Mania Symptoms without Psychotic Symptoms
The main difference from hypomania is that elevated mood affects the change in the norms of social functioning, manifested in inappropriate actions, speech pressure and increased activity are not controlled by the patient. Self-esteem rises and individual ideas of self-importance and greatness are expressed. There is a subjective feeling of lightness of associations, increased distractibility, colors of the world around are perceived as more vivid and contrasting, more subtle shades of sounds are distinguished. Accelerates the pace of time and significantly reduces the need for sleep. Increased tolerance and the need for alcohol, increased sexual energy and appetite, there is a craving for travel and adventure. The constant risk of contracting a sexually transmitted disease and getting into stories with unpredictable consequences. Thanks to the leap of ideas, many plans arise, the realization of which is only planned. The patient tends to bright and catchy clothes, speaks loudly and later in a hoarse voice, he does a lot of debt and gives money to barely familiar people. He easily falls in love and is confident in the love of himself for the whole world. Collecting a lot of random people, he arranges holidays in debt.
Diagnosis of Mania without Psychotic Symptoms
The main symptoms of mania are the following:
- Increased, expansive, irritable (angry), or suspicious mood that is unusual for a given individual. Changes in mood should be distinct and persist throughout the week.
- At least three of the following symptoms should be present (and if the mood is only irritable, then four):
– increased activity or physical anxiety;
– increased talkativeness (“speech pressure”);
– the acceleration of the flow of thoughts or the subjective feeling of a “leap of ideas”;
– a decrease in normal social control, leading to inappropriate behavior;
– reduced need for sleep;
– increased self-esteem or ideas of greatness (grandeur);
– distractibility or permanent changes in activities or plans;
– reckless or reckless behavior, the consequences of which are not recognized by patients, for example, reveling, stupid enterprise, reckless driving;
– a marked increase in sexual energy or sexual promiscuity.
- The absence of hallucinations or delusions, although there may be perceptual disorders (for example, subjective hyperacusis, the perception of colors as particularly bright).
Mania should be differentiated with affective disorders in addiction diseases (euphoria in cocaine and marijuana use), organic affective disorders, and manic-hebephrenic arousal in schizophrenia and schizoaffective disorders. In case of intoxication euphoria as a result of cocaine use, somatic symptoms are noted along with manic excitement: headaches, tendency to seizures, rhinitis, increased blood pressure, tachycardia, mydriasis, hyperthermia, increased sweating. In case of intoxication euphoria as a result of the use of marijuana, mania can proceed with slurred speech, increased dryness of mucous membranes, tachycardia, depersonalization, and dilated pupils.
Organic mania occurs with a change in consciousness, neurological and somatic disorders are detected, other components of the psycho-endocrine syndrome, such as cognitive decline.
Manic-hebephrenic state, in contrast to manic, is characterized by non-invasive fun, formal thinking disorders (rupture, amorphism, paralogical thinking), foolishness, instinctive regress symptoms (eating inedible, distortion of sexual preference, cold aggression).
Treatment of Mania without Psychotic Symptoms
In therapy, large neuroleptics (tizercin, aminazine), lithium carbonate in increasing doses with control of the level of lithium in plasma, as well as carbamazepine are used.