Following brain injury, the person with damage to the frontal lobes and associated networks may exhibit ‘manic type’ symptoms which can appear similar to mania (as seen in bipolar disorder). The person may present as euphoric i.e. elated in mood. Emotional states may be observed where a superficial ‘happy’ mood or euphoria is prominent; not dissimilar to elevated mood observed in mania.
This clinical presentation can make it difficult to differentially diagnose a manic illness following brain injury from a manic state related to a bipolar disorder. Where an elated mood is observed in patients following brain injury, there is generally no associated other features of a bipolar disorder e.g. pressure of speech, flight of ideas and grandiose delusions.
Communication impairments arising from language processing impairment and/or cognitive impairment should not be confused with manic symptoms (e.g. tangentiality, pressure of speech, naming errors, reduced listening skills, distractibility). Although the symptoms of mania, executive functioning impairment and communication impairment may share similar features, it should be recognised that these conditions arise from different causes.
It is important to seek psychiatric assessment and advice regarding differential diagnosis and management of manic type symptoms. It is also important to ensure that a full assessment of cognitive, communicative, perceptual and sensory abilities is carried out prior to making a definitive diagnosis.