To My Speedy Gonzales

Have you ever felt like you were floating on top of the world? Your energy level is through the roof, and you cannot sit down. You're cleaning, writing, drawing, organizing, reorganizing, talking 100 miles a minute, and pacing back and forth. Your mind is full of great successful ideas, non-stop creativity, and enlightenment. Excitement is the best feeling in the world! But come on, if you feel this good, why not go shopping? Forget the light bill is due; you have to have those new shoes. As you are throwing those dollars around, you realize, man, I could enjoy getting laid, by you, right there, yeah you, who cares, right? My goodness, when was the last time you slept? Was it 3 or 4 days ago? A week?! Do you mean to tell me for the past 4-7 days, you have been surviving on less than 3 hours of sleep? Wow, you are like a superhero, pretty invincible. Everyone should admire your dedication to your newfound passions. What's wrong with them? So if you are hyper, talking too fast, and can't so down, you feel AMAZING. Geez, what's that around the corner? No, please, don't, dang, it's darkness. Could you leave me alone that project was stupid?

Does any of the above sound like you? Well, you may have experienced a manic or hypomanic episode. The difference between the two is simple, duration and interference of functioning. Mania usually lasts for more than a week with similar symptoms described above, whereas hypomania has less severe symptoms, typically lasting about 3-4 days. Mania can lead to a severe decline in functioning, resulting in loss of employment (because who needs a job when you're feeling high), strained relationships (now you dare to say what was on your mind), and educational failures (you missed that assignment because you never really was able to focus on it to complete the task). In some people with mania, the symptoms become so severe they end up in the hospital.

Hospitalizations usually occur when a person is a danger to themselves and others. Typically with mania, this includes activities with high consequences, theft, reckless endangerment, disturbance of the peace, or anything that disrupts another person. By this point, a person needs treatment. Mania or hypomania should be treated with mood stabilizers, sedatives, and antipsychotics without too much explanation. Treatment options are designed based on the diagnosis, including the symptoms above. Mania and hypomania can be symptoms of several diagnoses. Bipolar I or Bipolar II, schizoaffective disorder, cyclothymic disorder, substance/medication-induced bipolar, and related disorders. There is also a small subset of individuals who do not meet the criteria for a bipolar and related disorder resulting in a diagnosis of MDD with mixed features (someone who has depression and some manic/hypomanic symptoms). If you feel you may have suffered a manic episode, please reach out for an evaluation.

Will someone recover from a manic or hypomanic episode without medication? Sure, but will they sustain themselves is a better question. Those who suffer from these attacks spend most of their lives in depressive states. Usually, before a manic episode, a person may remember a period of intense depressive symptoms, followed either by a "normal" period or straight to the symptoms described above, then returning to a depressive episode. Realizing what has transpired usually is pretty devastating, depending on the destruction one causes while manic.

If you or someone you know has experienced mania or hypomania, please reach out to discuss your options. If you or someone you know is a danger to themselves or others, please call 911 or go to an emergency room.

---Dr. Jasmine Kearse