Severe anxiety (with or without agitation) can definitely be a dysphoric mania. Sheer hell. And in my experience, requires a different treatment approach than non-bipolar mania does. For example, I had a vile, severe anxiety that kept going and going...pdoc kept prescribing standard anti-anxiety meds, which didn't do anything at all. Finally, my current pdoc prescribed Gabapentin and that has really helped level off the anxiety.