There are 8 main manifestations of manic episodes. Do you know?

Author: Sun Yi, Chief Physician, Beijing Huilongguan Hospital

Reviewer: Zhang Yu, researcher at Chinese Center for Disease Control and Prevention

Manic episodes are characterized by elevated emotions as the main symptom.

When the patient is emotionally high, he may appear ecstatic and jubilant, but this joyful mood is inconsistent with his situation.

Mild emotional upsurge will not have a big impact on his social function. Severe emotional upsurge, that is, manic episodes, will affect his social function and may even cause some delusions and hallucinations.

The main clinical manifestations of manic episodes are as follows:

1. Lack of concentration

For example, when students have a manic episode, they have difficulty concentrating in class, cannot hear what the teacher says, and their learning efficiency is very low. Their test scores may also plummet. Whether in elementary school, middle school, or college, they will fail the test.

If the person is an adult who has already joined the workforce, his work efficiency is obviously low. For example, he may not listen to or remember the tasks assigned by his leader, and he may procrastinate and fail to complete them. At this time, his social function will be significantly affected. However, in the early stages of hypomania, the patient often feels particularly good, and when he is focused on doing something, his efficiency is very high.

2. A lot of language

He talks incessantly and can talk for half an hour or even an hour without stopping. There is foam at the corners of his mouth when he speaks, and it is very difficult for others to interrupt him. No matter what others interrupt, he will bring the topic back and continue talking non-stop.

Figure 1 Original copyright image, no permission to reprint

When this symptom occurs, it has a great impact on the patient. Often his interpersonal relationships with classmates, colleagues, leaders, and neighbors will deteriorate. His relationship with his parents or children will become tense, and his relationship with his partner will be disharmonious.

3. Thought Escape

Thought racing means that his thinking speed is very fast. The patient's subjective feeling is that his speaking speed cannot keep up with his thinking speed. After this happens, his thinking association is fast, very fast, and even erratic. He has a lot of ideas and thoughts, which change very quickly. His brain works very well and he feels that his brain is working very fast.

4. High self-evaluation

Because they think very quickly, they think they are very smart and are often a little conceited, thinking they are very capable and can become a high-ranking official.

If you ask him what kind of high position he can become? Mayor? He may say no, that position is too low. Secretary of the provincial party committee or governor? He may still think that position is not high enough. President of the country? He may say that it is almost enough. Not only president of the country, he may also think that he can become secretary-general of the United Nations. Some patients think that they are "invincible" and "omnipotent". They even think that they can "control the universe with their left hand and govern the galaxy with their right hand".

Therefore, the patient feels extremely inflated, arrogant, and feels particularly good. He feels that he has the ability and can reach this level.

5. Energetic

During a manic episode, the patient is extremely energetic, running around all day, busy all the time. However, he is not good at doing anything, and often starts well but ends badly, with no end in sight, and ultimately accomplishes nothing.

6. Act without regard for the consequences

They spend a lot of money, spend lavishly, or go on a shopping spree, or invest blindly, such as hastily opening a restaurant, buying stocks, or investing in funds, or entertaining guests or giving gifts without necessity, etc. They act without regard for the consequences, which often leads to adverse effects. Some patients quit their jobs rashly and keep changing jobs. Some patients keep changing their romantic partners, keep getting married and divorced, and lack careful consideration in their actions, and act recklessly and impulsively.

There was a patient who borrowed money from everywhere during a manic episode and spent more than 100,000 yuan in one day to buy daily necessities, air conditioners, washing machines, refrigerators, etc. So much so that when the things he bought were delivered to his home the next day or the day after, there was no room for them at home, so they had to be placed down the stairs. This is the manifestation of doing things without considering the consequences.

7. Reduced sleep

Patients with manic episodes may only need two or three hours of sleep every night, and after waking up, they will be busy all the time. They may remember to call a friend at night. No matter what time it is, they may call you and cannot stop for 10 or 20 minutes, chattering to you without considering other people's feelings.

Figure 2 Original copyright image, no permission to reprint

It is also possible that someone will post some information or express an opinion in a WeChat group, and he will keep posting regardless of whether others pay attention to it or reply to it. This phenomenon will occur.

8. Hypersexuality

During a manic episode, sexual desire is heightened in both men and women.

If the patient is married, he will have frequent sexual demands, and his partner may not be able to resist. Compared with before, the frequency has increased significantly. This is one manifestation; in addition to excessive demands for sexual desire, he may also chase other opposite sex outside, which is not conducive to the harmony and stability of the family.

If he is not married yet, he may change his romantic partners frequently, giving people the impression that he is frivolous and reckless, irresponsible in his relationships, and may even change several partners in a week or two.

Therefore, overall, manic episodes have a relatively large impact on patients.