While unipolar mania has been described by healthcare providers since the late 1800s, it is not an officially recognized mental disorder. Instead, people who experience mania without accompanying episodes of depression would be diagnosed with bipolar I disorder. Such variations can be explained by the differing definitions of unipolar mania utilized by researchers. For example, some studies have defined unipolar mania as a single episode of mania with no depressive cycles, while subsequent studies expanded this definition to three to four manic episodes without a history of depression.
Symptoms of Unipolar Mania
The symptoms of unipolar mania are similar to that of bipolar mania and include:
Abrupt changes in energy levels Behaviors that may have detrimental effects, such as risky sex and excessive spending Changing in thinking and mood Grandiosity and elevated self-esteem Impaired judgment Impulsivity Increased motivation and psychomotor activity Psychosis, including delusions and hallucinations Racing thoughts Reduced need for sleep Speech disruptions
Some research suggests that the symptoms of unipolar mania are somewhat different than those of bipolar mania. People with unipolar mania may exhibit more grandiosity, psychotic symptoms, and hyperthymic temperament than people with bipolar mania. Hyperthymic temperament refers to increased energy and enthusiasm. People with unipolar mania also appear to experience less suicidality and rapid cycling than those with bipolar mania. They also appear less likely to have comorbid (or co-occuring) anxiety disorders and better functioning in social and professional contexts.
Identifying Unipolar Mania
Unipolar mania is not recognized as a distinct condition in the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5-TR) or the “International Classification of Diseases” (ICD-11). To be diagnosed with bipolar 1 disorder, a person must have experienced at least one manic episode lasting a minimum of one week and including three more of the following symptoms:
Engaging in risky, dangerous, or impulsive activitiesGreater talkativeness or pressured speechIncreased distractabilityInflated self-esteem or grandiosityMore goal-directed activity or agitated movementRacing thoughtsReduced need for sleep
Such episodes must create impairments in a person’s life. Such impairments may be significant enough that they need to be hospitalized for their own safety, such as if they are experiencing hallucinations, delusions, or high-risk behaviors. A healthcare provider must also rule out other mental health conditions such as schizophrenia, schizoaffective disorder, or schizophreniform disorder. A 2014 review suggested that while unipolar mania may not be recognized as a distinct diagnosis, it would be reasonable for diagnostic classification systems such as the DSM and the ICD to consider it a bipolar disorder specifier. A 2018 review recommended that unipolar mania should be recognized as a condition distinct from the mania that occurs in bipolar disorder. Unipolar mania is connected to a lower rate of suicidality, less anxiety, and less substance use. Because of these differences, treatments designed for unipolar mania may be more successful than treating it as bipolar 1 disorder.
Causes of Unipolar Mania
The exact causes of unipolar mania are not well understood. Some factors that research has implicated in contributing to unipolar mania include:
Genetics
Bipolar disorder is believed to have a strong genetic component and is considered one of the most heritable mental illnesses. It is likely that unipolar mania is also influenced by genetic factors. Aspects of the condition, such as frequency of episodes, rapid cycling, comorbid conditions, and treatment responsiveness, also appear to be connected to family history.
Seasonality
While the causes of unipolar mania are unclear, research has found symptoms may be affected by seasonality and sun exposure. This suggests that factors such as sunlight and latitude may affect symptoms. One study, for example, found that the first episode of unipolar mania was more likely to occur in summer, while bipolar mania was more likely to occur in winter. Adding to the idea that unipolar mania might be affected by photoperiods, or the hours of light in a given 24-hour period, research has indicated that people with unipolar mania might be more likely to experience seasonal affective disorder (SAD). And evidence also suggests that manic relapses are more likely to happen during the spring and summer months.
Nutrition
Researchers also suggest that nutritional habits may impact symptoms in bipolar disorder. Diets high in omega-3s and other nutrients may help prevent some people from experiencing depressive episodes.
Treatment for Unipolar Mania
Bipolar 1 disorder is typically treated with medications and therapy. Psychoeducation and support groups can also be essential components of treatment. Medications often used to treat the condition include mood stabilizers and antipsychotics.
Coping With Unipolar Mania
If you are experiencing unipolar mania, it is important to talk to a healthcare provider about your symptoms. Getting the right diagnosis and working with your provider to find a treatment plan that works for you is essential for managing your condition. Appropriate treatment may help reduce the frequency and severity of manic episodes. Strategies that can help you cope with unipolar mania include:
Treatment Adherence
Treatment adherence refers to the extent to which a person follows the medications, therapy, diet, and lifestyle recommendations to manage their condition. Unfortunately, it is not uncommon for people with bipolar disorder and other chronic health conditions to have struggles sticking to their treatment plan. Taking your medication may help you minimize or avoid mood episodes. Look for ways to improve your treatment adherence, including working with a healthcare provider you trust and building a support system of people who can offer encouragement.
Track Your Symptoms
Consider keeping a mood journal to monitor how you feel and factors that might precipitate mood changes. For example, you might note how you feel each day and the events that contributed to those feelings. This record can help you start noticing patterns you might not otherwise spot.
Build Health Habits
Factors such as stress and lifestyle can impact symptoms of mania, so it is important to work on establishing healthy habits to help you cope with challenges. In addition to following a healthy diet and regular physical exercise, incorporate some effective stress management techniques into your daily routine.
Watch Your Triggers
If you’ve noticed that specific triggers increase your risk of experiencing a manic episode, take steps to minimize exposure to those things. Triggers that might affect you include consuming alcohol, not getting enough sleep, or interpersonal stress. Instead, look for ways to get back on track after your mood has returned to a more stable state. Talk to your healthcare provider about steps you might take to minimize the risk of having another episode, whether that means adjusting your medication, eliminating triggers, or making lifestyle changes.
