What is the Difference Between a Manic Mood and Just Feeling Good?

“I was diagnosed with bipolar disorder about a year ago, but I still have trouble knowing when I am manic. I am taking medication and most of my days are pretty even. However, on some days I feel really great, on top of the world. Am I manic on such days or just feeling good? What feelings are manic? How do I know when I’m having a manic episode?” 

My first reaction relates to the intensity of your “manic” episodes. You say that you are feeling “on top of the world.” I am not certain what this means. It is important to be able to describe the actual thoughts, feelings, and behaviors. A manic episode may include racing thoughts and ideas; your speech may be racing as well. You may go without sleep for days at a time, followed by a rather deep depression where it is difficult to accomplish even simple tasks. In the manic state, in addition to a heightened sense of well-being, you may have grandiose thoughts and often act on them. You may spend too much money, be extremely irritable, exhibit irrational behavior, engage in dangerous activities, and alienate those people close to you at home, work, and in social situations. If you were experiencing a truly manic episode, you would not only behave as if you were on top of the world, but you would have no awareness of your symptoms.

Your question seems to imply that you are not experiencing a truly manic state. While you are feeling very good, you seem fully aware of your symptoms. You probably are hypo-manic, characterized by symptoms such as problems sleeping, racing thoughts, a sense of entitlement, irritability, short temper, impatience, a loss of short-term memory, and a limited ability to concentrate or focus.

Since you state that you are on medication, I suggest that you keep a mood chart, including not only the degree of your moods but also a brief description of your behaviors when in heightened, normal, and depressed moods. You can share this information with your psychiatrist to assess the degree of your mood and manic-like symptoms. In this way, you can better determine whether you are having a manic episode. If so, some “tweaking” of your medication may alleviate the problem. The mood chart and tracking of your thoughts, feelings, and behaviors would be equally appropriate to share with a psychotherapist, assuming you are also in treatment with a licensed therapist.

Dr. Manuel S. Silverman, PhD