Mental Health Monthly #17: Mania

<p dir="ltr"><strong>Contributors:</strong></p> <p dir="ltr">Andrew White MD - Outpatient Psychiatrist; Fellowship Trained in Addiction Psychiatry; Denver Health</p> <p dir="ltr">Travis Barlock MD - Emergency Medicine Physician; Swedish Medical Center</p> <p dir="ltr"><strong>Summary</strong></p> <p dir="ltr">In this episode of Mental Health Monthly, Dr. Travis Barlock hosts Dr. Andrew White to discuss the elements of mania that may be encountered in the emergency department. The discussion includes a helpful mnemonic to assess mania, work-up and treatment in the ED, underlying causes of mania, mental health holds, inpatient treatment, and the role of sleep in mania.</p> <p dir="ltr"><strong>Educational Pearls</strong></p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Initial assessment of suspected mania can be done via DIGFAST:</p> </li> <ul> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation"><strong>D</strong>istractibility - Individual that is unable to carry a linear, goal-directed conversation</p> </li> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation"><strong>I</strong>mpulsivity - Executive functioning is impaired and patients are unable to control their behaviors</p> </li> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation"><strong>G</strong>randiosity - Elevated mood and sense of self to delusions of grandeur</p> </li> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation"><strong>F</strong>light of ideas - Usually described as racing thoughts</p> </li> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation"><strong>A</strong>gitation - Increase in psychomotor activity; start several projects of which they have little previous knowledge </p> </li> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation"><strong>S</strong>leep decrease - Typically, manic episodes start with insomnia and can devolve into multiday sleeplessness</p> </li> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation"><strong>T</strong>alkativenes