00:00
So we want to really think about
what kinds of episodes people have.
00:06
So manic.
00:07
Manic means a lot of energy.
00:10
And if I was going
to be a manic person,
if I was going to be a person
who had a manic episode rather,
I would be talking like this.
00:17
And I would really
be talking very fast,
mania or manic episodes really
have so much energy to them
that the person almost can't
contain that kind of energy.
00:26
There is so much
good in the world.
00:29
And I'm so in love
with all the world.
00:31
And the weather is perfect,
and their mood is so elevated,
and you see it in
the way they gesture.
00:38
You hear it in their voice,
you see it in the way they stand.
00:42
This is very different than
when we talked about JJ.
00:46
JJ, who was so sad and collapsed
that depression.
00:53
Mania,
manic episodes are the opposite,
very persistently elevated,
you also see that,
what do you mean?
What do you mean you're not going
to come with me on my vacation?
You have to come with me!
How come you're not coming with
me, all of a sudden, like that,
in a manic episode,
a person's whole manner might change.
01:18
And they may become
irritable in a quick second.
01:23
And then this expansive
mood I want to buy,
I want to buy presents
for everybody.
01:30
I want to do everything
for everyone.
01:33
I think I want to stay up for
the next week and knit scarves
for all the people who
don't have any scarves.
01:41
It's not realistic.
01:44
When you have a person
who has a manic episode,
they are not acting
realistically.
01:50
They cannot,
this persistently high mood
cannot be maintained without
it being a real problem
and to a normal
functioning human being.
02:03
It leads to very
impaired functioning.
02:06
People don't want to sleep,
they don't want to eat.
02:08
They don't think they
have to drink anything.
02:11
They want to keep moving.
02:12
They think they are invincible.
02:16
And it usually lasts
at least a week.
02:20
So what do we see when
we see a manic episode?
The first thing you might
notice pressured speech.
02:27
What does that means
president speech?
Here's a little
pressured speech.
02:32
I really wanted you
to come with me.
02:33
I really,
really wanted you to come with me.
02:35
You wouldn't come with me.
Why wouldn't you come with me?
I only asked you if you would
come with me once or twice.
02:40
And now, now you're not
going to come with me?
I can't believe it!
Why is that considered
pressured speech?
Because it's almost as though
there's a person in my throat,
pushing those words out at you.
02:54
That's pressured speech.
02:56
Another thing you might see is
this decrease need to sleep.
03:00
Now, the important thing
to understand is that
if a person is having a manic
episode, they don't sleep,
but they're not
tired in the morning.
03:11
There is no normal.
03:14
Oh, I'm so tired.
I didn't sleep last night.
03:16
I got so much done last night,
I cleaned my whole house.
03:20
And then I went outside
and I did all the shopping,
there's a 24-hour store
that's right down the street.
03:26
And now I'm ready to go and
I'm going to clean the garage.
03:29
That is where that
decreased need to sleep
is really different
from anything else.
03:37
Distractibility, they'll start on
one thing and switch to another thing
and then switch
to another thing.
03:43
So they might start taking
apart all the closets.
03:47
And then halfway through say,
"Oh I forgot to go get milk ",
go out to go buy milk,
and pass by another store
and say, "Oh, I actually wanted
to do something for the lawn."
And meanwhile, if you are living with
a person who's having a manic episode,
you come home and there
is a lot of disruption.
04:08
In the normal
processing of things,
you're going to see
that they have a lot of
what is called
psychomotor agitation.
04:19
So you have a lot of
movements, you have psychomotor
meaning the way they're moving
their body and agitation.
04:27
Meaning it's you
know, it's constant,
and they have no control over it
because this is a manic episode
and there's nothing that
they can do about it.
04:36
But you can see it
and you can note it.
04:41
They are getting very interested
in these goal oriented activities.
04:48
Like I'm going to clean
my whole entire house,
and then I'm going to clean the garage,
and I like to become a librarian.
04:57
So I think I'm going to go online and see
how many courses that I can get involved in
because I'm not sleeping anyway, I might
as well stay up all night and go to school.
05:09
This inflated self-esteem is
really an important piece.
05:13
It's important to remember
inflated self-esteem
is I have always been
incredibly smart,
like people have not really
noticed how smart I am.
05:26
And now, I think that I can
actually be a professor,
I don't think I need to get
a PhD to be a professor.
05:34
Because I know all
of this already.
05:37
People aren't seeing
it, but I know.
05:39
So I want you to think about that idea
of having that inflated self-esteem.
05:46
The flight of ideas, and that psychomotor
agitation comes together quite frequently.
05:53
So they start talking to you about one
thing and they jump to the next thing,
and they jump to the next thing.
05:59
And it's all wrapped up in almost
a bumble bee fury of movement.
06:06
When you are looking
at their activities,
these activities are not activities
that aren't going anywhere.
06:13
These are activities that actually
have some sort of a purpose.
06:18
Remember, this is an episode,
it is not lasting forever,
it's going to last about a week.
06:25
And we're only going to be looking
for three of these symptoms
to make sure that we
start thinking about
maybe this person is
having a manic episode.
06:36
This idea of grandiosity,
it's really hard to explain
this kind of grandiosity
until you hear a
person who tells you
that they are the smartest
person in the whole world,
I am a total genius,
and no one has ever even come
close to matching my intelligence.
07:00
I own most of the world's
intellectual property.
07:07
Now, that doesn't have to be
true when they tell you that
it's what they believe is true.
07:12
This grandiosity
is in their mind.
07:16
So three of these symptoms,
makes you think,
maybe this is a manic episode.
07:24
Maybe this person is
having a manic episode.
07:29
But why do we worry about that?
A person who's having a manic episode
usually really enjoys their mania.
07:37
It's an important
thing to understand.
07:40
They're not sleeping, but they feel
like they're getting a lot accomplished.
07:44
They feel great
about themselves.
07:46
They want to do
good for everyone.
07:50
Unfortunately,
because of this incredible elation,
that has taken over,
and they are a victim of this elation.
08:02
They take high risk activities.
08:05
They may be out way later,
they may be speeding
because they want to hurry
up and get to someplace.
08:12
It's really important to
understand that that elated,
grandiosity,
that increased self-esteem
makes them think that they can do
things that they may not be able to do.
08:25
They might think they
can go horseback riding,
they may never have done horseback
riding before in their lives.
08:32
But they may have an
idea in their head.
08:34
I can horseback ride.
08:36
I remember doing
it on a video game,
and I was great. I was the best.
08:40
I'm going to go horseback riding
and end up really
getting injured.
08:46
So we have to be really
careful as we're talking
to a person who might be
having a manic episode.