Acute mania is a medical emergency in psychiatry, probably second only to malignant hyperthermia. The public should therefore be more helpful in presenting their families to the primary healthcare centre as the patient more often than any psychiatric disease; have no insight. The compounding factor is the patient is usually more intelligent than the rest of the siblings and very dependable otherwise. This very pillar of your company or family will at a medical level be DSM classified.
1) Be excessively euphoric or have elevated mood.
2) Grandiose/elevated sense of own abilities.
3) Disinhibition for example in spending the family money or sexually.
4) Frank to the extreme about others.
5) Increased speed of thought, talkative or flight of ideas.
6) Increased activity in physical terms, gets through a lot of work, every other touch of the ball is his.
7) Reduced need to sleep.
8) May even be psychotic.
9) Above would have been for at least one week in duration
The biggest problem is half our heroes as I mentioned earlier are hypomaniac and for a good reason I should say. The disinhibition and the energy are prerequisite for any beyond the limits perfomance.
I will be brave and mention names of people that might offend many, e.g Winston Churchill for one. Muhammad Ali has been the beacon of my childhood existence when everything seemed impossible and distant for poor black children. I am therefore the first to mourn his then disability and I am just as proud that he ran with it and used it to its utmost. His punch drunk Parkinson’s has no relation to mania as it’s medically proven to be from boxing. Half the painters of our time did their best work in the hypomaniac phase. When then do you present Ali or Ronaldino, a fallen Brazilian soccer star for treatment and not be accused of jealousy. How do you enslave van Gogh and avoid the title of having arrested evolution in progress, we could still have no abstract art had psychiatry of that day been more developed. How do you safe a hero from burn out when the ball is still rolling. Are we not intervening for selfish reasons. With this in mind it needs chronology in monitoring the patient to know whether he is beyond what he normally is. You also have to know whether there is no basis for the elevated mood as this above average intelligence patient will be able to justify it. There is usually associated substance abuse. Incidence of suicide is much higher than in the general public.
The mainstay treatment is lithium for the manic phase. Being periodic table element/mineral, it cannot be patented to amass the amount of money to justify pharmacological companies’ second look. Research is therefore limited and will always be distant last to Aropax or Ritalin for example. Psychotherapy and meditation should account for something, in view of low rates in the east.
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