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80-552: The symptoms of mania include elevated mood (either euphoric or irritable), flight of ideas , pressure of speech , increased energy, decreased "need" and desire for sleep, and hyperactivity . They are most plainly evident in fully developed hypomanic states, however, in full-blown mania, these symptoms become progressively exacerbated . In severe manic episodes, these symptoms may even be obscured by other signs and symptoms characteristic of psychosis , such as delusions, hallucinations, fragmentation of behavior, and catatonia . Mania

160-399: A but still an ego ideal and phallic function; he places "psychotic autism" where there is no objet petit a , no social mirror , and the absence of the ego ideal and absence of the phallic function. Jaspers defined this as a delusion arising without apparent cause. For example, suddenly, without apparent cause, having the delusional belief that one is an alien. Autokabalesis is

240-447: A child does not speak at all in certain situations (such as in school) but speaks well in other conditions (like at home or at play). A rare cause of mutism is akinetic mutism which results due to a lesion around the third ventricle of the brain. Apperception is a normal phenomenon and refers to the ability to understand sensory inputs in their context, to interpret them and to incorporate them into experience. Failure of apperception

320-527: A degree that the feelings, thoughts and desires of a person are governed by their internal apprehension of the world and not by an external reality shared with others. Today the term is used most often to refer to a specific developmental syndrome (see autism spectrum ). Autistic thinking refers to a cognitive progress that is not in accordance with consensus reality , but rather emphasizes preoccupation with inner experiences and needs. See also § dereistic thinking . More generally, it means thinking that

400-613: A few weeks and complete recovery usually occurs within two or three months. Brain fag syndrome is an example of a culture-bound syndrome. "Brain fag" was once a common term for mental exhaustion. Today, the syndrome describes students (predominantly males, particularly in West Africa) experiencing symptoms including somatic, sleep-related and cognitive complaints, head and neck pains, difficulty in concentrating and retaining information, and eye pain. Synonym of § clouding of consciousness . Bruxism refers to teeth grinding behavior that

480-497: A lack of will or initiative. The individual is unable to act or make decisions independently. The condition may range from subtle to overwhelming in severity. Achromatopsia is a term referring to or acquired agnosia for color. This term includes color blindness . Achromatopsia is a condition characterized by a partial or total absence of color vision. People with complete achromatopsia cannot perceive any colors; they see only black, white, and shades of gray. Incomplete achromatopsia

560-417: A level far beyond that which they would be capable of during euthymia . A very simple indicator of a manic state would be if a heretofore clinically depressed patient suddenly becomes inordinately energetic, enthusiastic, cheerful, aggressive, or "over-happy". Other, often less obvious, elements of mania include delusions (generally of either grandeur or persecution , according to whether the predominant mood

640-495: A liability. English actor Stephen Fry , who has bipolar disorder , recounts manic behaviour during his adolescence: "When I was about 17 ... going around London on two stolen credit cards, it was a sort of fantastic reinvention of myself, an attempt to. I bought ridiculous suits with stiff collars and silk ties from the 1920s, and would go to the Savoy and Ritz and drink cocktails." While he has experienced suicidal thoughts , he says

720-685: A major concern for clinicians is the time course of irritability. If a person presents as uncharacteristically irritable, then a clinician may become concerned a change or episodic illness, such as a neurologic insult or mood disorder. Understanding the time course of irritability is critical for establishing the diagnosis of pediatric bipolar disorder from disruptive mood dysregulation disorder. In another example, chronic, severe irritability in older children (not including young children, e.g. preschool age, where normative irritability may be severe) may predict later depression and anxiety and suicidality. Several major neural systems have been implicated across

800-436: A manic episode as one where mood is higher than the person's situation warrants and may vary from relaxed high spirits to barely controllable exuberance, is accompanied by hyperactivity, a compulsion to speak, a reduced sleep requirement, difficulty sustaining attention, and/or often increased distractibility. Frequently, confidence and self-esteem are excessively enlarged, and grand, extravagant ideas are expressed. Behavior that

880-452: A manic episode of bipolar disorder involves the utilization of either a mood stabilizer (e.g., carbamazepine , valproate , lithium , or lamotrigine ) or an atypical antipsychotic (e.g., olanzapine , quetiapine , risperidone , aripiprazole , or cariprazine ). More recently, substances such as iloperidone have been approved for the acute treatment of manic episodes related to bipolar I disorder . The use of antipsychotic agents in

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960-427: A non-mental medical illness (e.g., hyperthyroidism ), and: (a) is causing obvious difficulties at work or in social relationships and activities, or (b) requires admission to hospital to protect the person or others, or (c) the person has psychosis . To be classified as a manic episode, while the disturbed mood and an increase in goal-directed activity or energy is present, at least three (or four, if only irritability

1040-424: A number of studies for idiopathic, chronic irritability. These include the following: 1) prefrontal areas that underlying complex, goal directed behavior, especially inhibitory control and the regulation of emotions; 2) cortico-subcortical systems underlying reward processing, particularly in reaction to a frustrating stimulus; and 3) cortico-subcortical systems underlying threat and arousal processing, particularly in

1120-430: A person could make them more engaging and outgoing, and cause them to have a positive outlook in life. When exaggerated in hypomania, however, such a person can display excessive optimism , grandiosity , and poor decision-making, often with little regard to the consequences. A single manic episode, in the absence of secondary causes, (i.e., substance use disorders , certain medications , or general medical conditions )

1200-457: A person with this condition can have their limbs placed in fixed positions as if the person were in fact made from wax. Chorea refers to erratic involuntary movements. The term comes from the Greek word " choreia " or "dance" since usually large groups of muscles are involved simulating dance-like movements. Circumstantial thinking, or circumstantial speech, refers to a person being unable to answer

1280-488: A question without giving excessive, unnecessary detail. This differs from tangential thinking, in that the person does eventually return to the original point, circling back on-topic. Clang associations are ideas that are related only by similar or rhyming sounds rather than actual meaning. Claparede's paradox refers to retention of non-verbal and implicit memory in people with Korsakoff's syndrome . Clouding of consciousness , also known as brain fog or mental fog ,

1360-452: A review and meta-analysis exploring this relationship found that this assumption may be too general and empirical research evidence is lacking. In hypomania, there is less need for sleep and both goal-motivated behaviour and metabolism increase. Some studies exploring brain metabolism in subjects with hypomania, however, did not find any conclusive link; while there are studies that reported abnormalities, some failed to detect differences. Though

1440-528: A role of dopamine in mania. Decreased cerebrospinal fluid levels of the serotonin metabolite 5-HIAA have been found in manic patients too, which may be explained by a failure of serotonergic regulation and dopaminergic hyperactivity. Limited evidence suggests that mania is associated with behavioral reward hypersensitivity, as well as with neural reward hypersensitivity. Electrophysiological evidence supporting this comes from studies associating left frontal EEG activity with mania. As left frontal EEG activity

1520-460: A term for committing suicide by jumping from a very high place. Automatic obedience is an exaggerated co-operation with an examiner's request, as if the individual were an " automaton " robotically obeying a command. It is often a sign of catatonia . Automatisms are sequences of activity that occur without conscious control. They may be simple and repetitive ( tic -like) or complex, and are usually natural-looking but purposeless. Automatic behavior

1600-956: Is antidepressant therapy. Studies show that the risk of switching while on an antidepressant is between 6-69 percent. Dopaminergic drugs such as reuptake inhibitors and dopamine agonists may also increase risk of switch. Other medications possibly include glutaminergic agents and drugs that alter the HPA axis . Lifestyle triggers include irregular sleep-wake schedules and sleep deprivation , as well as extremely emotional or stressful stimuli . Various genes that have been implicated in genetic studies of bipolar have been manipulated in preclinical animal models to produce syndromes reflecting different aspects of mania. CLOCK and DBP polymorphisms have been linked to bipolar in population studies, and behavioral changes induced by knockout are reversed by lithium treatment. Metabotropic glutamate receptor 6 has been genetically linked to bipolar, and found to be under-expressed in

1680-400: Is not usually recalled afterwards. Autoscopy is the reduplicative hallucination of "seeing one's own body from the outside" while still maintaining an egocentric visuo-spatial perspective. Autoscopy is sometimes used synonymously with out-of-body experience . Avolition is an inability to initiate and complete goal-directed behavior. It can sometimes be misinterpreted as laziness, but it

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1760-440: Is a catatonic subtype of schizophrenia . Cerea flexibilitas , meaning "waxy flexibility", refers to people allowing themselves to be placed in postures by others, and then maintaining those postures for long periods even if they are obviously uncomfortable. It is characterized by an individual's movements having the feeling of a plastic resistance, as if the person were made of wax . This occurs in catatonic schizophrenia , and

1840-488: Is a condition in which a person who has a certain disability seems unaware of the existence of their disability. § hemiasomatognosia is a subtype of anosognosia in which the person with hemiplegia neglects one half of their body. Anton syndrome , occasionally known as Anton-Babinski syndrome, is a form of cortical blindness in which the individual denies the visual impairment. The individual may attempt to walk, bumping into objects and injuring himself. Anton syndrome

1920-564: Is a disused psychiatric diagnosis. The phrase "running amok" describes the behavior of an individual who is very agitated and may be at danger of causing harm to themselves or others. The syndrome of "Amok" is found in the DSM-IV TR . Anhedonia refers to an inability to experience pleasure, and may be described as a feeling of emotional emptiness. It can be a negative symptom of schizophrenia. It also may be seen in severe depressive states and schizoid personality disorder . Anosognosia

2000-503: Is a global impairment in higher central nervous functioning. All aspects of cognitive functioning are affected. On mental status examinations it is manifest by disorientation in time, place and person, memory difficulties caused by failure to register and recall, aphasia , and agnosia . Impaired perception functioning leads to illusions and hallucinations often in the visual sensory modality. This then causes agitation and distress and secondary delusions . The term confusion state

2080-460: Is a milder form of the condition that allows some color discrimination. Achromatopsia also involves other problems with vision, including an increased sensitivity to light and glare (photophobia), involuntary back-and-forth eye movements (nystagmus), and significantly reduced sharpness of vision (low visual acuity). Affected individuals can also have farsightedness (hyperopia) or, less commonly, nearsightedness (myopia). These vision problems develop in

2160-486: Is a syndrome with multiple causes. Although the vast majority of cases occur in the context of bipolar disorder , it is a key component of other psychiatric disorders (such as schizoaffective disorder , bipolar type) and may also occur secondary to various general medical conditions, such as multiple sclerosis ; certain medications may perpetuate a manic state, for example prednisone ; or substances prone to abuse, especially stimulants, such as amphetamine and cocaine . In

2240-592: Is actually a negative symptom of schizophrenia . Belle indifference or la belle indifférence is characterized by a lack of concern and feeling of indifference about a disability or symptom. It can be seen in conversion disorder . Bouffée délirante is a French term used in the past for acute and transient psychotic disorders (F23 in ICD-10 ). In DSM-IV , it is described as " brief psychotic disorder " (298.8). The symptoms usually have an acute onset and reach their peak within two weeks. The symptoms start resolving in

2320-576: Is also a major feature of a number of other disorders, including autism spectrum disorders, traumatic stress disorders, generalized anxiety disorder , etc. Finally, it is a notable characteristic of delirium , dementia , hormonal change, metabolic disturbance, chronic stress , pain, and substance/medication withdrawal . Of course, given that irritability is not specific to any one condition, clinicians consider biological, social, psychological, and familial factors. Irritability may be an indicator of diagnosis, course of illness, or prognosis. For example,

2400-414: Is broad. It is also consistent with special definitions that are relevant to research and treatment. One definition is that irritability is a low threshold for experiencing frustration . This definition is helpful for experiments because researchers can induce frustration by blocking desired rewards or doling out unexpected punishments. However, it is not particularly specific to irritability, as frustration

2480-487: Is caused by damaging the occipital lobes bilaterally or from disrupting the pathway from the primary visual cortex into the visual association cortex. Anwesenheit refers to the false perception of an unfamiliar presence. It is commonly associated with periods of grief, schizophrenia and other emotional disturbances. This is an alternate term for delusional perception. It is one of the Schneiderian first rank symptoms and

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2560-436: Is commonly defined as the tendency to react to stimuli with negative affective states (especially anger ) and temper outbursts, which can be aggressive . Distressing or impairing irritability is important from a mental health perspective as a common symptom of concern and predictor of clinical outcomes. Irritability is the excitatory ability that living organisms have to respond to changes in their environment. The term

2640-457: Is considered to be irritable when they have a short temper, become easily frustrated , or feel grouchy or grumpy. Caregivers may report tension in the household or fatigue . They may make accommodations to avoid provoking their dependents. Irritability is associated with a number of mental health conditions . It is a defining characteristic of any mood disorder , such as bipolar , depressive , and disruptive mood dysregulation disorders . It

2720-443: Is defined as a true perception, to which an individual attributes a false meaning. Aphemia is the alternate term for mutism . Mutism is absence of speech with apparently normal level of consciousness. Mutism can be dissociative (hysterical) in which an individual (commonly a child or adolescent) stops speaking at once without involvement of any neurological or physical contributing factor; or it can be elective (selective) in which

2800-483: Is defined in the American Psychiatric Association 's diagnostic manual (DSM) as a "distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration, if hospitalization is necessary)," where the mood is not caused by drugs/medication or

2880-417: Is driven by internally oriented wishes and desires regardless of external factors. Lacanian Leon Brenner, citing Laurent, places autism at a level between "Ausstoßung" and "Bejahung", at the "first level of signification", under the banner of "autistic foreclosure", with Imaginary-demand and Real-need but no Symbolic-desire. Lacanian Pablo Lerner places "neurotic autism" where there is no objet petit

2960-531: Is euphoric or irritable), hypersensitivity, hypervigilance , hypersexuality, hyper-religiosity, hyperactivity and impulsivity, a compulsion to over explain (typically accompanied by pressure of speech), grandiose schemes and ideas, and a decreased need for sleep (for example, feeling rested after only 3 or 4 hours of sleep). In the case of the latter, the eyes of such patients may both look and seem abnormally "wide open", rarely blinking, and may contribute to some clinicians' erroneous belief that these patients are under

3040-546: Is generally thought to be a reflection of behavioral activation system activity, this is thought to support a role for reward hypersensitivity in mania. Tentative evidence also comes from one study that reported an association between manic traits and feedback negativity during receipt of monetary reward or loss. Neuroimaging evidence during acute mania is sparse, but one study reported elevated orbitofrontal cortex activity to monetary reward, and another study reported elevated striatal activity to reward omission. The latter finding

3120-502: Is important to manage symptoms of mania and depression, studies show relying on medications alone is not the most effective method of treatment. Medication is most effective when used in combination with other bipolar disorder treatments, including psychotherapy , self-help coping strategies, and healthy lifestyle choices. Lithium is the classic mood stabilizer to prevent further manic and depressive episodes. A systematic review found that long term lithium treatment substantially reduces

3200-488: Is its own construct with a number of emotional and behavioral associations. A second prominent special definition describes a group of behavioral issues often occurring in those diagnosed with an autism spectrum disorder. This deserves mention here because this version of irritability has been a commonly used in a number of clinical trials and defines the current US Food and Drug Administration irritability indication. As an emotional and behavioral symptom in humans, someone

3280-557: Is marked by the individual leaping from topic to topic which have only the most tenuous, if any, connection with each other. This is in contrast with flight of ideas , whereby the individual's successive ideas may be linked and "understandable" to the listener. See also § akataphasia and § entgleisen term introduced by (Cameron). From aut = "self" and - ism = "state or orientation". Originally, Eugen Bleuler used this term to describe schizophrenia. In general, it refers to any (pathological) tendency to be self-absorbed to such

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3360-527: Is none. Akataphasia (Kraepelin 1896) refers to a syntactic disturbance of speech resulting from dissolution of logical ordering of thoughts. It manifests as rambling speech. Compare Derailment . Akathisia refers to a subjective feeling of restlessness in the lower limbs that is related to abnormal activity in the extrapyramidal system in the brain, often due to antipsychotic medication. It tends to manifest as an inability to sit still. Alexithymia refers to an inability to identify and describe emotions in

3440-423: Is not always the case that the clearly manic/hypomanic bipolar patient needs or wants medical help; such persons often either retain sufficient self-control to function normally or are unaware that they have "gone manic" severely enough to be committed or to commit themselves . Manic persons often can be mistaken for being under the influence of drugs . In a mixed affective state , the individual, though meeting

3520-475: Is often sufficient to diagnose bipolar I disorder . Hypomania may be indicative of bipolar II disorder . Manic episodes are often complicated by delusions and/or hallucinations ; and if the psychotic features persist for a duration significantly longer than the episode of typical mania (two weeks or more), a diagnosis of schizoaffective disorder is more appropriate. Certain obsessive–compulsive spectrum disorders as well as impulse-control disorders share

3600-428: Is out-of-character and risky, foolish or inappropriate may result from a loss of normal social restraint. Some people also have physical symptoms, such as sweating , pacing, and weight loss . In full-blown mania, often the manic person will feel as though their goal(s) are of paramount importance, that there are no consequences, or that negative consequences would be minimal, and that they need not exercise restraint in

3680-413: Is present) of the following must have been consistently present: Though the activities one participates in while in a manic state are not always negative, those with the potential to have negative outcomes are far more likely. If the person is concurrently depressed, they are said to be having a mixed episode . The World Health Organization 's International Classification of Diseases (ICD) defines

3760-613: Is seen in delirious states. Astasia-abasia is a form of psychogenic gait disturbance in which gait becomes impaired in the absence of any neurological or physical pathology. The person usually walks in a bizarre manner. They stagger and appear as if going to fall, but always manage to catch hold of something in time. Sometimes these people cannot even stand, but on the other hand they are well able to move their legs while lying down or sitting. Often associated with conversion disorder or somatization disorder. Asyndesis means loosening of association. A milder form of derailment of thought, it

3840-442: Is sometimes used to mean clouding of consciousness, but is avoided whenever possible because it is ambiguous. Irritability Irritability is the excitatory ability that living organisms have to respond to changes in their environment. The term is used for both the physiological reaction to stimuli and for the pathological , abnormal or excessive sensitivity to stimuli. When reflecting human emotion and behavior , it

3920-442: Is used for both the physiological reaction to stimuli and for the pathological , abnormal or excessive sensitivity to stimuli. Irritability can be demonstrated in behavioral responses to both physiological and behavioral stimuli, including environmental, situational, sociological , and emotional stimuli. In humans, irritability may be a significant transdiagnostic symptom or disposition that occurs across or at any point during

4000-609: Is used to promptly alleviate symptoms of agitation, aggression , and psychosis . Antidepressant monotherapy is not recommended for the treatment of depression in patients with bipolar disorders I or II, and no benefit has been demonstrated by combining antidepressants with mood stabilizers in these patients. Some atypical antidepressants , however, such as mirtazapine and trazodone , have been occasionally used after other options have failed. In Electroboy: A Memoir of Mania by Andy Behrman, he describes his experience of mania as "the most perfect prescription glasses with which to see

4080-485: Is useful from a descriptive and differential diagnostic point of view. Mania varies in intensity, from mild mania ( hypomania ) to delirious mania, marked by such symptoms as disorientation, acute psychosis , incoherence, and catatonia . Standardized tools such as Altman Self-Rating Mania Scale and Young Mania Rating Scale can be used to measure severity of manic episodes. Because mania and hypomania have also long been associated with creativity and artistic talent, it

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4160-418: Is usually seen in children. In Capgras syndrome , the individual feels that a person familiar to them, usually a family member, has been replaced by an imposter . This is a type of delusion that can be experienced as part of schizophrenia . Capgras syndrome and several other related disorders are referred to as " delusional misidentification syndrome ". Catalepsy is the term for catatonic rigidity of

4240-618: The ICD-10 , there are several disorders with the manic syndrome: organic manic disorder ( F06.30 ), mania without psychotic symptoms ( F30.1 ), mania with psychotic symptoms ( F30.2 ), other manic episodes ( F30.8 ), unspecified manic episode ( F30.9 ), manic type of schizoaffective disorder ( F25.0 ), bipolar disorder , current episode manic without psychotic symptoms ( F31.1 ), bipolar affective disorder, current episode manic with psychotic symptoms ( F31.2 ). Before beginning treatment for mania, careful differential diagnosis must be performed to rule out secondary causes. The acute treatment of

4320-1364: The amygdala and other subcortical structures such as the ventral striatum tend to be increased, although results are inconsistent and likely dependent upon task characteristics such as valence. Reduced functional connectivity between the ventral prefrontal cortex and amygdala along with variable findings supports a hypothesis of general dysregulation of subcortical structures by the prefrontal cortex. A bias towards positively valenced stimuli , and increased responsiveness in reward circuitry may predispose towards mania. Mania tends to be associated with right hemisphere lesions, while depression tends to be associated with left hemisphere lesions. Post-mortem examinations of bipolar disorder demonstrate increased expression of Protein Kinase C (PKC). While limited, some studies demonstrate manipulation of PKC in animals produces behavioral changes mirroring mania, and treatment with PKC inhibitor tamoxifen (also an anti-estrogen drug) demonstrates antimanic effects. Traditional antimanic drugs also demonstrate PKC inhibiting properties, among other effects such as GSK3 inhibition. Manic episodes may be triggered by dopamine receptor agonists , and this combined with tentative reports of increased VMAT2 activity, measured via PET scans of radioligand binding , suggests

4400-638: The subthalamic nucleus in Parkinson's disease has been associated with mania, especially with electrodes placed in the ventromedial STN . A proposed mechanism involves increased excitatory input from the STN to dopaminergic nuclei. There are certain psychoactive substances that can induce a state of manic psychosis, including: amphetamine , cathinone , cocaine , MDMA , methamphetamine , methylphenidate , oxycodone , phencyclidine , designer drugs , etc. Mania can also be caused by physical trauma or illness . When

4480-670: The ability to think clearly. Racing thoughts and misperceptions lead to frustration and decreased ability to communicate with others. Mania may also, as earlier mentioned, be divided into three "stages". Stage I corresponds with hypomania and may feature typical hypomanic characteristics, such as gregariousness and euphoria . In stages II and III mania, however, the patient may be extraordinarily irritable, psychotic or even delirious . These latter two stages are referred to as acute and delirious (or Bell's), respectively. Various triggers have been associated with switching from euthymic or depressed states into mania. One common trigger of mania

4560-740: The causes are physical, it is called secondary mania . In some individuals, manic symptoms are also correlated with the season of spring. The mechanism underlying mania is unknown, but the neurocognitive profile of mania is highly consistent with dysfunction in the right prefrontal cortex , a common finding in neuroimaging studies. Various lines of evidence from post-mortem studies and the putative mechanisms of anti-manic agents point to abnormalities in GSK-3 , dopamine , Protein kinase C , and Inositol monophosphatase . Meta analysis of neuroimaging studies demonstrate increased thalamic activity, and bilaterally reduced inferior frontal gyrus activation. Activity in

4640-416: The cortex. Pituitary adenylate cyclase-activating peptide has been associated with bipolar in gene linkage studies, and knockout in mice produces mania like-behavior. Targets of various treatments such as GSK-3 , and ERK1 have also demonstrated mania like behavior in preclinical models. Mania may be associated with strokes, especially cerebral lesions in the right hemisphere. Deep brain stimulation of

4720-400: The current DSM-5 , hypomanic episodes are separated from the more severe full manic episodes, which, in turn, are characterized as either mild, moderate, or severe, with certain diagnostic criteria (e.g., catatonia , psychosis ). Mania is divided into three stages: hypomania, or stage I; acute mania, or stage II; and delirious mania ( delirium ), or stage III. This "staging" of a manic episode

4800-406: The elevated mood and energy level typical of hypomania could be seen as a benefit, true mania itself generally has many undesirable consequences, including suicidal tendencies , and hypomania can, if the prominent mood is irritable as opposed to euphoric , be a rather unpleasant experience. In addition, the exaggerated case of hypomania can lead to problems. For instance, trait-based positivity for

4880-428: The first few months of life. Achromatopsia is different from the more common forms of color vision deficiency (also called color blindness), in which people can perceive color but have difficulty distinguishing between certain colors, such as red and green. Mild illusions or misperceptions associated with changes in mood; e.g. mistaking a shadow for the presence of a person, perceiving movement in peripheral when there

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4960-426: The flow of thoughts. Racing thoughts also interfere with the ability to fall asleep. Manic states are always relative to the normal state of intensity of the affected individual; thus, already irritable patients may find themselves losing their tempers even more quickly, and an academically gifted person may, during the hypomanic stage, adopt seemingly "genius" characteristics and an ability to perform and articulate at

5040-485: The former, speech, though adequate in verbiage, conveys very little information and may consist of stock phrases or vague references. In poverty of thought, by contrast, there is a far-reaching impoverishment of the entire thinking of the individual, who, as a result, says very little. It is typically a negative symptom of schizophrenia , although it may also be seen in advanced dementia. Amenomania (compound of Latin amoenus , "cheerful"; and Greek μανία, "madness")

5120-404: The general criteria for a hypomanic (discussed below) or manic episode, experiences three or more concurrent depressive symptoms. This has caused some speculation, among clinicians, that mania and depression, rather than constituting "true" polar opposites, are, rather, two independent axes in a unipolar—bipolar spectrum. A mixed affective state, especially with prominent manic symptoms, places

5200-439: The individual's lack of judgment and insight regarding periods of exacerbation of characteristic states. Manic patients are frequently grandiose, obsessive, impulsive, irritable, belligerent, and frequently deny anything is wrong with them. Because mania frequently encourages high energy and decreased perception of need or ability to sleep, within a few days of a manic cycle, sleep-deprived psychosis may appear, further complicating

5280-686: The influence of a stimulant drug, when the patient, in fact, is either not on any mind-altering substances or is actually on a depressant drug. Individuals may also engage in out-of-character behavior during the episode, such as questionable business transactions, wasteful expenditures of money (e.g., spending sprees), risky sexual activity, abuse of recreational substances, excessive gambling, reckless behavior (such as extreme speeding or other daredevil activity), abnormal social interaction (e.g., over-familiarity and conversing with strangers), or highly vocal arguments. These behaviours may increase stress in personal relationships, lead to problems at work, and increase

5360-443: The lifespan. It is commonly defined as the tendency to react to stimuli with the experience of negative affective states (especially anger) and temper outbursts, which may or may not be aggressive. This definition is well known to have similarities with the definitions of anger and aggression . New hypotheses and data-driven research are focused on identifying what is unique to irritability, anger, and aggression. The definition

5440-478: The limbs which often results in abnormal posturing for long intervals. Cataplexy refers to a sudden loss of muscle tone and is commonly precipitated by a strong emotional response. Catatonia involves a significant psychomotor disturbance, which can occur as catalepsy , stupor , excessive purposeless motor activity, extreme negativism (seemingly motiveless resistance to movement), mutism , echolalia (imitating speech), or echopraxia (imitating movements). There

5520-465: The manic side of his condition has had positive contributions on his life. The nosology of the various stages of a manic episode has changed over the decades. The word derives from the Ancient Greek μανία ( manía ), "madness, frenzy" and the verb μαίνομαι ( maínomai ), "to be mad, to rage, to be furious." Flight of Ideas This glossary covers terms found in the psychiatric literature;

5600-440: The patient at a greater risk for suicide . Depression on its own is a risk factor but, when coupled with an increase in energy and goal-directed activity, the patient is far more likely to act with violence on suicidal impulses. Hypomania , which means "less than mania", is a lowered state of mania that does little to impair function or decrease quality of life. Although creativity and hypomania have been historically linked,

5680-430: The pursuit of what they are after. Hypomania is different, as it may cause little or no impairment in function. The hypomanic person's connection with the external world, and its standards of interaction, remain intact, although intensity of moods is heightened. But those with prolonged unresolved hypomania do run the risk of developing full mania, and may cross that "line" without even realizing they have done so. One of

5760-493: The risk of altercations with law enforcement. There is a high risk of impulsively taking part in activities potentially harmful to the self and others. Although "severely elevated mood" sounds somewhat desirable and enjoyable, the experience of mania is ultimately often quite unpleasant and sometimes disturbing, if not frightening, for the person involved and for those close to them, and it may lead to impulsive behaviour that may later be regretted. It can also often be complicated by

5840-467: The risk of bipolar manic relapse, by 42%. Anticonvulsants such as valproate , oxcarbazepine , and carbamazepine are also used for prophylaxis . More recent drug solutions include lamotrigine and topiramate , both anticonvulsants as well. In some cases, long-acting benzodiazepines , particularly clonazepam , are used after other options are exhausted. In more urgent circumstances, such as in emergency rooms, lorazepam , combined with haloperidol ,

5920-557: The self. In Alice in Wonderland experience, individuals perceive objects (including animals and other humans, or parts of humans, animals, or objects) as appearing substantially smaller than in reality. Generally, the object appears far away or extremely close at the same time. An alternate term for this is somaesthetic aura . Also see § Lilliputian hallucinations Literally, this term means "not having words". The term may refer to either "poverty of speech" or "poverty of thought". In

6000-416: The signature symptoms of mania (and to a lesser extent, hypomania ) is what many have described as racing thoughts . These are usually instances in which the manic person is excessively distracted by objectively unimportant stimuli. This experience creates an absent-mindedness where the manic individual's thoughts totally preoccupy them, making them unable to keep track of time, or be aware of anything besides

6080-650: The suffix "-mania," namely, kleptomania , pyromania , and trichotillomania . Despite the unfortunate association implied by the name, however, no connection exists between mania or bipolar disorder and these disorders. Furthermore, evidence indicates a vitamin B 12 deficiency can also cause symptoms characteristic of mania and psychosis. Hyperthyroidism can produce similar symptoms to those of mania, such as agitation, elevated mood, increased energy, hyperactivity, sleep disturbances and sometimes, especially in severe cases, psychosis. Postpartum psychosis can also cause manic episodes ( unipolar mania ). A manic episode

6160-449: The treatment of acute mania was reviewed by Tohen and Vieta in 2009. When the manic behaviours have gone, long-term treatment then focuses on prophylactic treatment to try to stabilize the patient's mood, typically through a combination of pharmacotherapy and psychotherapy . The likelihood of having a relapse is very high for those who have experienced two or more episodes of mania or depression. While medication for bipolar disorder

6240-504: The word origins are primarily Greek , but there are also Latin , French , German , and English terms. Many of these terms refer to expressions dating from the early days of psychiatry in Europe. Abreaction is a process of vividly reliving repressed memories and emotions related to a past event. Sigmund Freud used hypnosis to rid his patients of pathological memories through abreaction. Aboulia or Abulia , in neurology, refers to

6320-484: The world... life appears in front of you like an oversized movie screen." Behrman indicates early in his memoir that he sees himself not as a person with an uncontrollable disabling illness, but as a director of the movie that is his vivid and emotionally alive life. There is some evidence that people in the creative industries have bipolar disorder more often than those in other occupations. Winston Churchill had periods of manic symptoms that may have been both an asset and

6400-450: Was interpreted in the context of either elevated baseline activity (resulting in a null finding of reward hypersensitivity), or reduced ability to discriminate between reward and punishment, still supporting reward hyperactivity in mania. Punishment hyposensitivity , as reflected in a number of neuroimaging studies as reduced lateral orbitofrontal response to punishment, has been proposed as a mechanism of reward hypersensitivity in mania. In

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