How long do manic episodes last, and what causes them?

Everyone has periods of ups and downs in life. Sometimes we feel energized and excited, and sometimes we feel sad and maybe even a little hopeless. For the most part, these highs and lows are a natural part of life, and they don’t disrupt our ability to function in the long term. But this is not the case for people living with bipolar disorder. 

This mental health condition causes mood swings that can be rapid, severe, and harmful. People with bipolar disorder have periods of low mood called depressive episodes and periods of euphoria called manic episodes. While most people are familiar with what a depressive episode looks like, manic episodes are less widely understood. By learning more about mania, you’ll be better equipped to support yourself or someone else having this experience.

What is a manic episode?

Mania is a period of intense energy and euphoric mood caused by bipolar disorder. Manic episodes can range from mild to severe, depending on the person and the type of bipolar disorder they have. Some signs a person might be experiencing a manic episode include:

• Feeling intensely happy or elated
• Being abnormally energetic or irritable
• Not sleeping but staying energized
• Engaging in risky or impulsive behavior (like overspending, speeding, or unsafe sexual behavior)
• Talking so quickly that other people notice
• Thinking you’re unstoppable or invincible
• Experiencing racing thoughts that are hard to control
• Having trouble focusing and being easily distracted
• Becoming fixated on an activity or topic
• Walking, pacing, fidgeting, or other repetitive behaviors

In severe cases, manic episodes can also include psychotic features. These include hallucinations (seeing or hearing something that isn’t there) and delusions (believing something that is objectively untrue). It’s also worth noting that we all have different personalities and baseline energy levels. But someone experiencing a manic episode will have uncharacteristically heightened energy and euphoria. In other words, mania represents a major change from a person’s typical behavior and emotional state.

How long can a manic episode last?

Manic episodes are associated with three different types of bipolar disorder. Depending on the person and their condition, manic episodes can last varying amounts of time. 

• Bipolar I: Manic episodes last at least seven days but can persist for weeks. During this time, symptoms are present for most of the day, every day.
• Bipolar II: Manic episodes are less severe and are referred to as “hypomanic episodes.” They can last from two days to a few weeks, on average.
• Cyclothymic disorder: Manic episodes are milder (hypomania), don’t significantly impact functioning, and last for fewer than eight weeks.

Without support, episodes of mania can sometimes last for months. But fortunately, bipolar disorder is a treatable condition. With the right care, you can manage your symptoms and reduce the length and intensity of your manic episodes.

What triggers a manic episode?

It isn’t always possible to point to a single cause of a manic episode. But there are a few factors that are known to trigger manic symptoms, including:

• Heightened stress 
• Major life transitions
• Lack of sleep
• Substance use
• Having a baby
• Grief and loss
• Having trouble meeting basic needs
• Certain physical illnesses
• Various prescription medications
• Experiencing trauma or abuse
• Time of year (manic episodes may occur more often in spring)
• A family history of bipolar disorder or other mental health concerns

What makes people more likely to have manic episodes?

Manic episodes are caused by bipolar disorder. While we don’t know the exact cause of bipolar disorder, there are a few factors that may elevate your risk:

• Genetics: Having a family history of bipolar disorder, depression, or other mental health conditions may make you more likely to develop bipolar disorder.
• Chemical imbalances: Research suggests that an imbalance of three key brain chemicals — norepinephrine, serotonin, and dopamine — may contribute to the onset of bipolar disorder.
• Major life events: While they don’t cause bipolar disorder, stressful experiences can trigger manic or depressive episodes.

Types of manic episodes

Manic episodes can take many forms and range in severity. However, it’s important to remember that all forms of mania can be managed with the right support.

• Mild mania: Also referred to as hypomania, this is a symptom of bipolar II and cyclothymia. It is not severe enough to warrant hospitalization and does not seriously affect daily functioning.
• Severe mania: Severe mania causes significant impairment in your ability to function at home, work, or school. It can impact your social life and your ability to care for yourself. Left untreated, severe mania can cause psychotic features and may require hospitalization.
• Mixed episodes: People with bipolar disorder may experience periods of high and low mood in rapid succession or at the same time. These are called mixed episodes. For example, you may feel both irritable and energized while also feeling worried or depressed.

Find care with Rula

If you or someone you care about is showing signs of mania, know that you’re not alone. With the right support, people living with bipolar disorder can manage their mood changes and reduce the length and intensity of their manic episodes. 

At Rula, we believe that everyone deserves access to affordable, convenient mental healthcare. So we built our therapist-matching program to help you connect with a therapist you can meet with from the comfort of home in just a few clicks. We’ll ensure that your provider takes your insurance and specializes in whatever issues you’re facing. Plus, thanks to our extensive network, you can say goodbye to waiting months for an appointment. With Rula, you can make an appointment with your preferred provider as early as this week. 

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