First, what are the manifestations of mania? The typical clinical symptoms of bipolar disorder are high emotion, thinking and increased activity. 1, emotional high patients subjective experience is particularly pleasant, feel good about themselves, all day long, giddy, smiling, overflowing with joyful fun and attitude, and even feel that the sky is extraordinarily clear, the color of the surrounding things is extraordinarily gorgeous, they also feel incomparable joy and happiness. This high state of mind of the patient is infectious and often resonates with people around, causing laughter. Some patients are unstable and unpredictable, sometimes joyful and happy, sometimes excited and angry, despite their high emotions. Some patients are clinically characterized by anger, irritability, and hostility, and do not show high emotion, so they can easily jump like thunder, anger, and even appear to be destructive and aggressive, but often quickly turn anger into joy or apologize. When the patient’s emotions are high, the patient’s self-esteem is too high, manifesting as arrogance, arrogance, arrogance, arrogance, arrogance and arrogance. Exaggerated notions of being the greatest, the most capable, and the richest in the world may appear. It may even reach the level of exaggerated or rich delusions, but the content is not absurd. Sometimes there can also be relationship delusions, delusions of victimization, etc., mostly secondary to emotional highs, and generally do not last long. Sometimes, it feels as if the tongue is racing with the mind, and the speech cannot keep up with the speed of thinking, which is often manifested as increased speech, incessant speech, hand dancing and eyebrow dancing, even though the mouth is dry and the voice is hoarse. However, the content of the speech is superficial and messy and impractical, often giving people the impression that they are talking out of thin air. Because the patient’s attention shifts with the situation, thinking activities are often affected by changes in the surrounding environment, resulting in a sudden change of topic, and the content of speech often quickly shifts from one topic to another, i.e., manifesting as drifting ideas, and some patients can appear phonetic association and intentional association. 3, increased activity performance of high energy, a wide range of interests, fast and agile movements, significantly increased activity, and endurance, busy all day long, but often do anything is a tiger’s head and a snake’s tail, there is no end, nothing is achieved. The person is nosy and lacks proper judgment of his or her own actions, and often does as he or she pleases without considering the consequences, such as squandering money at will, being very generous, and giving gifts to colleagues or passers-by at will. Focus on dressing and decorating, but not decent, to attract the attention of the surrounding people, and even perform in public, joking around. At work, he thinks he has superior intelligence and can solve all problems, and he commands others, reprimands colleagues, is domineering and arrogant, but gets nowhere. He is socially active, treats people casually, often goes to entertainment places, behaves frivolously, and is close to the opposite sex. He feels energetic, has inexhaustible energy, does not know how to get tired, and sleep is significantly reduced. When the disease is serious, the ability of self-control decreases, rude behavior, and even impulsive destruction behavior. 4, physical symptoms because the patient feels good about himself, full of energy, so there are few complaints of physical discomfort, often manifested as a rosy face, eyes, physical examination can be found in mildly dilated pupils, heart rate accelerated, and symptoms of sympathetic hyperactivity such as constipation. Due to the patient’s extreme excitement and excessive physical exertion, it is easy to cause water loss and weight loss. Patients have increased appetite, hypersexuality and reduced need for sleep. 5, other symptoms of mania when the patient’s active and passive attention are enhanced, but can not last, easily attracted to the surrounding things. This symptom of shifting with the situation is most obvious in the acute attack period. Some patients have memory enhancement, and diffuse uninhibited, changeable, often full of many details and trivialities, often lose the correct demarcation of the time of memory, so that it is confused with the past memory and no coherence. When the attack is extremely serious, the patient is in a state of extreme excitement and agitation, there may be brief, fragmentary hallucinations, disorderly behavior without purpose, accompanied by impulsive behavior; there may also be a disorder of consciousness, with delusions, hallucinations and incoherent thinking and other symptoms, called delirium mania. Most patients lose their self-awareness in the early stage of the disease. The milder manifestations of mania are called hypomania. Patients may have high emotion, high energy, increased activity that lasts at least several days, a significant sense of self-importance, inattentiveness and also inability to sustain, mild profligacy, increased social activity, increased sexual desire, and reduced need for sleep. It sometimes manifests as irritability, conceited pride, and more reckless behavior, but is not accompanied by psychotic symptoms such as hallucinations and delusions. There is a mild effect on the patient’s social functioning. Some patients sometimes do not reach the degree of affecting social function, and the general public often do not easily notice. Second, what is the course and prognosis of mania? Whether it is single mania or recurrent mania, most of them are acute or subacute onset, and the good season is late spring and early summer. The age of onset of mania is around 30 years old, of course, there are some early onset, in 5-6 years old, and some late onset, after 50 years old, but more than 90% of the cases start before 50 years old. The natural course of mania is generally considered to last from a few weeks to 6 months, with an average of about 3 months, with some cases lasting only a few days and individual cases lasting up to 10 years or more. Some people believe that recurrent mania, each episode lasts almost similarly, and can become chronic after many episodes, and a few patients have residual mild emotional symptoms, and social functions are not fully restored to the pre-morbid level. Modern treatment can eventually lead to complete recovery of 50% of patients. It has been suggested that only one episode in a lifetime accounts for only 5% of cases, but others believe it can be as high as 50%. During the first 3 episodes, the interval between each episode becomes shorter and shorter, and the duration of the interval between subsequent episodes does not change. For each seizure, the rate of significant and complete remission is 70% to 80%.