Research paper says mania alters, but doesn’t erase, decision-making

—Mania can bring a rush of urgency that changes how people decide and act. But it may not wipe out their ability to act for themselves.

That’s the argument from University of Birmingham philosopher Elliot Porter in a 2024 Philosophical Psychology paper. He says manic states alter the structure of agency — the way people form and act on reasons — without destroying it.

The difference, Porter says, lies in urgency. People in mania can still notice reasons for action and adjust to them, but those reasons feel more immediate and pressing. That can lead to quick decisions and persistent activity, even if others see the choices as risky or unwise.

Porter distinguishes between “reasons-tracking” — spotting reasons for action — and “reasons-responsiveness” — changing behavior in response. In mania, both are intact, but urgency shifts how they operate.

The paper largely leaves aside other possible manic symptoms — delusions, hallucinations, grandiosity, racing thoughts or psychosis — treating them as background factors. Instead, urgency is the focus.

From inside the episode, actions often make sense within this urgency-shaped framework. The trouble, Porter says, is that outsiders may dismiss the person’s autonomy entirely. Autonomy depends not only on internal capacity, but also on whether others treat someone as a capable decision-maker.

When mania is misunderstood, people can be shut out of decisions that shape their lives. Porter believes recognizing manic agency could change clinical care and public attitudes. Instead of writing off choices as irrational, caregivers and peers could engage with them as products of a different, but still working, decision-making process.

That, he argues, isn’t just courtesy — it’s a way to preserve autonomy in practice. He calls for more research into how social environments can respect and support decision-making during mania, in hopes of reducing stigma and building trust in care.

Citation:
Porter, E. (2024). Mania, urgency, and the structure of agency. Philosophical Psychology. https://doi.org/10.1080/09515089.2024.2342543

Note from a person suffering bipolar I: In someways this article hits home. Attributing agency, accountability, or choice during a manic episode is challenging. As someone who experienced a prolonged manic episode, it’s difficult to reconcile my decisions with the decisions I made as a normal person. While in the episode, I had delusions, nonsensical reasoning, and thoughts that were beyond reality. The article makes me wonder what kind of autonomy I could have exerted over the bad decisons I made, as I regret so many. I feel the author does not fully understand the psychosis that mania an bring to a person’s mind, sense of responsibility, autonomy and realistic agency.