Do people with mania understand what's happening during an episode?

Generally, whether patients are aware of their condition during a manic episode depends on the severity of the illness and their individual cognitive functioning. The specific analysis is as follows:

If the manic episode is mild and the patient's cognitive function is not severely impaired, they may recognize that their mental state is abnormal. Such patients can notice their excessively elevated mood and racing thoughts, and sometimes realize their behaviors are more impulsive than usual. However, they often find it difficult to control themselves, although some may actively seek help to relieve discomfort.

If the episode is severe and accompanied by明显的 cognitive disturbances or psychotic symptoms, patients are typically unaware of their abnormalities. They firmly believe their heightened emotions, grandiose ideas, and impulsive behaviors are justified, resist feedback from others, and may even experience hallucinations or delusions, becoming completely immersed in their own distorted reality.

In daily life, it is important to maintain a calm and stable environment to avoid excessive stimulation that could trigger episodes. Encourage patients to maintain regular routines, adhere to prescribed medication, and assist them in tracking changes in mood and behavior. During an episode, remain patient, avoid arguments, gently guide the patient toward calmness, and promptly contact a healthcare provider if symptoms worsen.