Manic episodes are like whirlwinds, sweeping people into states of extreme energy, heightened moods, or intense irritability. Though these episodes can seem invigorating or empowering at first, they carry considerable risks and implications. Manic episodes are most often associated with bipolar I disorder, a serious mental health condition that affects mood, behavior, and energy. Knowing the subtleties of mania is crucial for people, caregivers, and healthcare providers.

Bipolar disorder is a life-long commitment to treatment, and determining the right cocktail of therapies often takes a good deal of time. While this is certainly challenging, constant care and support allow patients to have fulfilling lives.

Manic episodes are the main feature of bipolar I disorder; however, people with bipolar II disorder experience less intense mania known as hypomania with depressive episodes. Bipolar disorder is a lifetime condition and thus has to be under continuous treatment.

What is a Manic Episode?

A manic episode, which is also termed mania, is characterized by an abnormally elevated or irritable mood for at least one week, lasting longer than ordinary and accompanied by higher levels of energy. Other symptoms may include impulsive behaviors, increased activity, and decreased need for sleep during the episode. Mania is characterized by the experience of feeling elated or invincible; however, the mood can change to irritability, racing thoughts, and poor judgments.

These are considered symptoms of bipolar I disorder, which is a long-term mental illness characterized by periodic extreme mood shifts. The DSM-5 dictates that the manifestations of mania should cause an interference with everyday life and potentially require hospitalization.

Symptoms of Mania

Mania varies differently from person to person; however, a few common signs are seen below:

• People may have unthinking overconfidence or megalomanic delusions, such as believing they have special abilities or connections to famous people.
• Even though they may sleep only a few hours or not at all, people in a manic state often feel energized and alert.
• Speech may become rapid, loud, or even incoherent, mirroring the speed of their thoughts.
• Clanging—using words because of their sound rather than their meaning—is also possible.
• Mania tends to result in inability to focus on a single task or conversation with an ability to switch rapidly to irrelevant stimuli.
• Individuals engage in several activities or work on multiple projects simultaneously, usually far beyond what can be completed. Hypersexuality and obsessive social contact are common features.

In some cases, actions are performed that are potentially catastrophic in nature, including impulsive spending, dangerous driving, or substance use.

Also Read: Is Elon Musk Struggling With His Mental Health?

What Usually Follows A Manic Episodes

While manic episodes might seem exciting or productive, the consequences are usually severe. The impulsivity and poor judgment of mania can lead to such things as:

- Financial instability due to reckless spending.

- Strained or damaged relationships.

- Job loss or professional setbacks.

- Physical harm from risky behaviors.

This cycle of a manic episode followed by a crash often results in depression, which in turn creates another cycle that continues to disrupt a person's life.

Common Treatment Approaches

Management of bipolar disorder usually involves a combination of medication, therapy, and lifestyle changes:

Medications: Mood stabilizers, atypical antipsychotics, and antidepressants are commonly prescribed.

Psychotherapy: There are different types of therapies, including Cognitive Behavioral Therapy (CBT) and Interpersonal and Social Rhythm Therapy (IPSRT), which help the patient understand and manage their symptoms.

Lifestyle Changes: Regular exercise, meditation, and mood tracking can support overall mental health.

Managing a Manic Episode

Proactive management of mania involves the recognition of early warning signs and the implementation of coping strategies:

Keeping a journal or using a mood-tracking app can help find patterns and triggers. Involvement of closely knitted family or friends can help keep track of one's symptoms and provide a much-needed external perspective as well as timely intervention. Alcohol and drugs will, without fail, fuel the symptoms and confound treatment. Early communication can circumvent the problem from escalating.

Manic episodes are complex and multifaceted, affecting not only the individual but also their relationships and quality of life. If you or someone you know is experiencing manic symptoms, reaching out to a healthcare professional is an essential first step.

Bipolar Disorder. National Institute of Mental Health. 2020

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). 2013

First episode mania: We should have intervened earlier. Lancet. 2019

World Autism Awareness Day commemorates the period set aside to develop insight and promote solutions for those with autism spectrum disorder (ASD). Although the classic therapies of applied behavior analysis (ABA), speech therapy, and occupational therapy have been the standard intervention for autism, there has been an increasing interest in a different method: play therapy. Advoctates purport that play therapy stimulates a child's intrinsic method of acquiring knowledge, supporting communication, interpersonal skills, and emotional balance more effectively than can often be provided by mainstream interventions. Is play therapy the secret ingredient of autism intervention?

Autism Spectrum Disorder (ASD) impacts a child's capacity to communicate, socialize, and use imaginative play. Compared to neurotypical children, autistic children tend to have difficulties with pretend play and usually have a strong interest in particular activities. With these difficulties in mind, therapeutic interventions that address their needs are highly important. One of these interventions is play therapy, which is a structured but fun means of helping autistic children acquire vital life skills.

Play is the language of children, being a universal way of communication and learning. The Association for Play Therapy (APT) describes play therapy as the "systematic use of a theoretical model to establish an interpersonal process wherein trained play therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development." (APT, 2021).

In autistic children, play therapy provides a fun and organized setting to understand feelings, rehearse social interactions, and improve communication. A professional therapist helps the child progress through play-based strategies that promote self-expression and establish healthy relationships with parents, siblings, and friends.

Why Play Therapy Works for Autistic Children?

Play therapy is especially effective for children with ASD because it works within their natural learning and interaction style. It offers a low-stress, safe space in which children can:

• Learn social skills like turn-taking and understanding nonverbal communication.
• Enhance communication through verbal and nonverbal interaction.
• Learn to regulate emotions in order to cope with frustration and anxiety.
• Develop problem-solving and cognitive flexibility.
• Decrease anxiety and build confidence in social situations.

Because autistic children tend to interact with play differently—e.g., becoming fixated on the components of a toy instead of the object as a whole or having difficulty with pretend play—therapists employ systematic methods to enable them to connect with their environment and the individuals in it.

Types of Play Therapy for Autism

Play therapy involves a variety of methods adapted to a child's individual needs. Some of the most useful types for autistic children are:

Child-Centered Play Therapy (CCPT)

CCPT emphasizes establishing a nonjudgmental and accepting environment in which children are able to express themselves spontaneously. The therapist becomes the facilitator, with the child selecting activities of play while being treated with empathy and acceptance. This creates an atmosphere of safety and trust, with children able to explore their emotions and build up social skills organically.

Structured Play Therapy

Unlike CCPT, structured play therapy involves specific activities designed to target particular developmental goals. These sessions help autistic children develop essential skills in a step-by-step manner, ensuring they feel comfortable and supported.

Cognitive Behavioral Play Therapy (CBPT)

CBPT is an integration of cognitive behavioral therapy (CBT) with play therapy to assist children in identifying and managing their emotions. CBPT is particularly beneficial for children experiencing anxiety, frustration, or challenges with the adaptation to new circumstances.

Benefits of Play Therapy for Children with Autism

Enhanced Communication Skills

Play therapy allows autistic children to exercise verbal and nonverbal communication. By means of spoken language, gestures, or interactive stories, children become more at ease with self-expression.

Increased Social Interaction

Through play with a guide, children exercise basic social skills like turn-taking, sharing, and reading body language. These social skills enable them to develop more positive relationships with family members and peers.

Emotional Regulation and Coping Strategies

Play therapy provides a secure environment where children can experiment and learn to deal with their feelings. Therapists can demonstrate skills like deep breathing or the use of a "calm-down" toy to assist children in dealing with frustration and stress.

Problem-Solving and Cognitive Flexibility

Structured play activities encourage children to think creatively, adapt to new scenarios, and develop planning skills. This can be particularly helpful in improving their ability to adjust to changing routines or social expectations.

Reduced Anxiety and Increased Confidence

By providing a playful and interactive setting, play therapy makes autistic children less apprehensive about social interactions and new experiences. Gradually, this increases their confidence and readiness to interact with the world around them.

Play Therapy Activities for Autistic Children

Including therapeutic play activities at home can further increase the advantages of professional play therapy. Some ideas include:

Gross Motor Games

Obstacle Course: Create an indoor obstacle course with pillows, chairs, and painter's tape. Have your child jump, spin, and crawl through the various sections to promote coordination and sensory integration.

Tilt a Ball: Cut a hole at the bottom of a cardboard box to make a basic ball maze. Have your child tilt the box to direct the ball through the maze to develop hand-eye coordination.

Fine Motor Games

Free the Animals: Secure plastic toy animals with painter’s tape and have your child peel them off to strengthen fine motor skills.

Clay Sculpting: Use therapy putty or clay to model different shapes or animals, enhancing dexterity and creativity.

Interactive and Group Play Activities

Scavenger Hunt: Create a themed scavenger hunt to encourage problem-solving and exploration.

Ribbon Wand Dancing: Place ribbons on wooden spoons and invite dancing to music, enhancing gross motor skills and sensory awareness.

Row, Row, Row Your Boat: A cooperative game wherein children rock back and forth as they sing, enhancing cooperative play and rhythmic movement.

Role of Parents in Play Therapy

Parent participation is essential to the success of play therapy. By attending therapy sessions and applying learned skills in everyday life, parents can support gains and create further opportunities for development. Parents are frequently taught by therapists to use play-based strategies to facilitate communication, emotional control, and social interaction within the home environment.

Choosing the Right Play Therapy for Your Child

When selecting a play therapist, keep the following in mind:

Credentials: Seek professionals who hold a psychology, social work, or counseling degree, and play therapy certifications (e.g., Registered Play Therapist, RPT).

Experience: Opt for a therapist experienced in treating autistic children, as they will have in-depth knowledge of ASD-specific issues.

Approach: Talk to various therapy approaches to select the one that will best suit your child's needs and personality.

How Can Parents Support Play Therapy at Home?

To ensure maximum returns from play therapy, parents can:

• Encourage play learning: Integrate therapy skills into daily life.
• Design a supportive play environment: Create a quiet, stimulating area with sensory-friendly materials.
• Learn from sessions: Use therapist-recommended techniques to build on progress in the home environment.

Play therapy is an effective intervention for autistic children, providing a natural and fun means of establishing communication, social, and emotional skills. With the help of trained therapists and the integration of play-based strategies at home, parents can facilitate their children in acquiring key life skills in a fun and nurturing environment. Consulting professional services and remaining actively engaged in the therapy process ensures that autistic children get the assistance they require to flourish.

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder affecting social interaction, behavior, and communication. The etiology of autism is yet to be deciphered, although there is burgeoning evidence that an intimate relationship between the gut microbiome and the brain exists. In recent times, researchers have been investigating the possibility of using probiotics—the so-called "good bacteria"—as therapeutic interventions in children with autism. These supplements not only enhance digestive health but also reduce some of the behavioral symptoms, bringing hope to millions of families around the globe.

ASD is highly variable in its signs and symptoms. Some children have speech and communication problems, whereas others have sensory sensitivity or repetitive behaviors. Most have a problem with emotional regulation and social communication. Less openly spoken is that kids with autism very often have gastrointestinal (GI) problems like bloating, constipation, diarrhea, and irritable bowel syndrome (IBS).

Research has shown that people with autism tend to have an imbalance of their gut microbiota, with less healthy bacteria and more pathogenic bacteria like Clostridia. This has prompted scientists to study if normalization of the gut through probiotics would help improve symptoms of ASD.

Role of Probiotics in Gut Health

Probiotics are live bacteria and yeasts that are beneficial to the digestive system. They are present in fermented foods such as yogurt, kefir, kimchi, and miso, and also in dietary supplements. Probiotics assist in keeping the good and bad bacteria in the gut in balance. These good microbes enhance digestion, boost the immune system, and can lower inflammation—factors that may contribute to autism symptoms.

Increased numbers of studies now indicate that probiotics may provide an effective complimentary treatment for individuals with ASD. In a more recent study revealed by the BMJ Journal, it was identified that children consuming probiotic supplements noticed a reduction of 47.77% in behavioral signs. The trial further indicated an attenuation of social withdrawal by 40% as well as the rate of repetition reduced by 37.77%. Further, enhancements in gastrointestinal well-being were observed, such as a rise of 18.18% in formed stools and a decrease of 6.66% in watery stools.

The Autism-Gut-Brain Connection

The brain and the gut are closely linked by the gut-brain axis, a two-way communication network between the nervous system and the digestive system. The US Department of Health and National Institutes of Health (NIH) place significant importance on gut microbiota in postnatal brain development. Scientists feel that alterations in gut bacteria can be responsible for neurological and behavioral abnormalities in children with autism.

Ohio State University Study links kids with ASD were noted to have lower amounts of Faecalibacterium prausnitzii, a gut bacterium linked to good gut health.

Another research stated that how chemicals made by gut bacteria affect autism behaviors.

A 2016 International Meeting for Autism Research (IMFAR) detected Haemophilus parainfluenzae in the stools of autistic children, tying it to gastrointestinal distress and behavioral difficulties.

Based on this evidence, numerous scientists now think that enhancing gut health with probiotics may help ease symptoms of autism.

Probiotics and Digestive Health in Autism

Individuals with autism have a higher tendency to experience GI disorders like IBS and leaky gut syndrome, which results when toxic bacteria and toxins escape into the blood through a weakened intestinal lining. Leaky gut symptoms can be:

• Constipation
• Bloating
• Excess gas
• Nutrient deficiencies
• Food allergies

By restoring the balance of gut flora, probiotics can potentially treat these gastrointestinal disturbances. Probiotic strains including Lactobacillus acidophilus, L. rhamnosus GG, L. reuteri, and Bifidobacterium have been effective in maintaining intestinal health and relieving symptoms of children with inflammatory bowel disease (IBD), a condition typically observed in children with ASD. Saccharomyces boulardii, a probiotic yeast, has also been reported to be responsible for the relief of obsessive-compulsive behaviors, which are characteristically observed in children with autism.

How to Choose the Right Probiotic for Autism?

When choosing a probiotic supplement for an autistic child, parents need to take the following into account:

Strain Diversity: A variety of bacterial strains is best for maintaining gut health.

Scientific Support: Opt for probiotics that have scientific evidence, like Lactobacillus and Bifidobacterium species.

Live Cultures: Make sure the product has active, live bacteria that can withstand stomach acid and travel to the intestines.

Consultation with a Physician: Always consult with a physician prior to the initiation of probiotics, particularly for children with weakened immune systems.

Although probiotics are regarded as safe, side effects can be in the form of slight gas, bloating, constipation, or allergic reactions. Nevertheless, these are generally tolerated as the body acclimatizes to the new bacterial load.

Are Probiotics a Safe and Effective Treatment for Autism?

The US Food and Drug Administration (FDA) oversees probiotics as foods, not as drugs, so their efficacy and safety are not under the same level of intense testing as pharmaceuticals. However, experts in the health field are unanimous in saying that probiotics are safe for children as well as adults when used properly.

Although probiotics cannot be considered a sole treatment for autism, they can be used to augment current therapies like behavioral therapy, speech therapy, and special education programs. Stool analysis can also be used to identify the most appropriate probiotic strains for a child's individual needs so that a customized approach to gut health can be adopted.

Autism can be difficult to handle by families, but research on the gut-brain relationship provides new promise. While researchers keep finding the connection between gut health and neurological function, probiotics can become the hoped-for component in the overall treatment of autism.

Improvements in microbiome science, as well as greater knowledge of probiotics, are a giant leap toward enhancing the quality of life in ASD-affected children. Although larger clinical trials are necessary to delineate the role of probiotics in autism treatment comprehensively, the early results are promising. Parents willing to use probiotics for the child should visit a healthcare practitioner to decide on the most suitable method for their child's specific requirements.

A regular manicure became a lifesaver for 58-year-old Michelle Tagliamonte of Centreville, Ohio. What appeared to be a minor cosmetic issue—a strange black line on her thumbnail—proved to be an early warning sign of melanoma, one of the most dangerous types of skin cancer. Her experience highlights the value of being attentive to changes in your body and seeking medical advice when things do not feel right.

Tagliamonte, like many others, had a regular beauty routine. She visited a nail salon every four weeks for a manicure, a routine she followed without much thought. Yet, at the time of her last September visit, she noticed something odd—thin black lines on her right thumbnail. She initially dismissed it, thinking that nothing was wrong.

"I typically get my nails done every four weeks, so I don't know how long it had been there," she remembered. "But my nails grow pretty quickly because I have really good nutrition. It could have been there for six months or longer."

She snapped photos of the lines and went on with her nail appointment, unaware that this apparently insignificant detail was an indicator of something much more severe.

As the weeks went by, Tagliamonte observed that the lines did not extend out with her nail as she had anticipated. Rather, they stuck at the base of her thumbnail and appeared to be getting deeper. By the time her next appointment arrived, the marks persisted—unchanged and unerased.

That was the wake-up call. Not taking any chances, she went to see a doctor. Over Thanksgiving, the results revealed her worst fears—the black lines were evidence of melanoma, stage zero or 'melanoma in situ.'

What is Stage Zero Melanoma?

Stage zero melanoma, or 'melanoma in situ,' is a situation where the cancer cells remain in the epidermis and have not extended beyond it. Although it is the most treatable and earliest stage, it can become invasive melanoma, spreading to other regions of the body and threatening life, if it goes undiagnosed.

Physicians moved quickly to eliminate the cancerous cells before they had a chance to disperse. On January 17, Tagliamonte received a four-hour surgical procedure in which physicians amputated her entire thumbnail. To reattach the damaged area, a skin graft was conducted using tissue from the rest of her thumb.

The dermatologist noticed discoloration at the bottom of my nail," she said. "Whatever was producing this black line was originating from within the growth plate, way down deep inside my nail.

The procedure was invasive and complicated. The melanoma extended down to the first knuckle of her thumb, and a considerable amount of tissue had to be removed. The exposed bone and tendon were covered with the skin graft to allow the area to heal. Although she permanently lost her thumbnail, Tagliamonte is thankful for the timely medical intervention that left her alive.

Tagliamonte attributes her routine manicure sessions and her own vigilance for detecting the disease before it advanced to a more serious phase.

"The nail appointment definitely saved my life," she stressed. "I am thankful that I noticed it and then went about having it checked out."

Her experience is an eye-opener that even slightest changes in the body, whether seemingly innocuous, can prove to be signals of major illness at times. She now prefers others to be alert and hearken to instincts.

If you notice something unusual or different, listen to your own instincts and have it looked at," she warned. "If I'd have ignored it, Lord only knows what might have happened to me in the future."

Hidden Dangers of Nail Health and Exposure to the Sun

Tagliamonte's account also makes one mindful of other health hazards of nail care. Numerous individuals are not aware that dark or black stripes in the nails can be markers of hidden underlying medical conditions. At times, such markings could be a consequence of a disorder known as subungual melanoma, an infrequent yet malignant form of skin cancer beneath the nail.

Moreover, experts caution against the dangers posed by the UV lamps that are employed in certain professional manicures to harden gel nail polish. Such machines release UVA rays, which penetrate deep into the skin, heightening the risk of skin cancer with extended exposure.

"Too much exposure to UV light can harm the DNA of skin cells, causing them to grow out of control and form tumors," say dermatologists. "UVA and UVB radiation both help cause skin cancer, though UVB is more directly responsible for sunburn, with UVA causing more long-term harm and hastening the skin's aging process."

Uncommon Signs of Melanoma

Although melanoma is usually linked to moles and skin lesions, Michelle Tagliamonte's situation featured a number of uncommon warning signs:

Black Stripes on the Nail – Rather than a visible skin lesion, she saw dark stripes along her thumbnail, a less common symptom of subungual melanoma.

No Discomfort or Pain – Most people expect cancerous tumors to be painful, but Michelle felt no pain, making the diagnosis even more surprising.

Slow and Steady Growth – The streaks did not fall out or simply grow out with her nail, an indication that there was something amiss.

Concealed Source – The melanoma was growing from the growth plate of the nail underneath, hence hidden at first.

Stage Zero Diagnosis – Despite the alarming signs, the melanoma was actually in its earliest stage, illustrating how intervention at this point could avoid fatal effects.