When you are manic your thoughts race and that can cause them to be intrusive. Irritablity is a common characterisitc of mania. And it can be hard to know where you are, especially early on. Mania feels good, it can feel normal or like you are having a good day when really you are having a GOOD day.

Until I was hospitalized the first time I lived with a great fear of it and since I've been in there several times I live with a great desire to not go back. So personally I'd try the medication to avoid having that become more of a reality. But that's just me.