Overview

Before starting Mania, this article would like to introduce bipolar disorder first. Bipolar disorder is a mental illness that causes extreme emotional changes, including extreme highs (mania) and extreme lows (depression).¹ 

Mania is one stage of bipolar disorder. The manic phase usually lasts for 1 week or more, and people with mania have behaviour changes that significantly affect their activities.²

Symptoms 

People with mania live in a stage of high energy, mood, and behaviour, which seems to be good feelings, but they may present more negative feelings as well, such as anxiety or irritation. Mania symptoms are characterised by:^1,2

• You talk a lot more than usual and talk very quickly
• You do not want to sleep
• You have a full of thoughts, such as great new ideas or plans
• You get distracted easily
• Your activities focus directly on your goals
• You become irritated or agitated easily

Importance of studying mania's impact on work performance

Prevalence of bipolar disorder in the workforce

Over one in fifty people in the UK develops bipolar disorder, which is 1.3 million people.³ In addition, bipolar disorder becomes a common long-term mental complication in patients living with other diseases such as cancer, dementia, epilepsy, autism, rheumatoid arthritis and learning disabilities.³ Approximately one-fifth of people with long-term mental illness are employed. Less than one in twenty women on employment support allowance experiences bipolar.³

Implications for employers and employees

Almost all employees with bipolar disorder choose to tell their company about their illness, but over one-fifth feel regret about making that decision.4 This indicates that there are some issues with the awareness of employers toward bipolar disorder.

Understanding mania

Symptoms of mania

Mania can have a wide range of symptoms from mild to severe. Mild mania is involved in positive moods and productivity, whereas severe cases can develop delusions and increase the risk of suicide attempts.

Elevated mood and increased energy

Increased activity, energy, or elevated mood are core symptoms of a mild manic episode. In mild cases known as hypomania, a person is temporarily in a stage of productivity, living in a good mood and having the energy to be productive, lasting for 4 days rather than 1 week.^2,5 Nevertheless, hypomania is different from mania since it does not affect social or professional activities.² Symptoms of hypomania can include:^{1, 2}

• Feeling very happy, euphoric or very excited
• Feeling irritable and agitated
• Being easily distracted or having a hard time concentrating
• Increasing self-esteem or self-confidence
• More energetic than usual
• Talking very fast and more than usual

Impulsivity and risk-taking behaviour

Impulsiveness tends to lead to unplanned reactions without thinking thoroughly or considering consequences. This includes risky decision-making, high-risk-taking attitudes, poor self-inhibitory control and quick decision-making. These can lead to bad consequences such as abuse, suicide attempts or aggressive behaviours.

Decreased need for sleep

Almost all patients with a manic episode are found to have a reduced need for sleep and take a longer time to fall asleep. The sleep pattern is disturbed in mania patients, leading to a poor quality of sleep.⁶

Grandiosity and distractibility

Grandiosity is when you feel superior to others and have high self-esteem or excessive confidence.⁷ Distractibility is when your attention shifts easily to unimportant or irrelevant activities or thoughts.⁸

Diagnosis and treatment

Diagnostic criteria

To diagnose mania, your doctor will ask about your history on topics related to characteristics of this condition, such as sleep, activity or moods. The main evaluation tool is DSM-5, where patients with a manic episode should experience a rapid mood swing (very happy or angry) lasting for at least one week, or any time if they stay in the hospital.²

Common treatments

In general, medicinal therapy combines medications that reduce acute symptoms of mania and, concomitantly with medications, maintains mood stabilisation. In the past, treatments were mood stabilisers and anticonvulsants. However, current treatments are shifting to antipsychotics because they are more effective.²

Impact of mania on work performance

Positive impacts

Increased productivity and creativity

As in hypomania, patients tend to have increased self-esteem, greater creativity, productivity and goal-oriented activities. This provides beneficial effects in the workplace by increasing productivity and problem-solving skills. For example, in one case from a depression survey, a 26-year-old female with bipolar disorder said that during hypomania, she was able to create her best works and solve a problem that she had been stuck with for 2 months. Unfortunately, hypomania has a short shelf life that can last at least 4 days, then it will turn to a depressed state.⁹

High energy levels and enthusiasm

People during hypomania have high levels of energy and feel enthusiastic. These behaviours can drive people to do their best work, which benefits their careers or leads to success in their careers. For example, one hypomanic patient had made some successful projects and written key articles, bringing him to a more public reputation.⁹

Negative impacts

On the opposite side far from the utopia of mania, mania is associated with negative effects and interpersonal difficulties in the work environment. The symptoms are associated with work performances described further.

Erratic behaviour and impulsivity

Manic individuals often perform unpredictable or illogical behaviours which increase the likelihood of making mistakes, such as making a mistake on numbers, or not being able to take messages. Overspending can occur during hypomania, resulting in impulsive financial decisions. Some patients had made financial mistakes.⁹

Difficulty in maintaining focus and completing tasks

Extreme energy and distractibility during mania can make it difficult to focus and easily get distracted, which sometimes can result in unfinished tasks and missing deadlines. Some people may have a lot of thinking or ideas, but they cannot concentrate on the ideas popping up, and then they cannot remember.

Interpersonal conflicts and workplace disruptions

Agitation, grandiosity and poor decision-making can create issues with supervisors and colleagues or a hostile work environment. In addition, some cases cannot be consistent in work, for example, they cannot continue their job for a long period.⁹

Risk of burnout and subsequent depressive episodes

When facing long periods of mood swings, high activity and reduced sleep can cause physical and mental exhaustion.  Poor work performance and interpersonal problems can lead to a stage of burnout, and a lack of passion for their jobs, resulting in going to depressive episodes and repeated failure repetition.⁹

How to manage mania in the workplace

Self-management techniques

Recognising early warning signs

First, start by understanding and accepting your symptoms. Common symptoms occurring in bipolar disorder are changes in emotions, energy and activity levels combined with the characteristic symptoms of mania or known as “DIG FAST” ²

• Distractibility
• Irresponsibility or Irritability
• Grandiosity
• Flight of ideas
• Increased activity
• Decreased sleep
• Talkativeness

If you have experienced these symptoms, you should see your doctor and receive therapy to solve this condition and not let it cause problems in the future.

Adhering to treatment plans

As medications, in particular for mental illnesses, have unbearable side effects and need a long time to treat to adjust chemicals in your brain, the important thing is to be disciplined in your treatment. The first thing is to adhere to treatment and take medication at the same time every day. Therapy needs to take time to be effective.¹⁰

Stress management and healthy lifestyle choices

Apart from medication, lifestyle modification and taking supplements can help you cope with the symptoms of mania, such as eating healthy foods, increasing physical exercise and having good quality of sleep. Include this in your daily life and keep it regular. If your stress bursts, you should seek some help from your friends or your family or find other activities to change your mind direction to focus on something else.¹⁰

Workplace accommodations

Currently, many companies are increasing awareness of mental illnesses in the workplace. The number of legal rights and company policies is increasing.

Flexible work hours and modified duties

According to the GOV.UK, employees in the UK have the right to request flexible working management, including a change in

• The number of working hours
• Time to start or finish work
• Work locations
• Work patterns

Creating a supportive work environment

Building a supportive work environment needs collaboration from various departments, especially the employer. Employers should pay attention to employees’ mental health by promoting work-life balance, providing training programmes on improving soft skills and fostering an inclusive culture.

Communication strategies between employees and employers

Promoting open conversation about mental health and communication channels that are accessible to everyone can build effective communication.¹¹

Summary

Mania is one stage of bipolar disorder that causes high energy, mood and behaviours. Hypomania is mild mania, which provides positive impacts on the work environment, including creativity, productivity and enthusiasm. However, this stage generally does not last for long. In addition, the negative effects of mania are impulsiveness, sleep disturbance, distractibility and grandiosity, which lead to a huge impact on work performance. To manage mania in the workplace, start with individuals recognising and accepting their illness. Next, stick to their treatment and reduce stress. Lastly, employers should have an awareness of mental illness and develop policies or a health centre to assist their employees.