Manic Episode
Manic Episode
Definition
A manic episode is a discrete period lasting at least a week during which a person experiences abnormally elevated, expansive, or irritable mood.
Description
A person experiencing a manic episode shows persistent and often inappropriate enthusiasm which may involve taking on new projects for which he or she
KAY REDFIELD JAMISON (1946–)
Kay Redfield Jamison is a psychologist and educator who is considered an authority on manic-depressive illness. Her volume Manic-Depressive Illness, compiled with Frederick K. Goodwin, is regarded as a key contribution to the study of manic-depressive illness, a biochemical disorder which results in periods of mania alternating with bouts of depression. The book encompasses a range of issues and subjects, including diagnosis, clinical studies, psychological ramifications, and patho-physiological elements. Larry S. Goldman, reviewing the work in the New England Journal of Medicine, acknowledged Jamison and Goodwin as “two highly regarded senior clinicians and researchers” and proclaimed their book “thorough and most readable.” Goldman concluded, “It is hard to imagine a clinician working with patients with the illness… or a researcher in any part of the field of mood disorders who should not have this tour de force available.”
Jamison followed Manic-Depressive Illness with Touched with Fire: Manic-Depressive Illness and the Creative Temperament, a detailed account of the ties between artistic sensibilities and manic-depressive illness. While conceding that not all artists are manic-depressive, Jamison argues that a significant association exists between the
artistic and manic-depressive temperaments. There is, for example, a high rate of suicide among both types. In her analysis, Jamison incorporates scientific and medical data, including diagnostic methods and genetic information, and she applies this data to a host of creative individuals, including the composer Robert Schumann, the painter Vincent Van Gogh, and such American writers as Ernest Hemingway, John Berryman, and Hart Crane. Jamison notes that many of the creative individuals considered in Touched with Fire had little recourse to any suitable psycho-medical care.
In 1995 Jamison published An Unquiet Mind, a memoir of her own experiences with manic depression. In this volume Jamison recounts her extreme moodiness as a child and relates her first, exhilarating experience of mania when she was in her mid-teens. She notes that mania and depression sometimes exist simultaneously. It is during these periods, when the depths of despair are coupled with the impulsiveness characteristic of mania, that sufferers, according to Jamison, are more likely to consider suicide. Jamison discloses in An Unquiet Mind that she attempted to take her own life, and she credits psychotherapy with helping her realize greater acceptance and stability.
is ill suited. It might also involve engaging strangers in detailed conversations, acting without concern for consequences of one’s actions, or increased sexual activities. Less commonly, a person may be abnormally irritable during a manic episode. On average, the episodes begin before age 25. This means that some individuals experience their first episode while in their teens and others during middle age.
Psychiatrists use five criteria to identify someone in the midst of a manic episode. First, the period of abnormal behavior must persist for at least one week unless the person is admitted to a hospital. Typically, the episodes last from a few weeks to a few months. Second, the diagnosis requires three additional symptoms if the mood change results in expansive behavior, or four if it results in unnatural irritability. These symptoms include an unwarranted sense of self-importance, a tendency to be easily distracted, a decreased need for sleep, a rapid flow of ideas with one replacing another before the first is acted upon, an inability to sit still or increased activity directed at achieving some goal, an irrepressible need to talk, and finally, a devotion to some activity the patient finds pleasurable but could be harmful (e.g., buying sprees, reckless driving). The third criterion is that the symptoms do not qualify the patient for a diagnosis of mixed episode, which involves elements of depression. Fourth, the patient can not function normally at home or at work, or shows signs of psychosis. The fifth and last criterion is that the cause of the episode can not be attributed to side effects from any drug abuse, medication, medical treatment, or medical condition.
Many of these symptoms are also present in a hypomanic episode. A hypomanic episode is similar to a manic episode, but the symptoms may be experienced to a lesser extent. The main differences between a manic and hypomanic episode are the following:
- A hypomanic episode may only last four days, whereas a manic episode, by definition, lasts one week.
- In a manic episode, psychotic features (hallucinations and delusions) may be present, but in a hypomanic episode, they cannot be.
- A manic episode significantly impairs the affected person’s functions, but a hypomanic episode does not.
Both of these kinds of episodes may be seen in patients with bipolar disorder.
Resources
BOOKS
Goodwin, Frederick K., and Kay Redfield Jamison. Manic-Depressive Illness. New York: Oxford University Press, 2007.
VandenBos, Gary R., ed. APA Dictionary of Psychology. Washington D.C.: American Psychological Association, 2007.
PERIODICALS
Frey, Benício Noronha, and others. “Increased Oxidative Stress After Repeated Amphetamine Exposure: Possible Relevance as a Model of Mania. Bipolar Disorders,” Bipolar Disorders 8.3, Jun. 2006: 275–80.
Keck, Paul E., Jr., and others. “A Randomized, Double-Blind, Placebo-Controlled 26-Week TrialofAripiprazole in Recently Manic Patients With Bipolar I Disorder.” Journal of Clinical Psychiatry 67.4, Apr. 2006: 626–37.
Lin, Daniel, Hiram Mok, and Lakshmi N. Yatham. “Poly-therapy in Bipolar Disorder.”CNS Drugs” 20.1, 2006: 29–42.
Michalopoulou, Panayiota G., and Lefteris Lykouras. “Manic/Hypomanic Symptoms Induced by Atypical Antipsychotics: A Review of the Reported Cases.” Progress in Neuro-Psychopharmacology & Biological Psychiatry 30.4, May 2006: 549–64.
Dean A. Haycock, Ph.D.