior.

Some common symptoms of manic episodes include:

  • Sleeping less, but feeling extremely energetic
  • Racing thoughts that jump from one subject to another quickly
  • Talking rapidly (so much so that others may not be able to follow what is being said)
  • Difficulty concentrating, easily distracted
  • Feeling unusually optimistic or euphoric OR feeling extremely irritable
  • Impaired judgment or impulsive behavior
  • Hallucinations or delusions (in severe cases)

Warning Signs That Indicate Bipolar Mania Episodes

Typically, people can experience emotional changes and move from one mood to another without difficulty.  People with bipolar disorder, however, have more difficulty moving from one phase or mood than others.  Recognizing potential warning signs of bipolar disorder is essential for knowing when to seek help.  If you or anyone you know is experiencing any of the following symptoms of mania that may be associated with bipolar disorder, make an appointment with your primary care provider to discuss any possible causes.

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  • People with bipolar disorder often feel overly ambitious during the manic phase of the disorder. During manic episodes, productivity seems to be amazing.  However, as the manic episode begins to shift to a state of depression, it often becomes difficult to focus on the task at hand leaving many projects incomplete.
  • Mania episodes often involve extremely high levels of energy that may be accompanied by risky behavior. For example, a person experiencing a manic episode may feel that he or she can accomplish an otherwise seemingly impossible task.  They may take on multiple tasks at once believing he/she can complete them without assistance.  While the idea is good at the moment, when mood begins to shift, the person can feel overwhelmed and/or disappointed which may cause the following period of depression to worsen.
  • Manic episodes may cause feelings of intense anger, irritability, or aggression that is otherwise out of character for the person.

Treatment for Bipolar Disorder

Because bipolar disorder is a chronic, relapsing condition, it requires long-term treatment.  This is true even when symptoms are not obvious.

Treatment options related to bipolar disorder include medication, psychotherapy, or a combination of both.

The type of medication that is used to treat bipolar disorder may vary, depending on the type of the disorder and severity of symptoms.  It’s important to note that medication therapy is usually not a stand-alone treatment for bipolar disorder.  Your primary care provider will likely refer to the treatment of bipolar disorder to a mental health professional and work in collaboration with him/her to manage it.

Psychotherapy is often referred to as “talk therapy.”  It involves learning about changes in mood and how to effectively cope with them.  Therapists can help educate clients and their family members/significant others about bipolar disorder and teach ways to be supportive during episodes.  Psychotherapy also focuses on recognizing potential triggers for changes in episodes and ways to avoid triggers, such as avoiding stressful situations and behaviors.

Behavioral therapy is a type of psychotherapy that is an action-oriented approach to mental health treatment.  Other types of talk therapy include Dialectical Behavioral Therapy and Cognitive Behavioral Therapy (CBT).  In Dialectical behavioral therapy, individuals are taught to accept their own beliefs and behaviors and how to focus on developing healthy responses to mood and behavior.  CBT helps individuals identify and change unhealthy beliefs, behaviors, and inaccurate perceptions that they feel about themselves or others.  It is designed to teach healthy ways of reacting to anxiety, insecurity and changes in mood.

Getting Help for Bipolar Disorder

Even what some people may label as “minor” symptoms of bipolar disorder can feel significant to the person experiencing them.  If you or someone you know is having any of the symptoms of bipolar disorder or if you are concerned about changes in mood, consult with your physician.  A visit with your primary care provider is the first critical step in getting help to minimize symptoms.

If mental health services are required, there are various options to obtain those services.  For example, individual counseling may be scheduled at a local mental health clinic or a private therapist’s office.  While some people feel comfortable with in-person consultations and follow-up appointments, others do not.  If you don’t feel like face-to-face therapy sessions are a good fit for you currently, that doesn’t mean there aren’t other options, such as online counseling.

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In fact, online counseling options are a trend that is becoming quite popular with people who need mental health care but want more control over when and how that help is obtained.  Online counseling services, such as the services provided by BetterHelp, focus on providing convenient, affordable help anywhere you can use a phone or have internet access. You may access BetterHelp from the comfort of your own home. Whether you choose to seek in-person or online therapy, licensed counselors will work with you to develop a plan of care that is specific to your needs.

You Are Not Alone

If you are experiencing symptoms of bipolar disorder, you are not alone.  You do not have to experience bipolar disorder alone.  Reaching out can be as simple as a phone call or the click of a mouse on your computer.  No matter what you’ve been experiencing, there are healthy ways to move forward.


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