Getting a Grip on Mania

The electrifying pulse of elevated mood plays out in different ways—and often leads to scorching consequences

By Donna Jackel

When Keely Petri describes her first manic episode, she lists what might be considered “classic” symptoms.

“I had lots of energy, a case of the giggles, and racing thoughts,” says Petri, 43. “I couldn’t sit still. I’d go to my office and sit down and then I’d have to get up and pace the floors.

“I felt like Wonder Woman,” adds Petri, who lives outside of Boston. “No one could knock me down.”

For Julianna Shapiro of Orange County, California, the trademark manic exhilaration quickly breaks down into agitation, irritability, and physical discomfort.

“I get like 24 hours of euphoria and then a feeling like ants in my pants—like I’m crawling out of my skin,” the 46-year-old reports. “I get very agitated and I pick on people.”

In this mindset, Shapiro can’t stand to see things out of place. She’ll yell at her husband for leaving his shoes in the family room or dramatically sweep messy papers to the floor.

“I scratch my neck until it’s red,” she adds. “I feel so yecch.”

Psychiatry has established a central set of criteria to diagnose mania. But the list of symptoms in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) doesn’t fully reflect how mania can vary from individual to individual.

Just as episodes play out differently for different people, so does the course of episodes over time. Some people respond quickly to standard medications after a first manic episode and don’t relapse for years, if ever.

“There is a subgroup who, once they get on the right treatment, remain largely controlled—they might almost seem cured, but it’s because the treatment is working,” says psychiatrist Murray Enns, MD, a researcher and professor of psychiatry at the University of Manitoba in Winnipeg, Canada. “But not everyone latches on to the right treatment.”

For others, mania revisits despite the best interventions. It has taken Shapiro years to find medication that keeps her relatively stable, but she still has manic episodes every couple of months.

I get like 24 hours of euphoria and then a feeling like ants in my pants—like I’m crawling out of my skin.

Of course, that presupposes clinicians know what they’re treating in the first place. Clayton Buck consulted psychiatrists and counselors over the years as abrupt, disruptive mood shifts cost the chartered accountant two marriages and numerous jobs. It wasn’t until 2006, while living in a homeless shelter, that he was accurately diagnosed and prescribed effective medication.  Now 66, he’s a peer specialist in Calgary.

(End of excerpt)

Printed as “Getting a grip on mania”, Winter 2017

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Donna Jackel