Mania and bipolar symptoms
Mania is a state where mood, energy and activity are clearly increased or disturbed. Someone can be remarkably energetic, excited or irritable, talk a lot, think fast and need much less sleep. In hypomania similar changes are present, but less severe. A manic episode usually has much more effect on functioning and may in serious cases be accompanied by delusions or hallucinations.
Manic and hypomanic episodes are particularly common in bipolar disorders. In this case, periods of increased activity can be alternated with periods of depressive complaints. Mixed images can also occur.
Acupuncture and Chinese herbal medicine can only be used in addition to bipolar symptoms. In acute mania, psychosis or severe psychiatric disorder, regular psychiatric treatment is paramount.
Common symptoms
Manie goes beyond a good mood or have a lot of energy temporarily. There is a clear change from normal functioning.
Possible symptoms include:
- a remarkable amount of energy and activity;
- much less need for sleep;
- exuberance or strong irritability;
- talk fast and much;
- thoughts that follow each other quickly;
- increased self-confidence or self-confidence;
- be rapidly distracted;
- strong physical and mental distress;
- impulsive or risky behaviour;
- difficulty in assessing limits or consequences of behaviour.
In severe mania, aggression, delusions, hallucinations or strongly inhibited behaviour may also occur.
In hypomania, the symptoms are milder. In addition, mixed characteristics can occur, for example, with a lot of energy, insomnia and inner restlessness associated with gloomyness, anxiety or despair.
Possible causes
In bipolar disorder, different factors play a role. There may be a predisposition to the development of manic and depressive episodes, where circumstances can also influence the emergence of a new episode.
Changes in sleep-wake rhythm, prolonged or severe stress and drug use can contribute to disruption in sensitive people. Certain medications may also provoke manic symptoms.
Mania-like complaints therefore do not automatically mean that someone has bipolar disorder. A good medical and psychiatric assessment is important to determine the cause.
How can acupuncture help with mania and bipolar symptoms?
In the case of bipolar disorder, acupuncture is used as an addition to regular treatment. The treatment is tailored to current symptoms and the phase in which someone is being treated. During a stable period, for example, the treatment accent may be different from increasing anxiety or after an episode.
Depending on the picture of complaints, treatment may be directed at:
- calming the Shen in case of inner restlessness and mental overactivity;
- support sleep and regular sleep-wake rhythm;
- promote the free movement of Qi in the event of tension and stagnation;
- Reduce heat when strong irritability and hunting are present;
- Reduce Dampness and Phlegm when mental cloudiness is at the forefront;
- Qi, Blood and Yin support when prolonged symptoms are associated with exhaustion;
- treat additional physical complaints.
The consulted TCM source emphasises that Chinese medicine in severe Dian Kuang images has a place especially during more stable periods and not as a replacement for treatment during an acute psychiatric crisis.
How can Chinese herbal medicine help with mania and bipolar symptoms?
Chinese herbs are not selected based on the diagnosis of bipolar disorder alone. The overall picture of complaints and the underlying TCM pattern is looked at.
Depending on the pattern, herbal treatment may focus on:
- calm the Shen;
- Reduce heat of fire in the event of strong restlessness and activation;
- Transform Phlegm when TCM says this interferes with mental brightness;
- Reduce Qi and Blood stagnation;
- Supporting Qi and Blood in case of fatigue and exhaustion;
- Yin feed when prolonged heat and restlessness are accompanied by signs of dryness and exhaustion.
In the case of bipolar disorder and psychiatric medication, extra caution is needed. Chinese herbs are used in addition. Prescribed medication is not reduced or stopped on its own. The source also stresses this when treating Dian Kuang patterns.
How does Chinese medicine view mania and bipolar symptoms?
In classical Chinese medical texts certain serious mental states are described within the concept of Dian Kuang. This concept is not the same as a modern diagnosis such as bipolar disorder, but certain characteristics may overlap with it.
Dian mainly describes a withdrawn, inhibited or confused image. Kuang refers to strong mental and physical activation, for example with restlessness, much speaking, little sleep, impulsive behaviour and in severe cases delusions or hallucinations. The two images can alternate. The source consulted describes this as a change between more yin-like withdrawal and more yang-like activation.
An important concept here is Phlegm . Within TCM, Phlegm means more than bodily slime. It can also describe a disturbance that hinders the clarity of consciousness and thinking. The source considers Phlegm as an important part of the more serious Dian Kuang images. It may be associated with Qi-stagnatie, Heat of Fire and in case of prolonged complaints also with Blood stasis or deficits.
With a highly activated image, Fire de Shen can disrupt. The Shen is an understanding within TCM for mind, thinking, emotions and mental presence. Also the Their, connected to the Liver organ system, plays a role in ideas, plans, creativity and mental activity. When these functions become strongly disturbed, mental activity can be excessive, disordered or hunted according to TCM.
In case of long-term complaints, the image may change. Repeat periods of Heat and strong activation can ultimately damage Yin, while prolonged stagnation can contribute to Blood stasis. This can put different TCM patterns in the foreground for one person in different phases.
What is a TCM organ system?
A TCM organ system describes a group of connected physical and functional processes and is wider than just the anatomical organ with the same name. Read more at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance according to TCM is at the forefront. The treatment is tailored accordingly. Read more at TCM basics .
Below are only some important patterns discussed. Other patterns are possible and multiple patterns can occur at the same time. Also, the pattern may change between different stages of the complaints. Not everyone with the same pattern has all the symptoms mentioned; the pattern is determined based on the overall picture of complaints.
Most common TCM patterns
Qi-stagnation with Phlegm
Brief explanation
With this pattern, Qi does not sufficiently flow freely according to TCM, while Phlegm hinders mental brightness. The image is usually more inhibited and withdrawn than hunted and thus mostly connects with the Dian side of Dian Kuang.
Common symptoms
Retracted behavior, depressed or flat mood, little initiative, much worry, mental inertia or cloudiness, lots of sighs, chest tightness and sometimes nausea or low appetite.
Examples of Western disorders
Depressive episodes within a bipolar disorder and other psychiatric images with withdrawal and mental delay at the forefront.
Qi-deficiency with Phlegm
Brief explanation
When Qi is weakened, the body can process less well according to TCM, making Phlegm easier. This allows strong fatigue, withdrawal and mental cloudiness to be combined. The source describes this as a further development of long-term Qi stagnation with Phlegm.
Common symptoms
Strong fatigue, low initiative, withdrawn behaviour, slow or confused thoughts, poor concentration, low appetite, paleness, shortness of breath and sometimes anxiety, worrying or strongly turned into themselves.
Examples of Western disorders
Long-term depressive or withdrawn periods within severe mood or psychiatric conditions.
Heart- and Spleen-Qi- and Blood deficiency
Brief explanation
In case of long-term complaints, Qi and Blood may become exhausted. According to TCM the Shen does not receive enough nutrition and stability. The symptoms are mainly of a worn-out and withdrawn nature. The source stresses that this pattern should first support the deficit and that too strong Phlegm-exciting treatment can further weaken.
Common symptoms
Chronic gloomyness, low energy or initiative, much need for rest, anxiety, rapid scare, palpitations, poor memory, low appetite, pale radiant pain and sleep that is disturbed by many dreams or nightmares.
Examples of Western disorders
Long-term depressive periods within bipolar disorder and symptoms after prolonged mental or physical exhaustion.
Heart- and Liver-Fire
Brief explanation
This pattern puts strong Heat of Fire at the forefront. According to TCM, this stimulates the Shen and can lead to pronounced mental and physical activation. The source describes this mainly as an early pattern of an acute manic phase, in which no obvious delusions or hallucinations need to be present.
Common symptoms
Strongly increased energy, remarkably much self-confidence, talk a lot and fast, very little sleep without feeling tired, strong irritability, agitation, impulsive or reckless behavior, red face or red eyes, thirst and sometimes palpitations or constipation.
Examples of Western disorders
Manic or hypomanic episodes in which strong activation, irritability and insomnia are at the forefront.
Phlegm-Fire disturbs the Shen
Brief explanation
When Phlegm merges with strong Fire, a more severe activated image is created within TCM. Phlegm hampers the clarity of the Shen, while Fire causes strong agitation and mental overactivity. In the source this is described as a further development of the manic image.
Common symptoms
Very strong restlessness and hyperactivity, hardly sleeping, much or incoherent talk, impulsiveness, pronounced irritability or aggression and mental confusion. In more serious cases, delusions or hallucinations may occur.
Examples of Western disorders
Severe manic episodes and certain psychotic conditions. In case of psychosis, aggression, severe inhibition or danger to yourself or others acute regular psychiatric care is necessary.
Blood- and Flegmastase
Brief explanation
According to TCM, long-term complaints can cause both Phlegm and Blood stasis. This further impedes the normal movement of Qi and Blood. The source describes this as a more chronic and stuck pattern in which the manic image can be less fervent than with Phlegm-Fire.
Common symptoms
Long-term mood disorder, restlessness and insomnia, suspicion or anxiety, mental confusion and sometimes firm physical pain. In addition, clear Blood stasis may prevent dark or purple discoloration of the tongue.
Examples of Western disorders
Long-term bipolar or other severe psychiatric symptoms involving various periods of activation and withdrawal.
Yin-deficiency with Deficiency Heat
Brief explanation
Long-term periods of strong heat and activation, according to TCM, may eventually weaken Yin. This lacks sufficient cooling and rest to limit Yang. There may still be obvious mental restlessness, but at the same time more and more physical exhaustion occurs. The source describes this mainly as a later, more chronic stage.
Common symptoms
Inner restlessness and irritability despite fatigue, low and restless sleep, warmth, red or warm face, dry mouth and throat, dry skin or eyes, thirst, constipation, weight loss and physical exhaustion.
Examples of Western disorders
Long-term bipolar complaints where repeated periods of strong activation are interspersed with increasing exhaustion.
Outlook
The course of bipolar symptoms varies greatly per person. Bipolar disorder usually has a prolonged vulnerability to recurrent depressive, hypomanic or manic episodes. Regular sleep-wake rhythm, early sleep, energy and behavior, and regular treatment monitoring are therefore important.
Acupuncture and Chinese herbal medicine can be used in addition when the situation is sufficiently stable. The treatment can then, for example, focus on sleep, tension, fatigue and the underlying TCM pattern. Because the complaints between different phases can change significantly, the TCM treatment may also change during the course.
In acute mania, psychosis, severe depression, suicidality or severe behavioural disorder, rapid regular psychiatric assessment is necessary. Acupuncture and Chinese herbs are in that situation no substitute for acute psychiatric care.
Contact
Do you have bipolar disorder or symptoms surrounding periods of hypomania or mania and do you want to know if acupuncture and/or Chinese herbal medicine can be of additional benefit to you?
During a first consultation, we will discuss your complaints, medical history, medication and any regular treatment. Based on the overall picture of complaints, it will be examined whether additional treatment is appropriate and which TCM pattern is at the forefront.
You can make an appointment directly online or contact us for more information.