mania

Mania is a state of abnormally elevated, expansive, or irritable mood with increased energy or activity. It is a core feature of bipolar I disorder and, when milder and shorter, is described as hypomania. A manic episode is characterized by a markedly abnormal mood lasting at least one week (or any duration if hospitalization is required) and by symptoms that cause significant impairment, hospitalization, or include psychotic features.

Common symptoms, often summarized by the acronym DIGFAST, include distractibility; irritability or inflated self-esteem or grandiosity; flight of ideas; increased goal-directed activity or psychomotor agitation; decreased need for sleep; pressured speech. Manic episodes may also involve risky behaviors or poor judgment, and can include psychosis.

Causes are multifactorial. Genetic predisposition is strong; neurotransmitter dysregulation (notably dopamine, glutamate, GABA) and altered brain circuitry are implicated. Stress, sleep disruption, and substance use can precipitate episodes, and medical conditions or medications may mimic mania.

Diagnosis relies on criteria from psychiatric classification systems such as DSM-5-TR or ICD-11. The mood disturbance must be clearly distinct from the individual’s usual behavior and not attributable to substances or another medical condition. Clinicians assess duration, intensity, impairment, and safety.

Treatment focuses on rapid stabilization and prevention of relapse. Acute management may include mood stabilizers such as lithium or valproate, and/or atypical antipsychotics; benzodiazepines may be used for agitation or sleep. Psychosocial interventions—psychoeducation, psychotherapy, sleep regulation, and substance-use treatment—support long-term management. Maintenance therapy is often indicated, with ongoing monitoring for side effects and comorbid conditions.

Prognosis varies; with treatment, many individuals experience episodic but manageable courses, whereas untreated mania can lead to hospitalization, psychosis, or self-harm. See also bipolar disorder, hypomania, psychosis.