In Demi Lovato’s newly-released documentary, Simply Complicated, the star details her struggle with a multitude of mental illnesses, from eating disorders to depression to addiction to bipolar disorder—all of which went undiagnosed for years. The effects, however, were observable long before. Demi traces her bipolar disorder back to a fairly young age, before her career had even begun: she recalls staying up all night writing songs, highly motivated, overexcited, with no desire or need for sleep. At the time, she thought she was simply driven to produce music. But much later, it became clear that these were actually manic episodes.

A manic episode—characteristic of bipolar disorder—is a heightened mood state, in which an individual usually engages in significant goal-directed behavior beyond their normal abilities. Many explain feeling “on top of the world,” and as if they could accomplish anything they set their minds to. These episodes, however, can also take a turn for the worst, whereas an individual becomes irritable instead of overly-motivated and excited. Whichever the case, manic people typically experience a decreased need for sleep, racing thoughts, difficulty paying attention, and increased activity.

Mania can most often be observed and determined by others as such, being that the subsequent behavior is unusual of the individual’s everyday state. Furthermore, the feelings and consequences that accompany mania are severe enough to impair an individual’s normal functioning at work, school, or other important areas of life.

Symptoms of a Manic Episode

Mania is not a mental illness in itself, but rather a characteristic of bipolar disorder. Still there are symptoms that must be present for a manic episode to be determined. One must experience three or more of the following:

  • Decreased need for sleep (such that they feel adequately rested after only a few hours of sleep, for example)
    • A manic individual almost always experiences a decreased need for sleep, whereas they wake up significantly earlier than normal, filled with energy. Sometimes one may even go days without sleeping and still be a ball of energy.
  • Enhanced involvement in pleasurable activities (which may have harmful consequences)
    • The optimism and excitement that typically comes with manic episodes can lead to an individual’s overinvolvement in pleasurable activities, some of which can be harmful and/or reckless (e.g., shopping sprees, investments, and unusual sexual promiscuity).
  • Increased goal-directed activity or agitated psychomotor functions
    • This typically involves excessive planning and participation in a multitude of activities. For example, an individual may switch back and forth between projects without regard for potential risks of doing so—say one project should precede the other or can’t be effectively tackled before the other is completed.
  • Highly talkative (or more so than normal)
    • Manic speech is oftentimes loud, quick, and difficult to understand or interject. Theatrics, jokes, and drama also sometimes characterize manic speech.
  • Increased self-esteem
    • This is typically present, whereas the individual may simply be less critical of themselves or engage in delusional beliefs about their abilities—for example, they may give unwarranted advice about an area they are not knowledgeable in or express an inexistent close relationship with God or another significantly important figure (grandiose delusions)
  • Racing thoughts that are often too rapid to articulate
    • Individuals experience a continuous flood of thoughts, which leads to accelerated speech and abrupt topic changes, as well as in severe cases, incoherent speech.
  • Hindered attentiveness
    • When experiencing a manic episode, one may have trouble focusing their attention. Additionally, they may have trouble distinguishing between relevant and irrelevant information and blocking out irrelevant stimuli, such as cars passing by or buzzing cellphones.

Treatment for Manic Episodes

Mania can sometimes be hard to identify and understand. Doing so, however, can be detrimental to your mental health and overall wellbeing—as a misunderstanding of manic episodes can lead to additional harm: “Sometimes I felt invincible, and it was these moments when my mind would go all over the place,” Demi Lovato said of her manic episodes. “When you don’t know what’s happening, why you’re feeling certain ways, and you don’t have the answers yet, people tend to self-medicate, which is exactly what I did.” But once Demi saw the mania for what it was, she was able to seek proper treatment and cope with it—as well as other issues—appropriately. “Now I know that when I focus on my treatment plan with my team and my support system, I’m able to not only maintain a healthy mind, but I’m able to maintain my sobriety,” she told Women’s Health Magazine.

Because manic episodes can vary in presentation, treatment plans can vary as well. You may find that antipsychotics, such as olanzapine or risperidone, or mood stabilizers, such as lithium or carbamazepine, (or a combination of the two), adequately relieve your symptoms. Or sometimes simply avoiding triggers can do the job—or at least further efforts; triggers can include alcohol, illegal drugs, and certain mood-altering prescription drugs. Furthermore, introducing structure into one’s every day can also stabilize mood and prevent the onset or reduce the severity of manic episodes.