Mental Health Blogs

What is the Difference Between Mania and Hypomania?

One of the main differences between bipolar I and bipolar II is that bipolar II experiences hypomania and not mania. Last week I wrote from the perspective of a hypomanic mind, but what is hypomania really? Is hypomania fun or is it just plain crazy?

Mania

In type I bipolar, a defining characteristic is mania. Mania symptoms include:

  • Abnormally and persistently elevated, expansive, or irritable mood
  • Inflated self-esteem or grandiosity
  • Decreased need for sleep
  • More talkative than usual or pressure to keep talking
  • Flight of ideas or subjective experience that thoughts are racing
  • Distractibility
  • Increase in goal-directed activity or psychomotor agitation
  • Excessive involvement in pleasurable activities that have a high potential for painful consequence

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In order for the mood to be considered manic, these symptoms must cause a “marked impairment in… functioning… or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features” (official diagnosis criteria).

It’s that last part that’s really key; mania must be severe and result in danger to yourself, others, relationships, employment, etc, typically leading to hospitalization.

Hypomania

For bipolar II we experience hypomania, which I like to call mania-light. All the crazy with half the impairment. It includes symptoms like:

  • A distinct period of persistently elevated, expansive, or irritable mood
  • Inflated self-esteem or grandiosity
  • Decreased need for sleep
  • More talkative than usual or pressure to keep talking
  • Flight of ideas or subjective experience that thoughts are racing
  • Distractibility
  • Increase in goal-directed activity or psychomotor agitation
  • Excessive involvement in pleasurable activities that have a high potential for painful consequences

The mood must also be unusual for the individual and noticeable by others. And now the important part, “the episode is not severe enough to cause marked impairment in… functioning, or to necessitate hospitalization, and there are no psychotic features.” (official diagnosis criteria)

Diagnostically, mania must be at least seven days whereas hypomania has to be at least 4 days.

(Other complexities like mixed-moods and rapid cycling aren’t discussed here.)

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Mania vs. Hypomania

So if you’ve been paying attention, you’ll note that the symptoms of mania and hypomania are virtually identical, the key differentiator is the severity. Mania is very dangerous because people don’t just act abnormally; they typically endanger themselves or vital parts of their lives. Mania often requires hospitalization due to the damage they are doing. Hypomania, on the other hand, may be an unusual mood, and it may cause some harm to the person or their lifestyle, but not to the point where they need to be hospitalized. People in hypomania buy five pairs of shoes, people in a mania buy 50.

Is Hypomania Fun?

So, if hypomania doesn’t get you hospitalized, and doesn’t severely endanger your life, is it fun? Well, it depends who you ask.

Some people say hypomania is enjoyable, happy, fun and the only break they get from their depression. Some people feel they’re more like the person they were before bipolar disorder than at any other time. They’re also fun to be around, creative and are social butterflies at that time. Oh, and the sex tends to be really good too. So, yes, some people really enjoy hypomania and find it fun.

On the other hand, some people get extremely irritable and even angry during hypomanic phases. They become very dissociative and disconnected from the world around them. They feel constantly bombarded by thoughts they can’t control and obsessed with fragments of music or literature that repeats endlessly in their mind. They feel possessed and like they’re being crushed by a very fast, very powerful outside force they can’t control. This is not in the least bit fun.

I Prefer Hypomania

If I got to choose between mania, hypomania and depression, I’d pick hypomania. True, I do feel awfully crazy and disconnected from the world when going through it, and true, the obsessive thoughts are tormenting, but the energy is such a great change of pace from the depression that I’ll take it any day. I’m more creative, can put more energy into achieving goals, and just plain get more done.

But that’s a personal thing. Would anyone care to share their experiences with hypomania?

You can find Natasha Tracy on Facebook or @Natasha_Tracy on Twitter.

This entry was posted in Being Crazy, Hypomania, Understanding Mental Illness and tagged , , , , . Bookmark the permalink.

57 Responses to What is the Difference Between Mania and Hypomania?

  1. Vanessa Castellanos says:

    Also I have the need to go to the gym everyday no excuses but it does help me with my mood very much !

  2. Faye says:

    I haven’t been to my doctor about this because I wanted to read up on it first(great blog by the way, it was a great help) but from the symptoms described, I’m pretty sure I have hypomania. For about a year now, I’ve been.. well I think depressed? I’ll just sit in my room all day, talk as little as I can, I won’t go out, feel awful about my self, think about things over and over and just feel totally lost. But then about six months ago I started to feel really happy for no reason at random times. I’ll feel really happy and awesome about myself and my self-esteem will go through the roof! I’m also usually shy and awkward around people but in this crazy mood I’ll be running around like a little kid, laughing and singing in public. I’ll also get distracted really easily and want to bye everything. I kinda remind myself of a little kid when I’m like this. There are occasional times where I’m just ‘in the middle’, but normally I’m either really high or really low.

  3. Lee says:

    My husband was hypomanic with sociopathic tendencies. This made him “Fun and Funny and Bad with Money”!

  4. Katrika says:

    I guess I prefer depression when the hypomanic state becomes frightening or uncomfortable and I’m sort of desperate for sleep that might bring me back to a balance (especially if I’m having the obnoxious sounds or things seem to whiz through my field of vision).

    And I prefer hypomanic when in a deep and painful depression, because I’m so desperate to stop the pain. Especially when crying 4 hours straight.

    Most of all I prefer stability. But if I have to choose between hypo and depressed, I’d pick depressed. In all the pain of the depression, I’ve never had the fear of hospitalization. But in hypomanic states I have felt pretty sure I could be close to some kind of precipice where I might lose track of reality.

  5. Julia says:

    Bruce,

    Mixed episodes are the most dangerous of all the types, and they’re also the most difficult to treat. Of course this is in general.

    I suffer primarily from mixed episodes, period. I’m actually currently in one and have been for about a month. I did experience 5-6 weeks of relative normalcy for me prior to that, and these cycles are significantly slowed (ie longer lasting) from before. They are also mild to moderate rather than moderate to severe. Two medications have basically changed for me from the before, (stable on lithium at 1200 mg prior to these changes) and that was:
    1) a switch from effexor (375) to cymbalta (60, then raised to 90)
    2) the addition of seroquel (eventually raised to 300, considered to be the therapeutic dose from trials

    I also take two other meds, one for severe adhd and the other for idiopathic neuropathy (which just means they don’t know why I have it, so I actually call it *idiotic*)

    Lamictal was terrible for me; I got up to just before one of the later titrations, and I realized I hadn’t felt like myself in a while. The next day it was worse and I knew it was the lamictal, so my dr told me stop it. But I had like this paralyzing effect for three days straight, where I couldn’t move but I also couldn’t not move. It felt like I was being shocked, or so I thought.

    I take lithium, but aside from that, I would think it would be a first go-to in terms of choices for mixed episodes. The reason I say that is that the studies have clearly demonstrated an anti-manic effect, especially for acute phases, but it is also among the top in preventing suicidal feelings, gestures, and attempts. The combination of the two say “mixed” to me.

    It’s not uncommon for someone with bipolar (especially a more severe form . . .and I don’t mean I vs II here, but really just simple severity) to need a mood stabilizer and either an antidepressant of some type (usually at a lower dose, and *definitely* not added until after the mood stabilizer) or an anti-psychotic (usually atypical), and in some cases, both.

    As everyone always says, the right combo is different for each person. And over time, that combo can also change. Good luck!

  6. Eliza says:

    I recently,(in the last 6 months) was diagnosed with bipolar. I have been taking antidepressant medication (pristique 100) since the birth of my second child 5 years ago. I suffered post natal depression, (not sure how I got through that), with my first child 9 years ago. I did not seek treatment until the birth of my second as I was terrified to admit that I was not the perfect wife and mother. I have had a few changes of meds in the last 6 months. My gp started me on valproate with my pristique as he though I would not get into see my psych until 3 months. There was a cancellation and I got in the next day, he prescribed me lithium. In response to a previous comment, I agree that every person is different and may respond to different medications in a completely different manner. I have recently started lamictal on a low dose. Now I am taking lithium lamictal and pristique. Such a juggling act. Anyway in case you havn’t noticed I think I have hypomania right now due to lack of sleep and the extreme exercise program I have put myself on. I have been walking 7 kms, half up half down hills and doing 3km sprint intervals against wind resistance every day. This morning I woke up at 3am cleaned the house until 5.45am when it was daylight and started my exercise regime. I happily, said good morning to everyone then came home and reorganised the kitchen loungeroom and filing cabinet, still not really tired. Is this hypomania or mania. I am assuming hypomania because I must admit, if I don’t feel sick because my stomach is twisted with agitation and anxiety I love it!!!!!!

  7. Pascal says:

    thanks everyone for sharing their experiences.

    I much prefer the hypomania phase to the deep depression I experienced around the middle of last year. It lasted for months and I struggled with just getting out of bed and being present with my wife and 2 young sons.

    I’m pretty certain I’m in a hypomania phase right now. The difference is striking – I feel so much more engaged and interested in the world around me. I wake up before my alarm rather than struggling to get out of bed. I have so much more energy and motivation to do things. But it does have drawbacks – i get distracted easily. And i’ve noticed i’m more argumentative and less patient with people.

    I was diagnosed with Bipolar Type II early last year. It’s taken the better part of the year to find the right mix of medications. Lovan (aka Prozac) in the morning and Seroquel at night. it’s the best i’ve been feeling in quite some time.

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