A Manic Episode is characterised by an increase in either: sociability, over familiarity and articulation; or conversely irritability and suspicion. This combines with increased self-esteem, over optimistic attitude and general elation. Additional indicators are increased energy, loss of social inhibitions and inattention. Extreme cases can include violent behaviour and delusions or hallucinations (but this is far more uncommon). Onset age can be from any time from late adolescence onward. This a reoccurring disorder which has a 90% chance of being repeated after the first episode. The type of Manic episode can vary from Mild, Moderate to Severe, with or without Psychotic (violent) features, dependent on the severity and frequency of the associated symptoms. Associated problems include truancy, educational failure and anti-social behaviour. There is also a strong link with substance abuse.

A Hypomanic Episode is basically the same as a Manic Episode, however the disturbance is not as severe enough to disrupt social or occupational patterns and violent or psychotic behaviour is not common. Delusions are never present and all symptoms are less severe.

All episodes should last a minimum of 1 week. Severity of the episode is indicated by the number of incidents recorded.
Manic Episode - Must fulfil all categories A to C. If category D is also included then the disorder is considered to have Psychotic features. This must be server enough to disrupt normal patters of behaviour. Hypomanic Episode - Must only fulfil categories A to B. Severity should always be Mild and occurrences of behaviour the minimum.

A. Individual displays a distinct period of abnormal and persistently elevated, inflated, or irritable mood.

B. During the period of mood disturbance, at least 3 (4, if the mood is “irritable”) of the following have persisted or been present to a significant degree;

1. subject displays an inflated or exaggerated self-concept (e.g. “I’m the best there’s ever been”).
2. subject’s displays a decreased need for rest (e.g. feels rested after only three hours sleep).
3. subject is more talkative than usually or act like they cannot stop talking.
4. subject displays flights of ideas or racing thoughts off at tangents (e.g. jumps from one topic conversation to the next without break, due to own personal mental connection).
5. subject suffers from distractibility.
6. subject’s goal directed activity increases (either socially, at school or sexually) or subject displays inability to be still.
7. subject becomes excessively involved in self-pleasing activities with painful consequences for others (e.g. unrestrained sprees of bullying, sexual indiscretions or harassment etc.).

1. a marked impairment in school work.
2. a marked impairment in social activities.
3. a marked impairment in relationships with others.

1. subject needs restraint or hospitalisation to prevent harm to self or others.
2. severe and sustained physical activity or excitement induces aggression or violence in subject.
3. subject neglects eating, drinking and personal hygiene, resulting in serious self-neglect/dehydration.
4. subject suffers possible delusions and hallucinations.

Medical Supervision may include Pharmacological/ Drug Intervention, Counselling and Behavioural Therapy

“Depressive Disorder in Childhood and Adolescents”, R. Harrington (1995), London,

“Childhood Behavioural Disorders and Emotional Disturbance: An Introduction to”, S.J. Apter & J.C. Conoley (1994), London, Prentice-Hall.

“Chosen with Care?: Responses to Disturbing and Disruptive Behaviour”, G. Lloyd (1992), Edinburgh, May House Publications.

There is a good layperson's guide on BiPolar Disorders including Manic Episode at http://www.ka.net/jozgirl/bipol.html.

More links and data can be found at The Internet Mental Health Pages: BiPolar Disorders