MANIA (Lat., madness). A form of insanity characterized by exaltation of emotional state and hyper-excitation of cerebral and nerve func tion. The manner of one suffering from mania is indicative of active fancy, acute perception, extravagant ideation, rapidity of thought, and great exaggeration in action. There is a loss of natural self-control. Generally pleasurable and expansive ideas fill the mind. The pa tient imagines he is wealthy, prominent, pos sessed of unlimited strength, and he desires to make others happy by sharing his fancied pos sessions. Excesses in eating, drinking. and sex ual indulgence are frequent, in persons hitherto abstemious and moral. The maniac's condition resembles mild intoxication. and he is easily an gered by reproof or contradiction. or by imaginary affront or mere interruption. The pleasurable state then gives way to violent anger. The regnant note in mania is egotism. Violence is frequent. Hallucinations, delusions, and illusions are common. See INSANITY.
The outset of an attack of mania is rarely sudden. Generally a period of depression pre cedes. with digestive disturbance. pressure and pain in the head. insomnia, lack of power of attention. and physical and mental exhaustion. This period lasts from one to three months. The disappearance of depression and its replacement by exaltation is often mistaken for a return to health. till violence appears, and exaggerated ideas are found to have a delusional basis. Sim ple mania persists for about three months in acute cases, or for a year in milder cases. If a case continues for over a year. the chances of recovery are lessened. From In to 15 per cent. of all insane are maniacs. Unfortunately, the popular idea of a crazy person is that of a maniac, and many people hesitate to accept the truth of the existence of insanity in a patient of quiet demeanor. Mania appears generally between the ages of twenty-five and thirty-live years, the period of initial stress and strain in the average life, and the period during which alcoholic and venereal excesses are more fre quent. From 60 to SO per cent. of the cases
of mania recover, under proper custodial care. Institutional life. with its routine and its atmos phere of order and obedience, is very salutary for most cases, in addition to providing safety for both patient and relatives. Patients who do not recover pass into chronic mania and later into terminal dementia. About 4 per cent. of the eases of simple and acute mania are of the exhaustive type, and die of the mania or from a complicating pneumonia or from some such disorder, especially in alcoholic eases. As prog ress is made toward recovery in favorable eases, an occasional lucid interval occurs. with relapses into violence and exaltation, until convalescence is established.
In patients who are handicapped with a hered itary predisposition to insanity, attacks of mania are frequent upon subjection to the in jurious influences that produced the first attack. Such a condition has been called 'recurrent mania.' The toxic neuroses due to abuse of alcohol, chloral opium, the bromides, etc., are manias. With the exception of alcoholic insanity, they are rarely seen. The insanities occurring in some cases of hysteria and epilepsy are also manias. See EPILEPSY and HYSTERIA.
Mania occurs in circular insanity (cyclotlzy mia), alternating with melancholia and a lucid interval. The treatment of mania is largely dietetic and hygienic. In most eases of insanity more management is needed than medicine. To meet special indications the physician uses seda tives and hypnoties, tissue-builders, intestinal antiseptics. and stimulants of circulatory and lymphatic apparatus.
For the legal aspects of mania, see INSANITY and LUNACY.