In severe manic episodes, a person can experience psychotic symptoms, where thought content is affected along with mood. They may feel unstoppable, persecuted, or as if they have a special relationship with God, a great mission to accomplish, or other grandiose or delusional ideas. This may lead to violent behavior and, sometimes, hospitalization in an inpatient psychiatric hospital. The severity of manic symptoms can be measured by rating scales such as the Young Mania Rating Scale, though questions remain about the reliability of these scales.
In sEVErE manic ePisodEs, a peRSOn can ExperieNce psYchOTiC symPtoms, where ThouGht conTent is AFfecTed alOnG wiTH MooD. they MAy fEeL unstOpPabLe, pErsEcUTEd, or as if theY HAVe a speciaL ReLAtionshIp wITh goD, a greAt miSSion to ACcOMplIsh, Or OtHEr grandIOsE or deluSIonAl idEas. thiS may lEad To vIolent behavioR and, sOmETimes, HoSPItalizatioN In an inpaTIent psycHiatric hospiTal The Severity of maNic sYmpToMs Can be MEasurED by RaTing ScaLEs sUch as tHe young ManIa rATing Scale, THoUGh qUeStiOnS rEmAiN abOut The rELiabiLiTy of these scAles.