MANIA

Department of Psychiatry
V S Hospital
MANIA:A distinct period of an abnormally and persistently elevated,
expansive or irritable mood lasting for at least 1 week or less if a patient
must be hospitalized.

MOOD: Pervasive & sustained feeling tone that is experienced internally

and that, in extreme, can markedly influence virtually all aspects of a
person’s behavior & perception of the world. It is long lasting.

AFFECT: Can be defined as the patient’s present emotional responsiveness,

inferred from patient’s facial expression, including the amount & range of
expressive behavior. It changes with event to event.
 DSM 5 CRITERIA FOR MANIC EPISODE

A. A distinct period of abnormally and persistent elevated,

expansive or irritable mood and abnormally and
persistently increased goal directed activity or energy,
lasting at least 1 week and present most of the day,
nearly every day.

B. During this period 3 or more of the following symptoms should

be present(4 if the mood is irritable):

1.inflated self esteem or grandiosity

2.decresed need for sleep

 3.more talkative than usual or pressure to keep talking.

4.flight of ideas or subjective experience that thoughts are

racing.

5.distractibility.

6.increase in goal directed activity or psychomotor agitation.

7.excessive involvement in activities that have a high potential

for painful consequences like sexual indiscretions, money
spending, foolish business investments.

C. The mood disturbance is sufficiently severe to cause marked

impairment in social or occupational functioning

D. The episode is not attributable to the physiological effects of

a substance or to another medical condition.
 DSM 5 CRITERIA FOR HYPOMANIC
EPISODE
A. Same as manic episode but duration is at least 4
consecutive days

B. Same as manic episode

C. Episode is associated with an unequivocal change in

functioning that is uncharacteristic of the individual when
not symptomatic

D. Disturbance in mood and the change in functioning are

observable by others
E. Episode is not severe enough to cause marked impairment
in social or occupational functioning or to necessitate
hospitalization

F. Episode is not attributable to the physiological effects of a

substance.
Difference between a manic and
hypomanic episode
 A manic episode usually lasts longer than a hypomanic episode.

 Mania substantially impairs your functioning, where as hypomania often

actually improves functioning (for example, you have more energy and so
are able to get more things done in a day), or at worst causes only mild
impairment.

 When manic, your thoughts become speedy and disconnected, and your
speech becomes fast and nonstop. In a hypomanic episode, the thoughts
might be described as racing or crowded, but not to the same extent as in
mania, and these thoughts are often also described as creative.

 Mania is associated with aimless overactivity, such as starting many

different projects and not really getting anything done, whereas
hypomania often leads to an increase in goal-directed activities -- in
other words, you are able to achieve more.
 RANGE OF MOOD IN MANIA
Expansive – expression of feelings without restraint,
frequently with overestimation of their significance or
importance.
Euphoria – exaggerated feeling of well being that is
inappropriate to real events.
Elation – feelings of joy, euphoria, triumph and intense self
satisfaction or optimism (euphoria + hyperactivity).
Exaltation – feeling of intense elation and grandeur.
 Ecstasy – intense feeling of rapture.
Organic causes of mania
 Infection-
Cerebral (Meningitis,encephelitis,HIV,syphilis)
Systemic(Sepsis,UTI,Pneumonia)
 Cardiac and Vascular-
Cerebrovascular (Infacts,Haemorrhage,Vasculitis)
Cardiovascular (CHF,Shock)
 Trauma-
Cerebral contusion
Subdural hematoma
 Demyelinating-
Multiple Sclerosis
 Tumors
Primary cerebral,
Neoplasm
DRUGS CAUSING MANIA
-Corticosteroids
-Antidepressants of the tricyclic and
monoamine oxidase inhibitor
-Amphetamine
-Phencyclidine
-Cocain
-Hallucinogens
-Methylphenidate
-Opiates and opioids
Thank you