How to Stop a Manic Episode: 10 Ways to Cope

What Is a Manic Episode?

Symptoms of a manic episode can significantly interfere with daily life, making it difficult to function in work, school, or social situations. The impulsivity and grandiosity associated with mania can lead to reckless behavior, such as overspending, substance abuse, or risky sexual behavior. This can result in legal, financial, or interpersonal problems.

Mania also carries the risk of harm to oneself or others, particularly if the symptoms become severe. For example, a person experiencing a severe manic episode may engage in dangerous activities, experience paranoid or delusional thinking, or become suicidal. In extreme cases, hospitalization may be necessary to provide a safe and supportive environment for the person experiencing the episode.

A mild episode of mania may involve increased energy, elevated mood, and decreased need for sleep. Sometimes it may not significantly interfere with daily life or require intervention from a mental health professional. Someone experiencing a mild episode may be able to manage their symptoms with self-care strategies such as rest, stress reduction techniques, and maintaining a regular sleep schedule.

Common symptoms of mania include:¹

• Delusions
• Hallucinations
• Over-engaged activities
• Talking a lot
• Pressured speech
• Speaking loudly
• Easily distracted
• Hypersexuality
• Risky behaviors
• Rapid thoughts
• Flight of ideas
• Grandiose
• Hostility
• Thoughts of suicide
• Unusual clothing or dressing
• Aggression
• Hypomania

Types of Mania

While there are common symptoms associated with mania, it’s important to note that the experience of mania can vary from person to person. Mania is most prominent with bipolar disorder but can also occur in other conditions, such as schizoaffective disorder or substance-induced mood disorder.

Due to the range of symptoms and differences in presentation, there is not a one-size-fits-all solution that works for every episode of mania.  Additionally, treatment options may differ depending on the underlying condition and the severity of the symptoms.

Mania can be categorized into different diagnostic criteria, such as:

• Euphoric mania: Euphoric mania involves feelings of extreme happiness, joy, and euphoria. This type of mania is often associated with bipolar I disorder. It can be characterized by exaggerated self-esteem, excessive optimism, racing thoughts, increased energy, decreased need for sleep, and impulsive behavior.
• Dysphoric mania: Dysphoric mania is a specific type of manic episode characterized by a combination of manic symptoms and intense feelings of irritability, agitation, and anxiety. Individuals may experience racing thoughts, increased energy, decreased need for sleep, impulsivity, grandiosity, intense feelings of restlessness, irritability, and anxiety. This can lead to aggressive behavior, verbal outbursts, and difficulty interacting with others.
• Psychotic mania: Psychotic mania is a severe manic episode characterized by symptoms of mania, such as elevated or irritable mood, and symptoms of psychosis, such as hallucinations, delusions, or disorganized thinking. During a psychotic manic episode, individuals may experience a range of symptoms, including grandiose delusions (such as believing they have special powers or abilities), paranoid delusions (such as believing that they are being persecuted or followed), auditory hallucinations (such as hearing voices), and disorganized thoughts or speech. These symptoms can be frightening and distressing for the individual and may also be confusing and concerning for those around them.²
• Hypomania: Hypomania is a less severe form of mania that involves elevated or irritable mood and increased energy or activity, but to a lesser extent than classic mania. Hypomania is typically associated with bipolar II disorder or cyclothymia.
• Mixed features: Mixed features involve symptoms of both mania and depression, such as elevated mood and agitation, sadness, hopelessness, and suicidal thoughts. Mixed features can be seen in bipolar I and II disorders.

Causes of Mania

The exact cause of mania is poorly understood, but research suggests that multiple factors contribute to its development, including biological, environmental, and psychological factors. Biological factors, such as genetics and neurochemical imbalances, can trigger mania. Psychological factors, such as personality traits, cognitive biases, and early life experiences, also play roles in causing mania. Environmental factors like stress and sleep disruption can also contribute to mania.

Common causes and triggers of mania include:

• Brain trauma: A traumatic brain injury (TBI) can cause physical damage to the brain, disrupting the normal functioning of the brain regions involved in mood regulation. The severity and location of the brain injury can determine the likelihood and severity of manic symptoms.
• Tumors: A brain tumor can disrupt the normal functioning of the brain regions involved in mood regulation, leading to changes in neurotransmitter levels and alterations in neural activity.
• Dementia: Dementia can trigger manic episodes in some individuals, especially in the early stages of the disease. Dementia is a degenerative brain disorder that affects memory, thinking, behavior, and emotions.
• Encephalitis: Encephalitis is an inflammation of the brain that can be caused by viral or bacterial infections, autoimmune disorders, or other factors. Encephalitis can trigger manic episodes in some individuals, particularly in the acute phase of the illness.
• Lupus: Lupus is a chronic autoimmune disorder that can cause inflammation and damage to various organs and tissues in the body, including the brain. Lupus can trigger manic episodes in some individuals, particularly during disease flares or when the disease is poorly controlled.
• Medication: The physiological response to medications that trigger mania depends on the specific medication and its mechanism of action. For example, some antidepressants can increase neurotransmitters such as serotonin and norepinephrine levels, which can lead to mood elevation and trigger manic symptoms in individuals with bipolar disorder or other mood disorders.
• Drug or alcohol misuse: Drug abuse, particularly stimulants or hallucinogens, can cause mania or exacerbate symptoms in individuals with bipolar disorder. Drugs such as cocaine and amphetamines increase the levels of dopamine and other neurotransmitters in the brain, leading to alterations in mood and behavior.
• Schizoaffective disorder: Manic episodes are a common feature of schizoaffective disorder and can be triggered by various factors, including stress, medication, and changes in sleep patterns.
• Acute stress: Stressful events can lead to the activation of the hypothalamic-pituitary-adrenal (HPA) axis, releasing stress hormones such as cortisol.
• Hyperthyroidism: The physiological response to hyperthyroidism involves changes in thyroid hormone levels that can contribute to the development of manic symptoms.
• Genetics: This can result from alterations in the structure or function of specific brain regions involved in mood regulation.
• Neurochemical imbalances: Neurotransmitters such as dopamine, norepinephrine, and serotonin play a crucial role in mood regulation.
• Hormonal changes: Hormonal changes, such as those that occur during puberty, pregnancy, and menopause, can trigger mania in some individuals.
• Sleep Disruption: Sleep is essential for the proper functioning of the brain, and sleep disruption can lead to alterations in mood and behavior.
• Social Isolation: Social isolation and conflict with others can cause the release of stress hormones, which can trigger manic symptoms.

10 Tips to Cope & Stop a Manic Episode

Mania, particularly in the context of bipolar disorder, is not curable. Bipolar disorder is a chronic condition that requires long-term management. While medications and therapy can effectively manage symptoms and prevent relapses, there is no cure. This means that individuals experiencing mania or other manic symptoms must focus on managing them over the long term through medication, therapy, and lifestyle changes.

Effective management of bipolar disorder can significantly improve an individual’s quality of life, allowing them to lead a fulfilling and productive life despite the challenges posed by the disorder.

Here are ten tips for coping with mania:

1. Contact Your Care Team

Professionals, such as psychiatrists, psychologists, and other mental health providers, can play a crucial role in helping individuals experiencing manic episodes. The specific interventions used will depend on the severity and nature of the symptoms and individual factors such as the individual’s medical history and treatment preferences. The ways professionals can help include medication management, psychotherapy, hospitalization, and assisting with lifestyle changes.

2. Avoid Triggers of Mania

Removing oneself from triggers for mania is an effective way to manage manic symptoms and bring someone back to baseline. By removing themselves from triggers, individuals can better manage their symptoms and reduce the risk of relapse. Learning effective coping strategies, such as mindfulness techniques and relaxation exercises, can help individuals better manage their symptoms and promote overall well-being.

3. Take Your Medications

When feeling on top of the world, some people with bipolar disorder may stop taking their medications. They may believe that they no longer need the medication as they feel great and have high levels of energy and enthusiasm. However, stopping medications abruptly or without medical supervision can be dangerous and may lead to relapse or worsened symptoms.

4. Get Good Sleep

Maintaining good sleep habits is essential for managing and reducing the severity of manic symptoms. Lack of sleep can lead to increased agitation, irritability, and impulsivity–all symptoms of mania–which can exacerbate mood swings.

5. Stay Well Fed

When an individual with bipolar disorder is experiencing mania, their body is already in a state of heightened arousal and increased sympathetic nervous system activity. Not eating can further exacerbate this response, leading to increased levels of stress hormones and increased activation of the fight or flight response.

6. Monitor Finances

During manic episodes, individuals with bipolar disorder may experience impulsivity and engage in excessive or blind spending. This behavior can lead to financial stress and negative consequences, such as debt, bankruptcy, or legal issues. Therefore, individuals with bipolar disorder need to monitor their spending and restrict their spending behaviors.

7. Monitor Symptoms

During a manic episode, individuals with bipolar disorder may experience a range of symptoms that can be all-consuming and overwhelming. These symptoms can include increased energy, racing thoughts, irritability, grandiosity, and impulsivity. Because manic symptoms can be intense, individuals may overlook or disregard other symptoms that they may be experiencing, which could help explain why they were triggered into a manic episode.

8. Set Reminders

Mania can make it difficult for individuals to keep track of time, as they may experience a range of symptoms that can disrupt their sense of time and make it challenging to maintain a consistent routine. For example, racing thoughts and impulsivity can lead individuals to become absorbed in their thoughts or activities, causing them to lose track of time.

Additionally, changes in sleep patterns, such as insomnia or decreased need for sleep, can further disrupt an individual’s sense of time and contribute to a disordered routine. Losing track of time can lead to worse symptoms because it can exacerbate the effects of mania and make it more difficult for individuals to manage their symptoms effectively.

 9. Exercise

Exercise can be a powerful tool for managing manic symptoms associated with bipolar disorder. Some mental health benefits of exercise for mania include stress reduction, mood regulation, improved sleep, and increased self-esteem and structure. Incorporating regular exercise into your daily routine can be an effective strategy for managing manic symptoms and improving overall well-being.

10. Mindfulness

Mindfulness can be a helpful tool for individuals with bipolar disorder who experience manic episodes. Mindfulness involves being present and fully engaged in the present moment without judgment or distraction. Practicing mindfulness can help individuals with bipolar disorder to manage their symptoms better and reduce the intensity and frequency of manic episodes.

How to Prevent a Manic Episode

Preventing manic episodes is critical to managing bipolar disorder. Preventing manic episodes involves developing a comprehensive treatment plan, identifying triggers, building a support network, creating a crisis plan, and practicing self-care. By taking these steps, individuals with bipolar disorder can reduce the likelihood of manic episodes and ensure that they have the support they need to manage their symptoms effectively.

Develop Action & Safety Plans

Developing an action or safety plan can help individuals with bipolar disorder proactively manage their manic symptoms and ensure they have the support they need. By identifying warning signs, determining appropriate responses, identifying emergency contacts, creating a crisis plan, and communicating with their care team, individuals can take an active role in managing their bipolar disorder and reducing the likelihood of manic episodes.

Things to consider and include in your plan include:³

• Identify early warning signs: Work with your healthcare provider to identify early warning signs of a manic episode, such as changes in sleep patterns, increased energy levels, or mood changes. These warning signs can help you and your care team identify when you may be at risk for a manic episode.
• Determine appropriate responses: Once warning signs are identified, work with your care team to determine appropriate responses. This can include adjusting medications, increasing therapy sessions, or engaging in stress-reducing activities.
• Identify emergency contacts: Identify trusted friends, family members, or healthcare providers who can provide support during a manic episode. Make sure these individuals are aware of your warning signs and know how to respond in case of an emergency.
• Create a crisis plan: Develop a crisis plan that outlines what steps to take in case of a manic episode or other psychiatric emergencies. This can include identifying emergency contacts, outlining specific symptoms that indicate the need for emergency intervention, and identifying a healthcare provider who can provide emergency care.
• Communicate with your care team: Regularly communicate with your healthcare provider and other care team members to ensure that everyone is aware of your symptoms, warning signs, and responses. This can help ensure that everyone is on the same page and can respond quickly in case of a manic episode.

Develop a Psychiatric Directive

A directive or advanced care plan can ensure that individuals receive proper medication and treatment when hospitalized for mania. This document can outline an individual’s preferences for treatment, such as preferred medications and therapies, as well as any restrictions or limitations they may have. It can also include contact information for their care team and loved ones, who can provide additional information and support during hospitalization.

In addition to outlining an individual’s preferences and limitations, this directive can also help maintain their rights to treatment. The directive can specify that the individual should receive treatment for their manic symptoms, even if they cannot consent to treatment. It can also specify that the individual should not be subject to restraints or other forms of physical or chemical restraint unless it is necessary to prevent harm to themselves or others.

Practice Emergency Crisis Drills

Practicing safety plans and healthy coping mechanisms ahead of time can be a valuable tool for individuals prone to manic episodes. Developing these plans and coping strategies before an episode can help ensure that individuals have a clear plan of action and are more likely to utilize it when needed.

Maintaining Treatment & Medication Regimens

Maintaining treatment and medication regimens is essential in preventing manic episodes in individuals with bipolar disorder. Treatment plans are usually tailored to meet each person’s needs and may include medication, therapy, and lifestyle modifications. Medications such as mood stabilizers, antipsychotics, and antidepressants are commonly used to manage bipolar disorder and prevent manic episodes.

Helping Someone Experiencing Mania

If you have a friend who is experiencing a manic episode, you can help or support the friend in several ways, including educating yourself, offering emotional support, helping them stay on track with their treatment, and encouraging engagement in self-care. Remember that supporting someone with bipolar disorder can be challenging, and it is also okay to seek support for yourself. If needed, encourage your friend to seek support from online psychiatrists, support groups, or crisis hotlines. They can use an online therapist directory to locate a provider.

When helping a loved one experiencing mania, it is important to remember things such as:

• Be considerate
• Get them the help they need
• Give space for their feelings without trying to fix them
• Seek knowledge about bipolar disorder and mania
• Engage in self-care with them
• Encourage them to seek support

Recovery From a Manic Episode

After experiencing a manic episode, it is essential to seek professional help and follow through with any treatment recommendations. This may involve medication management, therapy, or a combination of both. It is also important to engage in self-care activities, such as getting adequate sleep, practicing mindfulness or meditation, exercising regularly, and maintaining a healthy diet.

Developing a support system of trusted friends and family members who understand bipolar disorder and can provide emotional support is also helpful. Additionally, taking time to reflect on the triggers and warning signs that led up to the manic episode can be valuable in developing strategies to prevent future episodes. This may involve journaling, attending support groups, or working with a therapist to identify patterns and develop coping mechanisms. It is important to recognize that managing bipolar disorder is an ongoing process that requires commitment and effort. However, with proper treatment and support, it is possible to live a fulfilling life with bipolar disorder.

Final Thoughts

Manic episodes can be challenging to manage, and despite taking preventive measures, they can still occur. However, by putting safety plans and healthy coping mechanisms in place, individuals with bipolar disorder can minimize the severity of manic episodes and reduce their impact on their lives. It’s important to remember that seeking help from mental health professionals, taking medication as prescribed, practicing self-care, and staying connected with supportive family and friends can all contribute to the effective management of mania. With the right support and tools, individuals can learn to navigate the ups and downs of bipolar disorder and live fulfilling lives.