It could be that she has ADHD and is very hyperactive. That can look like constant mania. My husband is like that and was an alcoholic His need to be active has not changed and he tends to be loud. I have learned that many of the people involved with AA are ADHD like my husband.

There is a spectrum with ADHD that is mild to very prominent. A therapist of mine that met my husband noticed it right away and that prompted me to read about it and sure enough I could see my husband’s behaviors being described. They can have a hard time slowing down and relaxing. Also can be very forgetful and impatient. My husband tends to get busy and constantly leaves the door open and puts his keys down and gets distracted and can’t remember where he put them down.

That being said there can also be co-existing issues including a personality disorder, or narcissistic traits. Yet, I don’t want to paint with a broad brush as each person varies. They can develop a pattern of behavior that can seem manipulative but often it’s more of what they can do to please rather then manipulative in nature.

So far there are only a few medications prescribed to help reduce that need to be in motion that can look manic. Some use medical marijuana, but not to be high and some find Wellbutrin helpful and there are other medications. I know someone taking three different medications as like what you have shared, they struggle to sleep. They are often very misunderstood individuals.