Dysphoric Mania
11 Minutes
CONTENTS
Dysphoric mania is a subtype and a part of the bipolar disorder spectrum. It is different from other types of mania because dysphoric mania includes irritability, agitation, and deep feelings of sadness. This particular state is quite problematic as it includes the impulsiveness and restlessness of mania and the hopelessness and exhaustion of depression.
Dysphoric mania episodes can be of a short-term nature, lasting for several days, or long-term, up to several months, depending on factors such as stress, sleep, and compliance with the prescribed medications.
Some of the early signs that should be looked at include changes in irritability and mood swings. It is generally managed through medication, therapy, and alteration of lifestyle to reduce the severity and frequency of episodes.
Dysphoric mania is an intricate and demanding state because it combines the features of mania, such as increased energy and impulsivity, with the signs of depression and its discomfort. This combination can lead to severe emotional disturbance and dysfunction. Dysphoric mania is different from other types of mania where people may feel euphoric and powerful, but instead, they may be irritated, anxious, and sad.
Key Features Of Dysphoric Mania
The following are the main characteristics of dysphoric mania:
Mixed Emotions: Dysphoric mania is defined by the coexistence of manic and depressive symptoms in the same episode. This implies that despite the energy, increased activity, and restlessness associated with mania, a person may also feel sad, hopeless, and worthless.
Increased Risk: Because of the cycling between manic energy and depressive despair, those with dysphoric mania are more likely to engage in self-harm and suicidal ideation. This can in turn make it difficult for them to handle other issues that are likely to come their way daily.
Unpredictable Behavior: High energy and negative affect can lead to behaviors that are unpredictable and may at times be risky. People can be reckless, become violent, or commit actions that they will later regret [1].
How Does Dysphoric Mania Impact Daily Life
It is not easy to live with dysphoric mania, as it is a severe condition that requires constant attention and care. This condition impacts social, occupational, and mental functioning in a person’s life. Here are some ways it can impact daily life:
Social Relationships: The symptoms of dysphoric mania such as irritability and mood swings are likely to cause conflict with family, friends, and even at the workplace. People may have problems with their relationships and may not be able to sustain normal and healthy interactions.
Productivity: The energy level and mood swings can be a problem when it comes to concentration, meeting deadlines, and being productive at work. This can impact the performance of a worker and the chances of a promotion.
Personal Well-being: The emotional stress and physical fatigue that comes with the condition can greatly affect one’s well-being. They might find it hard to do regular exercises, have a balanced diet, and have quality sleep at night [1].
A dysphoric mood is a state of mind which is associated with a mix of emotions such as anger, restlessness, and, depression. Thus, dysphoric mood is different from merely sad mood, as it also contains symptoms characteristic of mania, such as increased energy, irritability, and lack of self-control [2].
A dysphoric mood makes an individual move from feeling happy to feeling very sad within a short period, thus making the behavior of the patient unpredictable. The energy and negative emotions cause impulsiveness and increase the chances of self-harm or suicidal thoughts in a person.
Depression is mainly characterized by a low mood which is often described as feeling sad, empty, or hopeless. People with depressed moods are usually tired and have no energy to do things that are required to be done daily [2].
One of the diagnostic symptoms of depression is the lack of interest and pleasure in previously enjoyable things. Cognitive impairment manifests itself in problems with concentration, decision-making, and memory in patients with depression.
Now let’s have a look at the roots and origins of dysphoric mania.
Biological Factors
Dysphoric mania like other types of bipolar disorder is also determined by several biological factors. These include:
Genetics: If one has a family history of bipolar disorder or other mood disorders, then one is likely to develop dysphoric mania. Some people possess specific genes that put them at a higher risk of developing mood swings.
Brain Structure and Function: Neuroanatomic and neurophysiological abnormalities have also been reported in bipolar disorder. Neuroanatomical changes in the mood regulation circuits including the prefrontal cortex and amygdala might be involved in dysphoric mania [3].
Neurotransmitter Imbalance: Neurotransmitters are chemical substances that are present in the brain and which can control mood. These chemical imbalances may involve serotonin, dopamine, and norepinephrine neurotransmitters in which dysphoric mania is a feature of mood disorders.
Psychological Factors
It is also important to note that other psychological factors may cause dysphoric mania. These factors include:
Stress and Trauma: This type of mania is often associated with high levels of stress or traumatic events in a person’s life. Stressful life experiences like bereavement, change of job, or other stressful circumstances can trigger it.
Personality Traits: Some personality traits may predispose an individual to mood disorders, including dysphoric mania, for example, high neuroticism. These traits can also make individuals more susceptible to mood fluctuations and other forms of emotional stress.
Environmental Factors
Environmental factors are also important in the development and progress of dysphoric mania. These factors include:
Substance Abuse: Dysphoric mania can be precipitated or exacerbated by the use of alcohol or drugs. Drugs and alcohol can alter the brain chemistry and worsen mood swings.
Sleep Disruption: Sleep disturbances or lack of sleep can cause mood episodes, which means that a person has to have a proper sleep schedule. Lack of sleep causes manic or depressive episodes, and bipolar patients need to keep their sleeping habits consistent.
Lifestyle Factors: Stressful living conditions, unhealthy diet, sedentary lifestyle, and social isolation are some of the factors that can cause dysphoric mania and its severity. These are some of the ways that can be adopted to reduce and prevent the severity of the symptoms.
Medical Conditions and Medications
Some medical conditions and treatments also play a role in dysphoric mania, for instance, hormonal imbalances and contraceptive pills. These include:
Thyroid Disorders: Dysfunction of the thyroid gland also influences mood and energy, which can lead to mania or depression.
Chronic Illness: Medical conditions that result in chronic stress and pain may also put a person in a state of dysphoric mania due to mood swings.
Medication Side Effects: Certain drugs, especially those that act on the brain, may have side effects that include mood swings or mania. These side effects should be closely watched and treated with the assistance of a doctor.
Dysphoric mania symptoms can be categorized into manic, depressive, and mixed symptoms. Let’s have a quick look.
Manic Symptoms
Elevated Mood
- Experiencing an increase in energy levels, needing less sleep than usual, and being more talkative than before.
Increased Energy
- Energy, restlessness, and inability to sit still or remain still for long periods.
- Doing many things at once, and not being able to finish them.
Reduced Need for Slee
- Getting up fresh after having slept for just a few hours.
- Sleeplessness is a result of having many thoughts that would not allow one to sleep or wake up in the middle of the night.
Grandiosity
- Being proud or having excessive pride in one’s abilities, achievements, or possessions.
- The delusional conviction that one possesses extraordinary capacities or skills.
Talkativeness
- Speaking at a louder volume than usual using more words than usual, and/or speaking rapidly.
- Having a compulsion to continue speaking, and very often cutting others off.
Racing Thoughts
- A state of mind in which the flow of ideas is fast and one idea is succeeded by another one.
- Inability to focus on a single object or subject or in a single conversation.
Impulsivity
- Exposing oneself to danger, for example, shopping till the last cent, speeding, or taking drugs.
- This is a scenario where people make decisions without much thought being given to the effects of the decision to be made.
Depressive Symptoms
Sadness and Hopelessness
- Experiencing a sense of hopelessness, emptiness, or sadness that might be described as depression.
- Having to cry often and or feeling like crying but being unable to do so.
Irritability
- Getting irritated or angered very quickly, and this may be over trifles.
- Engaging in frequent fights or quarrels with other people.
Loss of Interest
- Feeling less pleasure from the things and events that previously gave pleasure.
- Avoiding other people and staying alone.
Fatigue
- Having the physical and mental fatigue that comes with the lack of energy expenditure.
- Being unable to get up from bed or perform simple tasks.
Guilt and Worthlessness
- Experiencing too much guilt or being worthless.
- Taking responsibility for matters that are not in any way one’s responsibility.
Difficulty Concentrating
- Difficulty in concentrating or in making choices.
- Problems with memory like forgetting things and not being able to recall information.
Appetite Changes
- Suffering from a major weight loss or weight gain.
- Lack of appetite or eating very little or eating a lot.
Mixed Symptoms
Dysphoric mania is a mood state that has elements of both manic and depressive episodes, which results in a state of agitation. This is especially so given that the presence of both types of symptoms can worsen the condition and its management.
Key mixed symptoms include:
Agitation: Suffering from nervousness and cannot sit still, may walk around or twist their hands.
Rapid Mood Swings: Fluctuating rapidly from one extreme of mood to the other, or from elation to depression.
Suicidal Thoughts: Having thoughts of self-harm or suicide, which can be more severe because of impulsivity and depression.
Aggression: This will cause one to become more easily angered or even become aggressive.
With the background of common symptoms, let’s have a brief review of the methods, tips, and strategies to prevent, manage, and treat dysphoric mania.
1. Medical Treatment
Medication
Mood Stabilizers: Lithium and other similar drugs can be prescribed for the treatment of mood swings and the stabilization of emotions.
Antipsychotics: Olanzapine or risperidone can lower the symptoms of mania and are recommended for use in bipolar disorders.
Antidepressants: These may be used cautiously as they may cause mania. Sometimes, they are prescribed together with mood stabilizers.
Regular Monitoring
A visit to a psychiatrist should be done often enough to monitor the patient’s progress and change the medications if necessary.
Some patients may require regular blood tests to check the levels of the administered medication or to determine whether the levels are still within the therapeutic window.
2. Therapy and Counseling
Cognitive Behavioral Therapy (CBT)
CBT can assist a person in reevaluating the negative patterns of thinking and behavior.
It offers ways of dealing with stress and avoiding stimuli that provoke it.
Psychoeducation
Education about dysphoric mania assists in the management of the condition and also aids the affected individuals and their families in gaining knowledge about the condition.
It enables them to identify the precursors of episodes and act in a way that would prevent them.
Support Groups
Support groups can help in getting emotional support and the feeling of loneliness is reduced.
Just talking to someone who has gone through a similar situation can be comforting and encouraging.
3. Lifestyle Changes
Routine and Structure
Routine is another way of creating a structure; it is recommended that one sets a daily schedule.
Routines such as sleeping, eating, and exercising can play a crucial role in stabilizing the mood.
Healthy Diet
Consuming a meal plan that contains a proper intake of nutrients can enhance the quality of life.
This can be avoided by reducing the intake of products containing caffeine, and taking foods rich in sugar and processed foods.
Exercise
Physical exercise can help to decrease stress and increase mood.
This means that even simple activities such as walking can be very beneficial.
Sleep Hygiene
Getting enough sleep is important to maintaining a good mood.
Going to bed with a routine and having the right sleep environment will help in having a better quality of sleep.
4. Stress Management
Relaxation Techniques
Activities such as deep breathing, meditation, and yoga are some of the ways that can be used to control stress and anxiety.
Mindfulness can assist people in staying present and prevent them from getting distracted.
Time Management
Time management can help in minimizing feelings of being overwhelmed by first arranging the tasks in order of importance, and then subdividing each of the tasks into more manageable parts.
Avoiding over-commitment is important and one way of doing this is to learn how to say no and how to delegate when the need arises.
4. Social Support
Family and Friends
It is important to maintain interaction with people who are encouraging and caring.
It is crucial to be as honest as possible when it comes to expressing needs and setting boundaries to sustain a good relationship.
Avoiding Isolation
Social interaction and having friends and relatives to interact with help to overcome loneliness and depression.
One can volunteer or participate in clubs to have a purpose and to feel like one belongs to a group.
5. Crisis Plan
Emergency Contacts
It is important to have a list of contacts in case of emergency, including doctors and close relatives.
It is good to know who to call when one is in a fix as this creates a safety net.
Safe Environment
Isolating or restricting objects that may be dangerous in the event of an outburst can help avoid destructive decisions.
It is possible to build a safe environment at home when one feels overwhelmed, and this will come in handy.
6. Self-Awareness
Tracking Mood
A mood diary is useful to know when you feel low and what has caused it.
Being able to identify changes in mood, sleep, and behavior may help in the early detection of the problem.
Recognizing Warning Signs
It is helpful to know what signals dysphoric mania is showing in the beginning so that one can act quickly.
Reporting these signs to a healthcare provider may result in modification of treatment plans.
1. WebMD. What Is Dysphoric Mania? https://www.webmd.com/bipolar-disorder/dysphoric-mania
2. Choosing Therapy. Dysphoric Mania: Definition, Symptoms, & Treatment. https://www.choosingtherapy.com/dysphoric-mania/
3. Medical News Today. How does dysphoric mania feel? https://www.medicalnewstoday.com/articles/315016
4. Healthline. Dysphoric Mania: Symptoms, Treatment, and More. https://www.healthline.com/health/bipolar-disorder/dysphoric-mania
FAQs
Can You Be Manic And Depressed At The Same Time?
Yes, it is possible to be manic and depressed at the same time, this is called dysphoric mania or a mixed state. This is a state in which a person simultaneously experiences symptoms of mania and depression, including elation, increased energy, and impulsivity on one hand, and sadness, hopelessness, and fatigue on the other. Such pairing can cause serious emotional reactions and should be managed cautiously.
How Long Does Dysphoric Mania Last?
The period of dysphoric mania can also differ from one person to another. Some episodes may be short-lived and may only take a few days while others may take weeks or even months. The duration of an episode depends on issues like compliance with medications, level of stress, and general state of well-being. Proper management of the condition and seeking medical attention at the right time can prevent the episodes from being severe and long-lasting.
Can Dysphoric Mania Be Misdiagnosed?
Yes, dysphoric mania can be misdiagnosed because it shares some of the symptoms with other mental disorders like major depressive disorder, borderline personality disorder, or anxiety disorders. Manic and depressive symptoms are often mixed and this can lead to misdiagnosis of the actual condition. An assessment by a mental health care professional is imperative to get a correct diagnosis of the condition.
Is There A Genetic Test For Dysphoric Mania?
To date, there is no direct genetic test for dysphoric mania. While current studies show that there is a genetic component to bipolar disorder and dysphoric mania, the disorder is polygenic, and the genes interact with the environment. Diagnostic tests for bipolar disorder and its subtypes through genetic testing are still unavailable.
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