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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.

Author: Natasha Tracy

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120 thoughts on “What is the Difference Between Mania and Hypomania?”

  1. I am not totally sure if I suffered from Hypomania (according to what you have described here) or mania. My docs said it was a manic episode. At the beginning it felt extremely good, like the best drug (I would imagine) that can be injected. But it became increasingly uncomfortable as things escalated until I found myself screaming in a doctors office refusing to take medication because I was convinced I was carrying twins that were from the direct genetic line of God. (I was not pregnant and did at least 7 tests at the docs office with the same negative result) The lonliness and severity of the episode was frightening and uncomfortable. It was the first episode I experienced and I had no idea what was happening to me.
    I spent a lot of time writing furiously, crying and seeing patterns all around me in numbers, colours, shapes and words which I believed were direct messages from God. I bought a lot of stupid stuff. I would have been hospitalized if the facilities were available but I live in China so I had to fly to my home country for recovery. It was exciting for a couple of days but I would not say its something I ever want to experience again. I had lost touch with reality completely. It took me months to recover.

  2. Lesa,

    I’m not a doctor, just a person with BP II, but losing touch with reality sounds more like Mania than Hypomania. That doesn’t mean you can’t have hypomanic episodes too from what I understand. Glad you got help.

    Me: I just ended a relationship. Semi-mutually, but still really hard to deal with today. Sometimes its better, sometimes its worse. But, the distractibility … (and I lost my train of thought by stopping to look up how to spell distractibility, crap.) The distractibility, the randomness of my conversations, the psychomotor restlessness, and the obsessive ping-ponging thought processes are the hardest to handle for me.

    After so many years of trying to get all this under control, it scares me not to be in control. So, hypomaniia is less fun that it used to be. Even if I am pretty sure it will pass. I have a great psychologist, but sometimes its a matter of riding it out.

    I still think its better than depression. Everything is better than depression when it comes down to how you feel. But sometimes, it is more destructive than depression. And it really does make people look at you funny. But at least you don’t care about that for very long. Or I don’t, unless I am paranoid.

    That’s something that I don’t think was mentioned specifically, but is part of my hypomanic states: the mild paranoia. Or maybe its just hyper-sensitivity and reading a subtext that isn’t really there. Not full-blown paranoia where I hear voices or think people are plotting against me, just spending a lot of time asking my friends and family, “What did you mean by that really?”.

    Question: Does anyone else have problems when the seasons change from summer to fall or from winter to spring?? Usually its the other way around, but if I’m not alone, I’d love to know.

    Nancy

  3. Hi Lesa,

    Yes, that definitely sounds like mania. Mania can have psychosis, which is defined as, “a serious mental disorder (as schizophrenia) characterized by defective or lost contact with reality often with hallucinations or delusions”. Delusions being defined as “A false belief strongly held in spite of invalidating evidence”.

    It’s common that in psychosis people feel a connection or communication with god.

    It can definitely be scary, especially if you don’t know what’s going on. It’s good that you’re getting the help you need and that you recovered.

    – Natasha

  4. Hi Nancy,

    Yes, I agree, anything is better than depression, and luckily for me, my hypomania doesn’t tend to be destructive, but it is for some people.

    Not to be definition girl, but paranoia is defined as:

    1 : a psychosis characterized by systematized delusions of persecution or grandeur usually without hallucinations
    2 : a tendency on the part of an individual or group toward excessive or irrational suspiciousness and distrustfulness of others

    Typically this manifests as “someone is coming to get me” or “someone is follow me” when no one is. A general distrust of people is more in the anxiety camp.

    (I happen to have had a discussion about a psychiatrist on this very thing. The medical meaning of paranoia is generally misunderstood.)

    Now, seasonality. Many people experience changes in their mood as the seasons change. The most well known is seasonal affective disorder (SAD) but there is evidence that season change affects bipolarity too.

    My personal feeling is that bipolarity has something to do with an individual’s circadian rhythm, which is affected be seasonal changes due to the changes in daylight. There is definitely research on light and darkness and bipolarity: http://psycheducation.org/depression/LightDark.htm

    I don’t find the seasons affect me, but light does. But that’s me.

    – Natasha

    (Oh FYI, the definitions are from the medical dictionary at dictionary.com)

  5. My hypomania bites. I often must drop exactly where I am or run to my bed and wait for the worst to pass. During those times, I often wish I was in the hospital. I have gone before and been turned away even as I was screaming obscenities. I don’t know if I have bad luck or I am not buying enough shoes or what.
    It is an odd thing to think about, really. Mania or hypomania = gun or hammer?
    don’t get me wrong, I am really happy to have dialog on any of it…I just think we run the risk of minimizing…

    (not used to talking to people, esp. if my opinion is a little different….hope this comes across.) I know you understand, N.

    thanks!
    ~sm

  6. Hi Shannon,

    Health care is all about triage. The sickest get the help. Which, of course, is how it should be, but people with a mental illness often get the short end of the stick on that because mental illness just isn’t taken as seriously. No one argues with a heart attack but they sure do argue with a person endangering themselves.

    You’re right, we could run the risk of minimizing, which is not my intent. I’m not suggesting one is better or worse, people have their own experiences of each condition.

    Don’t worry about a difference of opinion; I welcome them. I try to keep it pretty civil around here.

    – Natasha

  7. Nancy,

    I get the seasonal rollercoster quite frequently, but not always. At least we think it might be a trigger. But I have a trigger that may be a little more unusual, I get hypomanic (at least a little, but sometimes a lot) when my wife is ovulating. So my wife’s hormones have an impact on my mood.
    I too, have experienced that mild paranoia (that may not be paranoia 🙂 )

    When I get really hypomanic, I cut. But I only get that urge when I’m hypomanic, not depressed, so I know it’s a product of the disease. A couple years ago I was hospitalized for the cutting I was doing it so much.

    Well, that’s a little rambly, sorry, but it is nice to hear other people have some of the same symptoms.

    Scott

  8. Dear Natasha, I just joined this site, and watched your interview, and read a few of your blog entries. I was diagnosed as bipolar about 4 months ago. And – I enjoy my days of hypomania too. Although, on days when I have too many things to do, I get overwhelmed and extremely forgetful, and then I get really irritable. But, summer has been good. Lots of time to enjoy my hypomania. =) Make plans at the drop of a hat, go here, go there, change your mind, do something else, cancel plans, do nothing… it’s like being a child. Nothing bothers you, and if anything does bother you, you forget so fast, because you’re so easily distracted.

  9. Hi Scott,

    Thanks for sharing your experience. I haven’t heard of being affected by someone’s ovulation. I always like to learn something new.

    Thanks.

    – Natasha

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