Welcome to the Jungle. Hilary T. Smith
this shift messes up your ability to relate to other people or get your work done. If you're normally a beast on the dance floor who loves to hook up with hot strangers, good for you (enjoy herpes)! If you're a lifelong wallflower who is suddenly electrified with the belief that you're Justin Timberlake bringing sexxy back—well, maybe that's not normal. Let's be perfectly clear: you're allowed to grow and change, try new things, whatever. If done with a clear mind, almost any action you undertake can be considered normal. You should worry about it only if you start basing your actions on unusual logic or logic radically different than your default setting, or if people around you start noticing a marked departure from your usual behavior.
Going skydiving because you think it's cool = normal. Going skydiving because you temporarily believe you're an invincible god = not normal. Being a talkative person = normal. All your friend are staring at you because you've been talking like an auctioneer all day = not normal.
MANIA
All ghostin' aside, what is mania, and how can you or other people tell if you're manic? You're manic if your belief about your own capacities expands drastically, if you start engaging in activities that are drastically out of character, making plans drastically out of sync with reality, or behaving in an overblown, irrational, out-of-control manner. It can be hard for you to tell if you're manic, at least immediately, but it's pretty easy for other people to tell. You think you're a celebrity, believe you can walk in front of traffic, and obsessively call the Federal Reserve to tell them your brilliant solution to the economic recession. You feel like you don't need to eat or sleep, and feel a vast and potent connection to complete strangers. Words tumble out of your mouth in a great flood. You start taking your job as a mall cop too seriously and stay up all night drafting a new and improved plan for mall safety, which you work on tirelessly with no breaks for several days. It's the key, the key. People spend all their time in malls, right? Safety is key, right? Mall safety, that's where it's at, that's where it's at. Your friends and family notice a difference and try to talk you down. “Dear, can we not talk about the menace of escalators tonight?”
Technically, mania is defined by the DSM-IV as “a distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least one week (or any duration if hospitalization is necessary).” Therefore, drinking too much coffee and running around like a ferret for one day doesn't qualify as a manic episode (unless you get caught by animal control and hospitalized for it). The DSM-IV lists seven symptoms of mania, at least four of which are usually present in a full-blown manic episode:1
1 Inflated self-esteem or grandiosity You (mistakenly) think you're famous and important or think you have special powers. You suddenly realize you're a better painter than anyone else in your art class, and start plotting an elaborate gallery opening at the Museum of Modern Art, featuring your work next to Van Gogh's. Your teacher is confused because this represents a major change from your normally humble personality.
2 Decreased need for sleep You keep coming home from the bar at 3 a.m. Tonight you take a one-hour nap, then go for a run, paint the house, and organize a dinner party for all your friends. Sleep is a bad word.
3 More talkative than usual You have pressured speech (the sensation that you need to be talking) and a flood of ideas you need to express. Friends and teachers ask you to slow down and explain your thoughts, but it's too hard.
4 Flight of ideas, racing thoughts Your mind is like a speeding train, or several speeding trains on different tracks. You can't slow down your thoughts, and your ideas fly to their wildest conclusions. You might enjoy the sensation of being flooded with ideas at first, but later become overwhelmed and terrified by it.
5 Distractibility What?
6 Increase in goal-setting activity or psychomotor agitation You're working on a very important project and realize there are three other side projects you should be doing to really get it working. You check twenty books out of the library and start researching every aspect of your subject area. You don't understand why other people can't see the importance of your project. You feel the need to move around a lot.
7 Excessive involvement in pleasurable activities (such as buying sprees, sexual indiscretions, or foolish business investments) You run to the bar and make out with three different people over the course of a Rihanna single. You buy everyone a round, then flag down a taxi and give the driver a $100 tip for driving you home. You want to buy expensive presents for everybody you know.
The DSM-IV definition goes on to state that the above symptoms should not be the result of illegal drugs and must be severe enough to really wreck havoc on your normal life. Psychosis is sometimes a feature of manic episodes, too.
Everyone's experience of mania is different. Some people experience it as a fabulous period of elation, while other people get extremely agitated and experience no pleasure at all. Mania is on a continuum—it takes your normal behaviors and personality and amplifies them. A manic episode can lead to hospitalization or self-harm, and the tomfoolery you get up to while manic can demolish your savings, land you in prison, and make you feel embarrassed later on. Mania can also give you a unique drive and a window into realms of the mind that are inaccessible to most people. In other cultures, mania might be given a different name and be seen as a religious experience. The important thing isn't definitions, which change over time, but effects, which vary from person to person. For some people, mania has the effect of a revelation or mystical experience, while for others it only causes misery.
PUTTING IT ALL TOGETHER
Here's how mania might look. The numbers below refer to the symptoms listed on pages 34 and 35.
Let's say you work at a call center for IBM. You spend all day on the phone to customers, helping them fix their computer problems. You're also in charge of logging their questions and complaints in a database. Over the course of a week, you start to notice connections between calls that you never noticed before (4). You realize there's a pattern to the database that could revolutionize the future of IBM (1). You start staying at the office long past closing time, working on solving this pattern far into the wee hours (6). Solving the pattern is more important than eating or sleeping (2). When you tell your coworkers and supervisors about the pattern you discovered, they seem confused, though you talk about it incessantly (3). You get frustrated because nobody else can see how important and revolutionary your discovery is. Even your girlfriend doesn't understand your great discovery, but she wants you to tell Dr. Brunner about it because she thinks he will.
HYPOMANIA
For hypomania, take the mania section and turn the volume down several notches. You talk faster, walk faster, and think faster—enough for other people to comment. Maybe you start writing a novel, building a sailboat, and recording an electro album all on the same day. Or you join a rock-climbing gym because you “suddenly” realize you'd make a fabulous rock climber. It's hard to sleep and hard to sit still and listen when someone else is talking. Other people seem to be talking and moving incredibly slowly. Sitting in class is torture because it seems to drag on for hours and hours, and you've got more important things to do! You might be agitated and elated at the same time, the life of the party, but your engine's running a little hot. You dance down the street, filled with this wonderful sense of how happy the world is, or flit around your room like a trapped fly.
The DSM-IV definition of hypomania includes the same seven symptoms as for mania, but the difference is that the episode is not severe enough to land you in the hospital or make it impossible for you to get through a normal day at work or school. It also notes that a change in your mood and behavior should be observable to other people (i.e., that your parents or friends notice that you're talking faster and making uncharacteristic judgments). A hypomanic episode marks a distinct change from your usual self, and the elevated, expansive, or irritated mood should last for at least four days. Hypomania usually isn't accompanied by psychosis, and it doesn't count (at least, not to the guy in the white coat) if your symptoms are due to your taking a drug like ecstasy.