Mania Domains of the Bipolar Spectrum

Researchers at Duke University have refined Kraepelin’s four classes of mania to include hypomania (featuring mainly euphoria) , severe mania (including euphoria, grandiosity, high levels of sexual drive, irritability, volatility, psychosis, paranoia, hostility and aggression), extreme mania (most of the displeasures, hardly any of the pleasures) also known as dysphoric mania, and two forms of mixed of mania. (where depressive and manic symptoms collide).

The Mayo Clinic and others list as additional possible symptoms of mania: elation, extreme optimism, rapid unstoppable flow of speech, racing thoughts/flights of ideas, agitation, poor judgment, recklessness or taking chances not normally taken, inordinate capacity for activity, difficulty sleeping or lesser need for sleep, tendency to be easily distracted (may constantly shift from one theme or endeavor to another), inability to concentrate, exuberant and flamboyant or colorful dress, authoritative manner, and tendency to believe they are in their best mental state.

Manic patients may be inexhaustibly, excessively, and impulsively involved in various activities without recognizing the inherent social dangers.

Symptoms of psychosis include hallucinations (hearing, seeing, or otherwise sensing the presence of stimuli that are not there) and delusions (false personal beliefs that are not subject to reason or contradictory evidence and are not explained by a person's cultural concepts). Feelings of paranoia, during which the patient believes he or she is being persecuted or monitored by the government or a hostile force. Intense and unusual religious beliefs may also be present, such as a patient's strong insistence that they have a God-given role to play in the world, a great and historic mission to accomplish, or even that they possess supernatural powers. Delusions may or may not be mood congruent.