When Keely describes her first manic episode, she lists what might be considered “classic” symptoms.
“I had lots of energy, a case of the giggles, and racing thoughts,” says Keely, 43. “I couldn’t sit still. I’d go to my office and sit down and then I’d have to get up and pace the floors.
“I felt like Wonder Woman,” adds Keely, who lives outside of Boston. “No one could knock me down.”
For Julianna of Orange County, California, the trademark manic exhilaration quickly breaks down into agitation, irritability, and physical discomfort.
“I get like 24 hours of euphoria and then a feeling like ants in my pants—like I’m crawling out of my skin,” the 46-year-old reports. “I get very agitated and I pick on people.”
In this mindset, Julianna can’t stand to see things out of place. She’ll yell at her husband for leaving his shoes in the family room or dramatically sweep messy papers to the floor.
“I scratch my neck until it’s red,” she adds. “I feel so yecch.”
Psychiatry has established a central set of criteria to diagnose mania. But the list of symptoms in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) doesn’t fully reflect how mania can vary from individual to individual.