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Caring for Patients with Mania

Todd Belok

Todd Belok serves as a mental health technician at Temple University Hospital - Episcopal Campus in Philadelphia, Pennsylvania. Also a former psychiatric technician at the Psychiatric Institute of Washington, Todd Belok draws on experience caring for patients with mental illness symptoms such as mania.

A patient who is experiencing an acute manic episode may be vulnerable to unpredictable behavior and noncompliance regarding treatment. The patient's energy level and mood is likely to be extremely high, often to the degree that he or she feels indestructible. This may cause the person to engage in reckless behavior and have difficulty staying focused or still.
Management of mania requires the caregiver to meet the needs of the patient as much as possible, while also maintaining safety. For example, if the person needs to be physically active, the caregiver can bring him or her to a place where pacing will not disturb others. If the patient is making a specific request that is unsafe or impossible, the caregiver can suggest a reasonable alternative.
Meanwhile, the caregiver may be able to bring the person's energy down to a safer level by respecting his or her thoughts and ideas, while modeling slower speech and a single mental focus. The caregiver may need to watch for confusion and take a few quiet moments if the person seems to be losing control.
If the manic episode persists, the caregiver must monitor the patient's food and water intake. Encouraging eating may be easiest if the person is able to consume portable foods, such as sandwiches. Hydration may be even more important, particularly if the person is taking lithium as a medication, as dehydration can increase the likelihood it will reach toxic levels.

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