Mania is a mood state that causes people to have heightened emotions. The feelings experienced with mania range from euphoria to extreme irritability, and people often feel energetic and sleep less than usual when they’re in a manic state. Most commonly, mania is experienced as one of the phases of bipolar disorder.
Because each person’s body chemistry is different, treatments used to address mania may be highly variable. Sometimes, the acute mania phase itself can be treated directly. However, the best management is by addressing bipolar disorder and its underlying causes.
The list of medications for mania is extensive. Not everybody responds well to the same medications, so a variety is needed to best cover the diversity of patients. New drugs are still being developed to better treat mania with fewer side effects.
The types of medicines used to address mania are all mood stabilizers. Mood stabilizers are compounds that help reduce the symptoms of mood disorders like bipolar disorder depression, anxiety, and acute mania.
Antipsychotic drugs are typically used to treat psychotic disorders like schizophrenia. Recently, they have also been found to be effective for mania. Some of these can have some serious side effects, however.
Antipsychotics currently FDA-approved to be used for mania include:
Lithium can be used to successfully decrease the symptoms of mania. It was the very first pharmacological compound used to treat manic disorders, and it acts as a mood stabilizer. Lithium can be combined with other types of drugs like antipsychotics and anticonvulsants.
Unfortunately, lithium does come with some unappealing side effects, including hand tremors, diarrhea, vomiting, and weight gain. These can cause patients to stop taking their medication even if it was helping with their manic episodes. Taking alcohol and lithium at the same time can also be dangerous as it can make these adverse effects much worse.
Anticonvulsant medications are typically used to treat seizures, such as those that occur in cases of epilepsy. However, many anticonvulsants also work effectively as mood stabilizers and have been used to treat certain mood disorders, including bipolar disorder.
Currently, there are two anticonvulsant drugs typically used to treat mania: carbamazepine and valproate. There are newer anticonvulsants now available, but they have not been tested enough yet to determine if they are effective for mania. These anticonvulsants may be a bit less effective than other categories of drugs, but they also come with fewer side effects.
Electroconvulsive Therapy (ECT)
Electroconvulsive therapy (ECT) was previously known as electroshock therapy. During an ECT procedure, the patient is placed under anesthesia and a team of doctors send a brief pulse of electricity through the patient’s brain, causing a controlled seizure. Because of the complexity and the potential risks of the procedure, ECT is usually only used in severe cases or when other treatments fail. Little research has been done on ECT for acute mania, but since it can help with other mood disorders like depression, it may be helpful for severe cases of mania.
Hospitalization is often required for people in the throes of a severe manic episode. When they are manic, people exhibit poor judgment and impulse control and frequently take unusual risks, such as spending money compulsively, taking illicit substances or attempting dangerous feats. They may also act out aggressively or even violently because of extreme feelings of irritability or anxiety.
During inpatient care, patients are kept in a safe environment and monitored closely. During this time, they may be given medication or counseling to improve their condition.
Like other mood disorders, some healthy lifestyle features can help alleviate the symptoms of mania. Often, behavioral counseling can be helpful to learn what lifestyle changes would be helpful.
The following tips may help manage manic episodes:
- Maintain a stable sleep pattern and get plenty of sleep
- Stick to a daily routine
- Set realistic goals
- Avoid substances that worsen mania, like sugar, caffeine, and alcohol
- Avoid recreational drugs
- Seek support from family and friends
- Reduce stress at home and work
- Recognize the signs of entering a manic episode, so you know when to seek help
- Stick to your treatment plan
Treating Mania and Co-Occurring Disorders
With the different treatment options available, there are many ways mania and co-occurring mental health condition symptoms can be treated. Most medications for mania can also be taken with other pharmaceutical drugs that may be used for other conditions. In any case, psychotherapy, such as cognitive behavioral therapy, can be very helpful in managing mania and other disorders at the same time. Gradually, with the right types of help, recovery is possible.
If you or a loved one are struggling with mania and a drug or alcohol addiction, it is important that you receive specialized help. Contact The Recovery Village today to find out what options are available.
Hanwella R, de Silva VA. “Signs and symptoms of acute mania: a factor analysis.” BMC Psychiatry, August 19, 2011. Accessed May 11, 2019. Vieta E, Sanchez-Moreno J. “Acute and long-term treatment of mania.” Dialogues in Clinical Neuroscience, June 2008. Accessed May 11, 2019. Masi G, Milone A, Scrinzi G, Mucci M, Viglione V, Bruni G, Berloffa S, Pisano S. “Lithium treatment in bipolar adolescents: a follow-up naturalistic study.” Neuropsychiatric Disease and Treatment, October 17, 2018. Accessed May 15, 2019. Salik I, Marwaha R. “Electroconvulsive Therapy.” StatPearls, NCBI, March 13, 2019. Accessed May 11, 2019. Burgess P, Romito K, Maldonado CR. “Bipolar Disorder: Preventing Manic Episodes.” University of Michigan Health, September 11, 2018. Accessed May 11, 2019.
Hanwella R, de Silva VA. “Signs and symptoms of acute mania: a factor analysis.” BMC Psychiatry, August 19, 2011. Accessed May 11, 2019.
Vieta E, Sanchez-Moreno J. “Acute and long-term treatment of mania.” Dialogues in Clinical Neuroscience, June 2008. Accessed May 11, 2019.
Masi G, Milone A, Scrinzi G, Mucci M, Viglione V, Bruni G, Berloffa S, Pisano S. “Lithium treatment in bipolar adolescents: a follow-up naturalistic study.” Neuropsychiatric Disease and Treatment, October 17, 2018. Accessed May 15, 2019.
Salik I, Marwaha R. “Electroconvulsive Therapy.” StatPearls, NCBI, March 13, 2019. Accessed May 11, 2019.
Burgess P, Romito K, Maldonado CR. “Bipolar Disorder: Preventing Manic Episodes.” University of Michigan Health, September 11, 2018. Accessed May 11, 2019.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.