Mania or
first episode mania to be precise is a psychiatric disorder in which a person
has persistent and abnormal elevated or irritable mood lasting more than a week
or less if the disruption is such that patient needs hospitalization.
To seal the diagnosis of mania the patient should have at-least 3 of following symptoms if mood is elevated or 4 if mood is irritable
To seal the diagnosis of mania the patient should have at-least 3 of following symptoms if mood is elevated or 4 if mood is irritable
1. Pressure of speech or increased talkativeness
2. Disinhibit ion or lack of social inhibitions
3. Decreased need for sleep
4. Increased self-esteem or grandiosity
5. Distractibility
6. Reckless behavior like reckless spending or reckless driving
7. Increased sexual energy
8. Increased activity
9. Flight of ideas
8. Increased activity
9. Flight of ideas
The disorder
of mania can be without or with psychotic symptoms such as delusions and
hallucinations
Causes of mania-
No definitive
evidence has been found but a disturbance in neurotransmitters like dopamine
and serotonin; hormones like thyroid, growth hormone are implicated.
Risk factors for mania-
a) Genetic factors
b) Family history
c) Stressful environment
d) Stressful life events
e) Certain personalities
Mania should
be differentiated from hypo-mania in which there is no hospitalization, socio-occupational
dysfunction and no psychotic symptoms with symptoms lasting less than 4 days.
Course and prognosis
Average duration
of maniac episode can be anywhere between 2-4 months. It is a self-limiting
illness but chances of relapse are high.
Treatment of mania
Why should mania
be treated if it is a self-limiting illness?
a) It should be treated because severe
socio-occupational dysfunction caused by it and threat to patient and others
lives.
b) Prevent relapses.
When does a
patient need hospitalization?
1. Threat to patient’s and other lives
and property due to excessive violence.
2. Not talking care
3. Not willing to take medicines
4. Not enough family support
Scales which
can be applied for progress of success of treatment include young mania rating
scale.
Drugs used
in treatment of mania are
1. Mood stabilizers such as lithium, valproate,carbamazepine
2. Anti-psychotics
3. Benzodiazepines
Usual duration for treatment of mania is 1 year.
Wishing you a long and healthy life
Dr Hitesh Sharma
MBBS, MD (Psychiatry)
For asking a query or phone/video consultation with me visit- https://www.icliniq.com/hitesh
For asking a query or phone/video consultation with me visit- https://www.icliniq.com/hitesh