Mania deutsch

mania deutsch

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Choo Choo along, collect all the gems, avoid getting trapped or bumping into your own carriages. Progress levels all of them. A single manic episode, in the absence of secondary causes, i.

Hypomania may be indicative of bipolar II disorder. Certain of " obsessive-compulsive spectrum" disorders as well as impulse control disorders share the name "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.

B 12 deficiency can also cause characteristics 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.

To be classed 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 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 classification system defines 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, accompanied by hyperactivity, a compulsion to speak, a reduced sleep requirement, difficulty sustaining attention and often increased distractibility.

Frequently, confidence and self-esteem are excessively enlarged, and grand, extravagant ideas are expressed.

Behavior that 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 his or her goal s trump all else, that there are no consequences or that negative consequences would be minimal, and that they need not exercise restraint in the pursuit of what they are after.

The hypomanic person's connection with the external world, and its standards of interaction, remain intact, although intensity of moods is heightened.

But those who suffer from prolonged unresolved hypomania do run the risk of developing full mania, and indeed may cross that "line" without even realizing they have done so.

One of 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. Racing thoughts also interfere with the ability to fall asleep.

Manic states are always relative to the normal state of intensity of the afflicted 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 a level far beyond that which would be capable during euthymia.

A very simple indicator of a manic state would be if a heretofore clinically depressed patient suddenly becomes inordinately energetic, cheerful, aggressive, or "over happy.

Individuals may also engage in out-of-character behavior during the episode, such as questionable business transactions, wasteful expenditures of money e.

These behaviours may increase stress in personal relationships, lead to problems at work and increase the risk of altercations with law enforcement.

There is a high risk of impulsively taking part in activities potentially harmful to 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 the sufferer'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 the ability to think clearly.

Racing thoughts and misperceptions lead to frustration and decreased ability to communicate with others. In stages II and III mania, however, the patient may be extraordinarily irritable, psychotic or even delirious.

Various triggers have been associated with switching from euthymic or depressed states into mania. One common trigger of mania is antidepressant therapy.

Studies show that the risk of switching while on an antidepressant is between percent. Dopaminergic drugs such as reuptake inhibitors and dopamine agonists may also increase risk of switch.

Other medication 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 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 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. Mania can also be caused by physical trauma or illness.

When the causes are physical, it is called secondary mania. 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.

Meta analysis of neuroimaging studies demonstrate increased thalamic activity, and bilaterally reduced inferior frontal gyrus activation.

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.

Manic episodes may be triggered by dopamine receptor agonists, and this combined with tentative report of increased VMAT2 activity, measured via PET scans of radioligand binding, suggest 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 hypersensitivty, 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 generally though 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 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.

In the ICD there are several disorders with the manic syndrome: Before beginning treatment for mania, careful differential diagnosis must be performed to rule out secondary causes.

The acute treatment of a manic episode of bipolar disorder involves the utilization of either a mood stabilizer valproate, lithium, or carbamazepine or an atypical antipsychotic olanzapine, quetiapine, risperidone, or aripiprazole.

Although hypomanic episodes may respond to a mood stabilizer alone, full-blown episodes are treated with an atypical antipsychotic often in conjunction with a mood stabilizer, as these tend to produce the most rapid improvement.

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 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. More recent drug solutions include lamotrigine , which is another anticonvulsant.

Clonazepam Klonopin is also used. Sometimes atypical antipsychotics are used in combination with the previous mentioned medications as well, including olanzapine Zyprexa which helps treat hallucinations or delusions, Asenapine Saphris, Sycrest , aripiprazole Abilify , risperidone , ziprasidone , and clozapine which is often used for people who do not respond to lithium or anticonvulsants.

Verapamil , a calcium-channel blocker, is useful in the treatment of hypomania and in those cases where lithium and mood stabilizers are contraindicated or ineffective.

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.

A Memoir of Mania by Andy Behrman , he describes his experience of mania as "the most perfect prescription glasses with which to see the world The nosology of the various stages of a manic episode has changed over the decades.

From Wikipedia, the free encyclopedia. Redirected from Manic disorder.

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