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"What could be the reason I only feel alive and energetic during manic episodes, and should I be concerned?"

**Dopamine rush**: During manic episodes, the brain releases high levels of dopamine, a neurotransmitter associated with pleasure and reward, which can create feelings of euphoria and increased energy.

**Circadian rhythm disruption**: Manic episodes can disrupt the body's natural sleep-wake cycle, leading to insomnia or excessive daytime sleepiness.

**Increased creative output**: Many people with bipolar disorder report increased creativity and productivity during manic episodes, which can manifest as writing, art, or other forms of expression.

**Racing thoughts**: Manic episodes can cause rapid, racing thoughts, which can be overwhelming and difficult to control.

**Grandiose thinking**: People experiencing manic episodes may exhibit grandiose thinking, believing they have exceptional abilities or talents.

**Impulsivity**: Manic episodes can lead to impulsive decisions, such as excessive spending or reckless behavior.

**Social withdrawal**: After a manic episode, people may feel embarrassed or ashamed, leading to social withdrawal and isolation.

**Cortisol levels**: Research suggests that cortisol levels, a hormone associated with stress, may be elevated during manic episodes.

**Sleep deprivation**: Manic episodes can lead to severe sleep deprivation, which can exacerbate symptoms and worsen the episode.

**Neurotransmitter imbalance**: Manic episodes may be caused by an imbalance of neurotransmitters, such as serotonin and dopamine, which regulate mood and emotions.

**Lack of self-awareness**: During manic episodes, people may lack insight into their behavior and may not recognize the severity of their symptoms.

**Hypomania**: Manic episodes can be preceded by hypomania, a milder form of mania characterized by increased energy and activity.

**Comorbidities**: Bipolar disorder often co-occurs with other mental health conditions, such as anxiety disorders or substance abuse.

**Brain structure**: Research suggests that people with bipolar disorder may have differences in brain structure, such as a smaller hippocampus, which can affect mood regulation.

**Genetic component**: Bipolar disorder has a strong genetic component, with certain genetic mutations increasing the risk of developing the disorder.

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