Mania ≠ Mania

It is tempting to assume that two instances of mania are alike. Very tempting. I believe many in the Mental Health sector fall for this. In my experience, while my manias have had superficial features in common, those leading to a diagnosis of mania and hence Bipolar Disorder. But I would say that no two of my manias were alike.

Fire

Consider fire. In one sense there is only one type of fire: that where things combust: and by combust we understand that molecules break down and combine with oxygen and in so doing release heat.

But in practice, what matters in the immediate timeframe of a fire, is what type of fire it is (e.g. wood fire, chip pan fire, electrical fire). Moreover, once the fire is out, an important task is figuring out why the fire happened, and what can be done to prevent that fire again.

It is hopelessly naïve to take the position that since water puts out fires, we should just keep dumping water on a place where fire occurred previously, call it prophylaxis, and consider the problem solved. Yet that is what happens all too often in psychiatry: treat the symptoms by chemically suppressing them, and keep on chemically suppressing to prevent the symptoms returning.

In the case of mania, there may or may not be understandable reasons why it occurs, in the sense of some underlying problem which leads to mania occurring, or at least some explanation for both the susceptibility and for what happens on the route into mania.

But just diagnosing mania and Bipolar Disorder and leaving it at that is far from ideal.