Types of Mania in Bipolar Disorder
Explanation of the different types of mania and how they relate to bipolar psychosis.
Part II: A Deeper Understanding of Bipolar Psychosis
Now that you have some basic information about psychosis, this section of the article will explain how psychosis directly relates to mania and depression. But first, I'd like to recap the different types of bipolar mania as this is what makes bipolar psychosis so complicated and often difficult to treat.
Two Types of Mania: Euphoric and Dysphoric
Here is the lowdown on bipolar disorder mania. There are two main types of bipolar disorder:
The difference between the two is the severity of the mania. People with Bipolar I have full-blown mania. This is the kind of mania that puts people into the hospital if it's not monitored carefully. People with Bipolar II have hypomania. This is a milder form of mania that can cause significant impairment in judgment, but it never goes over-the-top as it can with the full-blown mania seen in Bipolar I. People with Bipolar I can start with hypomania and then move into full blown mania very, very quickly.
The next thing you need to know is that there are two types of mania:
- Euphoric mania
- Dysphoric mania
I have covered this briefly, but feel it needs a more detailed explanation.
What is Euphoric Mania?
Euphoric mania is just like it sounds- people describe it as wonderful, beautiful, unbelievable, fantastic and expansive. As Teri Cheney, the author of the memoir Manic puts it, "Everything becomes interesting."
Many people with Bipolar II hypomania really enjoy euphoric feelings, but many mistakes can be made when a person feels too good, such as recklessly spending too much money, having sex with anyone who looks appealing, sleeping a lot less and not getting tired and ultimately making very poor life decisions.
Full-blown euphoric mania in Bipolar I is far more dangerous. This mania can become over-the-top grandiose mania where a person believes they are superhuman and the greatest person in their profession. Thoughts such as I'm a genius or I'm a goddess and the most beautiful person in the room can be quite destructive if a person arrogantly acts out these thoughts. It's common for people with full-blown euphoric mania to stay up for weeks, start very risky businesses or simply pick up and leave their current life. Euphoric mania can be very cruel and selfish as the emphasis is strictly on the person with bipolar. The person can be extremely reckless and unable to judge the safety or effect of their behaviors. This type of mania can lead to a lot of drug and alcohol use as the person feels so good they lose perspective on the amount they consume. Euphoric mania always starts out feeling great, but ultimately the person comes down and often sees a path of destruction that is hard to clean up.
What is Dysphoric Mania?
Dysphoric mania (a combination of mania and agitated depression that is also known as mixed mania) is the opposite of euphoric mania. A person with this mood swing is agitated, uncomfortable, irritated, depressed, pessimistic and filled with negative energy. They don't sleep well, if at all, and ultimately their behaviors are destructive and sometimes life threatening. Dysphoric mania is especially dangerous due to driving, fighting and other self-destructive behavior. Dysphoric mania can be mild to moderate (hypomania) or full blown. I have heard it described as, "It feels like I'm coming out of my skin. My body and mind are in a civil war."
Ultimately, until it goes too far, people with euphoric mania feel PAIN FREE and GREAT while people with dysphoric mania feel UNCOMFORTABLE and AWFUL.
Are you ready for your test? I'm just joking of course, but there is a reason you need to know this information. Everyone with bipolar disorder has experienced at least one form of the above manias or hypomanias and you need to know what they are like without psychosis before you can understand what they look like when combined with psychosis. As you have read, 70% of people with Bipolar I experience mania with psychotic features. Of that 70%, over half are euphoric manias. These euphoric psychotic manias are particularly difficult to diagnose as they can be so appealing and fun to the people around the manic person! For some reason, crazy behavior can attract people who want to join you for the ride.
Last Updated: 27 March 2017
Reviewed by Harry Croft, MD