The principal symptom of the manic phase is a elevated, expansive or irritable mood. The early stages may reveal one to be more active, sociable, talkative, self-confident, perceptive and creative than usual. As the mood becomes higher some or all of the following symptoms may be seen:
Decreased need for sleep.
Feeling excessively good or euphoric. This is a feeling of "being on top of the world".
Creative thinking and heightened perceptions.
Extreme irritability.
Restlessness.
Excessive energy and excitability.
-This may lead to jumping from one activity to the other without ever completing anything.
Rapid, unpredicted emotional changes.
-The initial euphoria may swing to irritability and anger for no apparent reason.
Racing thoughts and flights of ideas and speech.
-One's thinking processes may be speeded up, resulting in talking faster than usual, and an abrupt change from one topic to the next i.e. one is easily distracted.
Overreaction to stimuli and misinterpretation of events.
-One may get angry over trivialities and completely distort the meaning of ordinary comments or situations.
Hyperactivity, excessive plans and increased participation in numerous activities.
-This may result in reckless driving, spending sprees, foolish investments etc.
Grandiosity and inflated self-esteem.
-Self-confidence may reach the point of grandiose delusions in which one thinks one has a special connection with God, celebrities, or political leaders. This unwarranted optimism makes one think one is more powerful than most.
Increased sexual activity.
Inappropriate and impulsive behaviours.
Poor judgement and lack of insight.
Loss of touch with reality and disorientation.
-This may result in delusionary thoughts, hallucinations or even hearing of voices.
Paranoia and delusions of being persecuted.
- This may result in violent behaviour or hostility.
Severe insomnia, profound weight loss and exhaustion.
It is imperative to know that manic depression is an illness, and that the extreme mood poles are not a mindset that can be overcome by auto suggestion or any other means. A wide range of environmental factors such as stress, loss, childhood experiences, seasonal factors, intake of medications and/or drugs etc certainly may play a large role in precipitating either the manias or the depressions. One of the most striking aspects of manic- depressive illness however is, that it tends to run in families and is by and large determined by genetic factors. There are still many questions with respect to this as can be highlighted by the current research project being undertaken in Cape Town. The Department of Psychiatry and of Human Genetics of the University of Cape Town are involved in a project aimed at attempting to identify the possible genetic origins of Bipolar Affective Disorder. They are working in conjunction with the University of California, San Diego and the Swiss Pharmaceutical Company, Sandoz. This disorder is seen as the probable result of several independent gene defects. The gene search and its identification will enable the development of more effective and permanent therapies.

As can be revealed from the above, the most important factor is treatment. A short description of some treatments is given below.
Almost all manic depressives - even those with the most severe form - are able, to gain substantial relief from their mood swings. It is of primary importance firstly that they are under the care of a psychiatrist skilled in the diagnosis and treatment of this disease.

Lithium Carbonate is a naturally occurring salt that is found in the human body in small quantities. It is the standard drug of use and has been found to be particularly effective in controlling mania and preventing the recurrence of both manic and depressive episodes. More recently, however the anticonvulsants carbamazephine and valproate have been successfully used in treatment. Depression may in addition necessitate the use of several types of antidepressants. Electroconvulsive therapy (ECT), despite it's controversiality, is often helpful in treating severe depression and/or mixed mania that does not respond to medications. In addition to medications, psychotherapy is often helpful in providing support, education and guidance to the patient as well as the family and those involved.

Hospitalisation forms part of treatment and is often needed. For anyone that has been in a mental hospital, this is not the most pleasant of experiences and is furthermore aggravated by the stigma attached to these absolutely vital institutions. Hospitalisation can be essential to prevent self-destructive, impulsive. or aggressive behaviour. Manic patients often lack the insight that they are ill and require hospitalisation, but on hindsight research has shown that they are grateful for being institutionalised. During depression, potentially suicidal patients obviously require this form of aid. Hospitalisation is also used for individuals who have medical complications that make it more difficult to monitor medication and for those with an additional drug or alcohol problem. A concluding, but equally essential means of treatment is for the patient to help him/herself. Become an expert on your illness. Since bi-polar disorder is a lifelong illness, it is imperative that you learn as much as possible about its nature, its cycles, its causes , its treatments as well as the latest research and developments.

The knowledge on this creatively destructive disease is expansive and yet not all encompassing. This article is a small insert of only some of that knowledge, but hopefully it has shed some light onto the basics of bipolar mood disorder. Hopefully, it has educated and touched at least someone, so that one day I will walk away with a feeling of stable happiness that at least someone took the time to understand and not to judge.