The ascent into mania: a review of psychological processes associated with the development of manic symptoms.

A comprehensive psychological account of the development of manic symptoms is needed to improve interventions for bipolar disorder. This review aims to develop the basis for such an account by covering three domains of evidence: (1) the multiple symptoms of mania; (2) the signs and symptoms leading up to mania; (3) the psychological processes associated with bipolar disorder, in particular during elevated mood states. It is concluded that the development of mania is characterised by a core experience of psychomotor activation that builds up over time and is associated with, and potentially enhanced by, increased processing of internally generated evaluative (positive and negative) information about the self and close others. The challenge of a theoretical account is to explain this dynamic process and predict how different symptom profiles develop over time within different individuals.