mania is a “natural” state which is the characteristic of bipolar i disorder. a single manic phase is sufficient to make the diagnosis of bipolar i disorder, although most cases of bipolar i also involve hypomanic and depressed episodes. the etiology of mania, and more generally, bipolar i disorder, are not known. the amygdala is hyperactive in patients with bd, and the hippocampus and prefrontal cortex are hypoactive.
this increased activity in the amygdala along with decreased activity in cortical regions may be the reason why the executive function is impaired in mania while the emotions are heightened and unrestrained. one of the most common situations that may mimic mania is caffeine or other stimulant intoxication, especially cocaine, amphetamine (including methamphetamine), pcp, and nicotine. the prognosis of manic patients is favorable, granted they are adherent to medications and therapy. the outcomes for patients with mania are guarded.
 as the mania intensifies, irritability can be more pronounced and result in anxiety or anger.  though the elevated mood and energy level typical of hypomania could be seen as a benefit, true mania itself generally has many undesirable consequences including suicidal tendencies, and hypomania can, if the prominent mood is irritable as opposed to euphoric, be a rather unpleasant experience.  to be classified as a manic episode, while the disturbed mood and an increase in goal-directed activity or energy is present, at least three (or four, if only irritability is present) of the following must have been consistently present: though the activities one participates in while in a manic state are not always negative, those with the potential to have negative outcomes are far more likely. these behaviours may increase stress in personal relationships, lead to problems at work, and increase the risk of altercations with law enforcement.
there is a high risk of impulsively taking part in activities potentially harmful to the self and others. targets of various treatments such as gsk-3, and erk1 have also demonstrated mania like behavior in preclinical models. decreased cerebrospinal fluid levels of the serotonin metabolite 5-hiaa have been found in manic patients too, which may be explained by a failure of serotonergic regulation and dopaminergic hyperactivity. in more urgent circumstances, such as in emergency rooms, lorazepam, combined with haloperidol, is used to promptly alleviate symptoms of agitation, aggression, and psychosis. antidepressant monotherapy is not recommended for the treatment of depression in patients with bipolar disorders i or ii, and no benefit has been demonstrated by combining antidepressants with mood stabilizers in these patients.
bipolar i disorder (most common condition for mania to occur). seasonal affective disorder. postpartum psychosis. schizoaffective disorder. when your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. these mood hypomania and mania are periods of over-active and excited behaviour that can have a significant impact on your day-to-day life., .
the terms “mania” and “manic episode” describe a state of mind characterized by high energy, excitement, and euphoria over a sustained bipolar disorder is characterised by extreme mood swings. the mood swings can range from extreme highs (mania) to extreme lows (depression). manic episodes are common in people with bipolar i disorder but they can also be caused by other factors and health conditions, including:., .
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