Mood Disorders~The Symptoms of Depression and Mania~Mania

Symtoms of Mania

Affective Symptoms
In mania, the person's mood is elevated, expansive, or irritable. Social and occupational functioning is impaired, as shown in the following case:

Alan was a forty-three-year-old unmarried computer programmer who had led a relatively quiet life until two weeks before, when he returned to work after a short absence for illness. Alan seemed to be in a particularly good mood. Others in the office noticed that he was unusually happy and energetic, greeting everyone at work. A few days later, during the lunch hour, Alan bought a huge cake and insisted that his fellow workers eat some of it. At first everyone was surprised and amused by his antics. But two coleagues working with him on a special project became increasingly irritated because Alan didn't put any time into their project. He just insisted that he would finish his part in a few days.

On the day the manager had decided to tell Alan of his colleagues' concern, Alan behaved in a delirious, manic way. When he came to work, he immediately jumped onto a desk and yelled, "Listen, listen! We aren't working on the most important aspects of our data! I know, since I've debugged my mind. Erase, reprogram, you know what I mean. We've got to examine the total picture based on the input!" Alan then spouted profanities and made obscene remarks to several of the secretaries. Onlookers thought that he must have taken drugs. Attempts to calm him down brought angry and vicious denunciations. The manager, who had been summoned, also couldn't calm him. Finally the manager threatened to fire Alan. At this point, Alan called the manager an incompetent fool and stated that he could not be fired. His speech was so rapid and disjointed that it was difficult to understand him. Alan then picked up a chair and said he was going to smash the computers. Several coworkers grabbed him and held him on the floor. Alan was yelling so loud that his voice was quite hoarse, but he continued to shout and struggle. Two police officers were called, and they had to handcuff him to restrain his movements. Within hours, he was taken to a psychiatric hospital for observation.

People with mania, like Alan, show boundless energy, enthusiasm, and self-assertion. If frustrated, they may become profane and quite beligerent, as he did.

Cognitive Symptoms
Some of the cognitive symptoms of mania include flightiness, pressured thoughts, lack of focus and attention, and poor judgement. The verbal processes of patients with mania reflect their cognitive state. For example, their speech is usually quite accelerated and pressured. They may change topics in mid-sentence or utter irrelevant and idiosyncratic phrases. Although much of what they say is understandable to others, the accelerated and disjointed nature of their speech makes it difficult to follow their train of thought. They seem incapable of controlling their attention, as though they are constantly distracted by new and more exciting thoughts and ideas.

Behavioral Symptoms
Individuals with mania are often uninhibited, engaging impulsively in sexual activity or abusive discourse. DSM-IV-TR (Diagnostic and Statistical Manual) recognizes two levels of manic intensity- hypomania and mania (American Psychiatric Association, 2000). In the milder form, hypomania, affected people seem to be "high" in mood and overactive in behavior. Thier judgement is unusually poor, although delusions are rare. They start many projects but complete few, if any. When they interact with others, people with hypomania dominate the conversation and are often grandiose.

People who suffer from mania display more disruptive behaviors, including pronounced overactivity, grandiosity, and irritability. Their speech may be incoherent, and they do not tolerate criticisms or restraints imposed by others. In the more severe form of mania, the person is wildly excited, rants, raves (the stereotypical type of a wild "maniac"), and is contantly agitated and on the move. Hallucinations and delusions may appear. Becuase these individuals may be uncontrollable and are frequently dangerous to themselves or to others, physical restraint and medication are often necessary.

Physiological Symptoms
The most prominent physiological or somatic characteristic is a decreased need for sleep, accompanied by high levels of arousal. The energy and excitement these patients show may cause them to lose weight or to go without sleep for long periods. Whereas hypomania is not severe enough to cause marked impairment or hospitalization, the mood disturbance in mania is sufficiently severe to cause marked impairment in social or occupational functioning.

Quote 'O The Day: But you must admit hallucinations are more interesting than depression.

Text taken from the book 'Understanding Abnormal Behavior' by David Sue, Derald Wing Sue and Stanley Sue, Seventh Edition, pp.351-352, copyright 2003-Houghton Mifflin Company. Used with permission.



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