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Dr. Paul Latimer, maniaHave you ever noticed a friend or family member go through what appears to be a total personality change? Perhaps he or she was slightly introverted but suddenly became the extroverted life of the party. Or maybe a quiet friend suddenly became a high speed talker.

This can sometimes be the dramatic face of mania – one of the extreme mood states found in bipolar disorder. Individuals with this serious mental illness may cycle between states of mania and depression throughout their lives although only one episode of mania is required to qualify for the diagnosis.

While the above-mentioned traits can be found in mania, it can appear in a variety of different forms.

It is usually characterized by a combination of symptoms, which can include excessive euphoria with little or no connection to life events or abnormal feelings of power and confidence. Increased energy, racing thoughts, extreme irritability, uncharacteristically bad judgment, increased sexual drive, less need for sleep, and restlessness are also hallmarks of the manic state.

While some of these symptoms may sound like they’re not all that bad, a manic individual’s behaviour is often reckless, impulsive and dangerous and can lead to serious problems in life functioning.

Usually associated with a lack of insight, the manic individual might begin to behave in ways that are completely uncharacteristic of them. Spending money excessively and having irrational thoughts and arguments with friends and family are just a couple of the many manifestations of this lack of insight.

Family members often perceive a complete change in personality in the manic individual. Fears disappear and a once cautious loved one might decide to take up base jumping as a hobby. A once patient individual may become extremely irritable with the smallest things setting off a quick temper.

For doctors, the first sign of trouble may be a previously cooperative and appreciative patient who suddenly blames all problems on a prescribed medication and abruptly discontinues treatment.

Unfortunately, this lack of insight and irrationality often hinders the individual’s ability to realize the impact of his or her behaviour. Manic individuals often quit jobs or damage important relationships while in the manic state.

However, since mania doesn’t last forever, these people tend to feel extreme remorse and regret when their mood cycles back to normal or into a depressed state.

Mania is difficult to treat because unlike the depressed state, a person experiencing mania often feels good and doesn’t realize the danger or abnormality of his or her actions. Sometimes, family intervention is needed in order to bring the manic individual to safety.

Once treatment is sought, it usually involves the use of mood stabilizing medications such as lithium, valproate or quetiapine. It is important to have a proper diagnosis as treatment of bipolar depression with regular antidepressants can cause a person to cycle from depression into the equally dangerous and debilitating state of mania.

If you or a loved one seems to be experiencing symptoms of mania, see your family doctor. Treatment is available and there is no need to continue shifting from one extreme mood to another.

Dr. Latimer is president of Okanagan Clinical Trials and a Kelowna psychiatrist.

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