Mania

For a lay person:

Mania is a period of abnormally high, excited or irritable mood with greatly increased energy, lasting at least a week or severe enough to need hospital care. People may sleep very little, talk fast, have racing thoughts and do risky things they would not normally do, and some lose touch with reality. It is most often part of bipolar disorder and is treatable.

For a trained medical person:

A manic episode is abnormally and persistently elevated, expansive or irritable mood with increased energy, lasting at least a week or requiring admission, with features such as grandiosity, reduced need for sleep, pressured speech and risk-taking; it usually indicates bipolar I disorder but can be induced by drugs, antidepressants, steroids or medical illness. Diagnosis is clinical, with assessment of risk and investigations for organic and substance-related causes. Acute management is a mood stabiliser such as lithium or valproate and/or an antipsychotic, stopping antidepressants, a safe environment and hospital admission when needed, followed by maintenance treatment and psychoeducation.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Liver Stagnation Transforming into Fire; Accumulated Heat in Stomach and Intestines; Phlegm-Fire Disturbing the Heart; Yin Deficiency with Deficient Fire. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: Mania is a psychiatric emergency: get urgent help from a doctor, crisis team or emergency department, especially if there is risk of harm to self or others, psychotic symptoms or thoughts of suicide. It needs medical treatment and Chinese medicine is adjunctive at most; do not stop prescribed mood stabilisers or antipsychotics, and check before using herbs, which can interact with lithium and other psychiatric drugs.