In the know: Making sense of manic patients

Stressed Out Nurses Weekly, March 23, 2009

People who are depressed usually know that something is wrong, and they don't like the way they feel. But people who are hypomanic or manic usually don't think anything is wrong. They wonder what is wrong with those around them.

Mania and hypomania can be seductive. People feel more energized, creative, and interesting. But manic episodes often turn destructive. People in manic episodes wipe out their bank accounts; lose their reputations in their communities; and lose their jobs because of their inability to concentrate, poor judgment, and intense behavior. The life of a manic person is a whirlwind, and then the whirlwind stops, sometimes leading to a deep depression or psychotic state.

When we nurses are faced with dealing with a manic patient who is out of control, it can easily make them feel out of control too. Here are a few things to keep in mind:

  • The patient is being controlled by his or her disease. Control of behaviors and feelings is simply not possible.
  • The patient lacks any insight into his or her behavior. People in manic states do not realize they are sick, and they are unaware of the consequences of their behavior. They reject any idea that any illness is involved, and they find excuses to make sense of what is going on around them.
  • The patient with mania becomes frustrated, often with others who cannot keep up with him or her. The patient may lash out and show his or her frustration in inappropriate ways. It often appears that the patient knows exactly how to push your buttons, or knows the exact things about which you are most sensitive.
  • The patient with mania is hyperalert. People in manic states are hypervigilant and are often aware of things going on in the environment that others do not pick up on.

Source: Stressed Out About Difficult Patients, HCPro, Inc. 2007. Be sure to pick up your copy today!

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