What is the Difference Between Mania and Hypomania?

Monday, August 30 2010 Natasha Tracy

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

Many are familiar with Bipolar I mania, but few understand the hypomania in bipolar II. Hypomania and mania are similar but have a critical difference.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

 

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.)

 

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 differentiation 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

Natasha Tracy is a renowned speaker, award-winning advocate and author of Lost Marbles: Insights into My Life with Depression & Bipolar.

Find Natasha Tracy on her blog, Bipolar BurbleTwitterGoogle+ and Facebook.

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What is the Difference Between Mania and Hypomania?

Lesa
says:
August, 30 2010 at 8:22 pm

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.

Nancy
says:
August, 31 2010 at 6:14 am

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

Natasha Tracy
says:
August, 31 2010 at 8:05 am

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

Natasha Tracy
says:
August, 31 2010 at 8:25 am

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)

Shannon Marie
says:
August, 31 2010 at 10:16 am

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

Natasha Tracy
says:
August, 31 2010 at 10:45 am

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

Mental Disorders 101
says:
August, 31 2010 at 6:36 pm

What is the Difference Between Mania and Hypomania? | Breaking ......

I found your entry interesting do I've added a Trackback to it on my weblog :)...

dracorogue
says:
September, 1 2010 at 11:58 am

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

vino
says:
September, 1 2010 at 6:46 pm

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.

Natasha Tracy
says:
September, 2 2010 at 6:36 am

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

Natasha Tracy
says:
September, 2 2010 at 6:38 am

Hi Vino,

It's nice that you get to enjoy your hypomania, even if stability aims to even out the ups as well as the downs.

Thanks for sharing your experiences.

- Natasha

Chris
says:
September, 3 2010 at 7:43 pm

Hi Natasha,

I am in a committed long distance relationship and my wonderful girlfriend was diagnosed with BP some time ago. She will be moving in with me soon, however in the interim, I don't get to see her during the week and occasionally she deals with episodes of hypomania. Cleaning constantly, not sleeping, getting irritable with others, not with me so much thank goodness :) What sorts of things do you think I can do to help or be more supportive during these times. As I am very inexperienced with BP, I feel helpless to be properly supportive to her. I don't want to push her away by asking too many questions or saying the wrong thing. I just feel like she's in a fragile state and I don't want to do too little or cross the line and do/say too much. Does that make sense?

Thank you!

-Chris

Annie Haz
says:
September, 4 2010 at 6:46 am

Wow, it's SOO good to know there are so many people who feel and think similar things to me. That enjoy the distractation of Hypomania as a relief from the weight and weariness that often goes with my depression. Spending too much and coping with the fear that accompanies these episodes, takes up a lot of my 'brain space' thank god for an understanding partner and a great therapist. There are worse things to be than Bipolar and also, it has to be said, happier states than those of Hypermania, but all in all, I wouldnt be anyone but me. And yes, the seasons do affect me. Waking up on a sunny day is infinitely preferable to waking up on a cloudy day.
Annie

Natasha Tracy
says:
September, 7 2010 at 5:08 am

Hi Chris,

First, congratulations on your relationship! And the fact that yo're considering the wellness of your partner seems like a step in the right direction.

First off, I think you and she need to sit down and have an honest conversation about her illness. What are her "normals"? What is she like when she's depressed? What is she like when she's hypomanic? How frequently does she cycle? What are her treatments, and so on. You _need_ to know this stuff. What if you had to take her to the doctor and didn't know her medications?

I don't believe this is pushing her away, I believe this is just the honesty required in any relationship. You need to know what you're getting into and hopefully, how to react.

Nothing is perfect, but anything I can tell you will pale in comparison to what she, herself, can tell you, as we're all so different.

I talked about walking on eggshells around an ill person here: http://www.healthyplace.com/blogs/breakingbipolar/2010/09/walking-on-eg…

Basically, don't do it. Just like in any relationship, honesty matters. She needs to know what you feel just as much as you need to know what she feels. It's best for both of you.

Hope that helps,

- Natasha

Natasha Tracy
says:
September, 7 2010 at 5:11 am

Hi Annie,

Yup, no matter how you feel, there are people out there that are feeling it too.

It's great to hear you wouldn't want to be anyone but you. That's the best mental state I can think of.

- Natasha

Chris
says:
September, 7 2010 at 8:37 pm

Hi Natasha,

Thanks a lot for your advice. That's a really good idea and she agreed it was too. We will be sitting down to discuss those things. That link you provided also lent some really good insight. Thanks again, I really appreciate it!

-Chris

talkingtocactus
says:
September, 9 2010 at 5:40 am

i'd pick hypomania out of the 3 too, sure it's frustrating at times (ok, most of the time) and the fact it stops me being able to do normal stuff is horrible, but it's less full on than either depression or mania, you do still have a grip on reality, by which i mean when i'm hypo i know i'm hypo, i can tell and can use that knowledge to temper it a bit, whereas once it goes over into mania i lose that grasp.

lucky for me i get mixed states so i get it all at once - hurrah. *sarcasm sign*

Natasha Tracy
says:
September, 9 2010 at 10:26 am

Hi Chris,

You're welcome. I'm glad that helped. Good luck on the work ahead.

- Natasha

Natasha Tracy
says:
September, 9 2010 at 10:27 am

TalkingtoCactus,

Something I haven't talked about on here is mixed states, but I get them, and yes, I hate them too.

- Natasha

Terrie
says:
January, 13 2011 at 6:36 pm

Any suggestions for approaching a teenager (14-yr-old girl) to open a dialogue about her bipolar disorder? It's gotten gradually worse over the years. Dietary changes used to help dramatically; now she either isn't sticking to the restrictions anymore or they don't work. It's hard to tell. she's not home as often now, and is convinced she's "outgrown" the issues. (She was restricted from casein experimentally, with a few accidental double-blind studies reinforcing it; she changed dramatically within 3 days of cutting out casein and relapsed within 24 hours of re-including it. Then the hormones kicked in. Can't tell anymore...)

The only other alternative her (bipolar) oldest sister and I can come up with is to run her to the E.R. next time she starts cutting herself. That's what got the older sister to get help. Could use any ideas. the above-mentioned "mild paranoia, or just hyper-sensitivity and reading a subtext that isn’t really there" is driving the rest of the family insane...I suppose we should be glad she's not currently in a depressed state.

Natasha Tracy
says:
January, 16 2011 at 6:28 pm

Hi Terrie,

Sorry I haven't gotten back to you sooner.

Regarding casein, I don't see any studies on PubMed. There is one paper that measured casein levels in bipolar I and found them correlated with psychotic symptoms and severity of mania. Basically, there's very little evidence: http://www.ncbi.nlm.nih.gov/pubmed/21176030

I have heard of many diets for bipolar disorder and none have any real evidence behind them. If you're concerned, I recommend getting her tested for food allergies and then you'll know for sure.

(Also, I'm not sure how you restricted her diet but it's always possible she was reacting to something else and caesin was just coincidental.)

Yes, it sounds like she needs to be properly diagnosed. At 14 (I'm hoping) she should respond to some logic. My guess is that if her older sister is bipolar, it's probably the last thing in the world she wants to be. But, if she's properly assessed then you can know for sure either way.

I would try to focus on the upside of being diagnosed and/or treated. If she's hurting herself then it'll give her the opportunity to stop. It may make her happier. Calmer. If she's in distress then treatment is a way of alleviating that. Try to be clam and collected when you talk to her. Try to think of the logical reasons treatment is good for her. If you're emotional, she's going to get more emotional too.

Have you tried therapy? If she's really resistant to doctors, how about a therapist? A therapist should be able to get a good idea of whether she has a mental illness or not and regardless, the therapist should be able to help. There are skills that she can learn now to manage her own head, and maybe she can do that without medication. (Look for a therapist that specializes in CBT or DBT.) Keep in mind, people get better when therapy and meds go together. And if the therapist also determines she needs a doctor, they may be able to approach her in a way that her family just can't.

Finally, if she's hurting herself and she's 14 then yes, you have the option of taking her to the hospital. If that's what works, then that's what works. But I would try therapy first, talking to her about doctors second and ER third.

I don't know your family, obviously, but this is really emotional stuff and she just might not be willing to hear it coming from you or her sister. If someone close to her is a person she listens to, maybe that person could talk to her.

She could also try to connect with other teens with mental health issues, probably on the internet (unless you have local options). This will make her feel less alone. Even though her sister is diagnosed she might still feel alone and scared. It's something people tell me all the time.

You're in a tough spot, but there are options. Good luck. Best to you and your family.

- Natasha

Gledwood
says:
August, 10 2011 at 12:11 pm

I think I get both hypomania and mania. My mind tends to go pretty quick anyway so I don't notice thoughts "racing" until they're really going so fast I'm losing track then my thoughts are like fireworks, exploding all over the place. I can tell I'm in full mania when I close my eyes and see vivid imagery (making it impossible to sleep).

I have gone manic enough for my thoughts to become totally garbled and to break up into noise, which I was yelling out at the top of my voice, unalbe to think in English any more. That wasn't particularly nice.

I found I actually felt better as the mania became less intense. In the big episode I had this year I went from depressed to full-blown manic with visions and voices in 3 days. On day 1 I was probably hypomanic, on day 2 irritable and paranoid; on day 3 I was already grandiose. It peaked about 4 days later when I was higher than I've gone on any drug and I've tried them all.

The whole thing took about 10 weeks to wear off and as I say I felt better in the long hypomanic stage at the end than during most of the mania. When I was manic I could lose my temper just from thinking about something (and I did a LOT of thinking). If only I could harness the best of it and get rid of the worst.... and if only I could live without depression.

I'm only glad I've gone higher on mania than low on depression ~ even though I've spent far longer depressed than manic. It also, incidentally, took me 20 years to get diagnosed and I'm labelled schizoaffective not bipolar. My dr says I was too floridly psychotic to be just manic (I hallucinate very vividly), and this is using ICD10 criteria. In America I might be bipolar, as I'm not sure I've had hallucinations and/or delusions in the absence of marked mood symptoms for 2 weeks or more. Basically because I've never gone 2 weeks without marked mood symptoms and because the antipsychotics break up the psychosis better than they dispel the mood swings and I'm not prescribed a mood stabilizer.

Those oppressive thoughts you describe sound nasty. My problem tends to be the "flight of ideas" ~ I jump from topic to topic, totally forgetting where I've been and why I'm there. I can do this in writing almost as badly as in speech. I'm prone to tangentiality even in a normal mood, so when the mood is "elevated" it really becomes marked sometimes. I've also found not all the symptoms peak at the same time, so I might feel higher one week but far speedier the next. The only really good book I've read on mood disorders is Emil Kraepelin's Manic-Depressive Insanity and Paranoia. It blows all recent efforts out of the water!

Alex W
says:
February, 24 2012 at 9:21 am

I am a teenager and I was diagnosed with BP when I was 12 following a move from the city with my family. I have been on meds since about then. Last October, I did something I would never suggest to anyone. I went of my meds without my doctor's permission. It was a VERY bad idea. I went through a depression so bad that I tried to/thought about committing suicide several times. I have been a cutter for several years.

However, recently some of my friends and my new therapist have been a wonderful help. My three closest friends, Ben, Madison, and Steph, have pulled be back and helped me through so much these past few years! They have been there for me no matter what mood I have been in. I am posting here to remind everyone that even when everything is at its worst there are ALWAYS people who care. Even when you feel that it would be better to die there are ALWAYS people who will miss you and wish that you had told them what was going on. NEVER EVER EVER forget that! It may be so difficult to remember that when you are depressed or in a mixed state, but try to remember that you are worth more than any object in the entire world.

You are a human, made in God’s image. He loves you and will always love you! It took me so long to realize that, but now that I know I understand so much more. Jeremiah 29:11-14 says “11 ‘For I know the plans I have for you,’ declares the LORD, ‘plans to prosper you and not to harm you, plans to give you hope and a future. 12 Then you will call upon me and come and pray to me, and I will listen to you. 13 You will seek me and find me when you seek me with all your heart.’”

I have been working on improving my control over my moods for several years now. I am a little better off now, but it is mostly because of my friends, my therapist and God. I have been safely back on my meds for the past year and a half and I am so grateful that my attempts did not work! God has given me this life back for a reason and I am thankful that I have friends who can help me figure out that reason. God loves you, never forget that!

Alicia
says:
June, 1 2012 at 6:38 am

I don't know if I have hypomania. For days at a time I'm very depressed and barely talk but then within the next day I'm happy, I can't stop talking and I have all these ideas for example moving out if my sons dads house with my son even though I have no money or going down to Texas to visit my mother. During my sad state I never have sex but when I'm happy I have sex with people that later in I regret, for example my bestfriends. Boyfriend or older men only regret it after my happy episode. Sometimes I get urges to just do straight upbbad things

Alicia
says:
June, 1 2012 at 6:52 am

I don't know if I have hypomania. For days at a time I'm very depressed and barely talk but then within the next day I'm happy, I can't stop talking and I have all these ideas for example moving out if my sons dads house with my son even though I have no money or going down to Texas to visit my mother. During my sad state I never have sex but when I'm happy I have sex with people that later in I regret, for example my bestfriends. Boyfriend or older men only regret it after my happy episode. Sometimes I get urges to just do straight up bad things once I overdosed on BZP for no reason

Natasha Tracy
says:
June, 1 2012 at 8:55 am

Hi Alicia,

I'm not a doctor and certainly no one could diagnose you based on the information you have provided, but in my opinion, if this cycle is causing you distress, it's worth seeing a doctor about. What you're describing does seem to be an ultra-rapid cycling variant of bipolar disorder. But it may not be. The only way to know for sure is to have a psychiatrist do a full evaluation of your symptoms.

It's OK to question this pattern but you need a doctor to help you work out exactly what's going on for you.

- Natasha Tracy

delonix
says:
November, 9 2012 at 10:36 am

I don't prefeer none of this sympthoms.

A hypomania can be transform in a mania. You can make decisions that damage you, for example abandon your couple, drive fast... I consider that is enough dangerous.

Sorry for my writen english (I'm spanish)

Sarah
says:
November, 19 2012 at 10:48 pm

Hi,

I am really confused about the difference, how do you measure the harm? I feel like crying and like i'm hurting people at the same time as feeling like I'm the most intelligent person in my classes, I'm going to do amazing things in my future, my horrific past is a badge of honor which I must share with the world. I'm happy bordering on aggressive. Then it comes crashing down and I'm exposed and vulnerable and everyone thinks I'm strong and so confident and well off as i'm wearing shoes I can't afford. I can't stay anywhere, watch a film, listen to music, draw read, all I can do is sit and stare at a wall (usually smoking like a chimney). If I leave the house I know I won't come back I will sit on a step in the city or waste my money on coffee and wish someone would come get me. I never know what I want or who I am. I don't know if I'm ever me, and everything hurts, everything. The only distinctive change is when I feel stable, when I'm not like that, but aside from that I can't distinguish anything between high or low most of the time or which has the worst consequences, both leave me sick and disorientated. Sorry to blab, I just don't know anyone who is bipolar so I don't get a chance to really discuss it x

Sarah
says:
November, 19 2012 at 10:51 pm

p.s I have been diagnosed but I don't know which one, or anything else. I take lamotragine and an antidepressant called sertraline

Sarah
says:
November, 20 2012 at 6:18 am

Hi other Sarah,
I get highs and lows at the same time - when mania and depression occur together it's called a 'mixed episode'

I don't know if it's possible to measure harm or decide which is worse. Often the harm done by an episode depends on the surrounding circumstances rather than your actual symptoms. So for example you can be extremely manic but if you are properly supervised then you won't cause harm to yourself or others.

Hope I haven't confused you.

Sarah
says:
November, 21 2012 at 12:01 am

No that helps, thank you!

Laura
says:
January, 12 2013 at 5:37 am

Dear Alex,
I was so impressed by your comment....way to go! I'm reading up on here about my dear friend who got diagnosed with bipolar and is not doing so well but is also a bright believer and thanks to her friends and family and her dear God who looks out for her she is getting the care she needs now, however I know bipolar is a serious illness and needs to be treated because if not treated it can be so harmful to the person suffering from it.....I think we can be so thankful now in this day and age that we have the resources to treat mental illnesses (I too suffer from post Partum anxiety) because if you look at the history of it all ....years ago there was NO treatment and people were left to suffer through these horrible anxieties and worst case scenario they were lobotomized(horrible operation where they cut into the brain and it often left people impaired)!
So let's be thankful for the meds we have and that we can live a fairly normal live with them and for family and friends as support and foremost Jesus our Lord and Savouir!
Good website keep going!
Laura

Jill
says:
January, 27 2013 at 4:39 pm

Hypomania for me is .....I'm gonna chop my hair off right now! I'm gonna go get a tattoo right now! I'm going to learn the entire American Sign Language right now! I'm totally inspired and I'm going to write the most amazing book right now! I'm going to become an expert in mixed martial arts right now! I'm going to adopt a dog right now!
Everything sparkles, everything is shiny and beautiful. I'm so sexy. I drive fast and I skip instead of walking and it's okay because I'm glamorous and I flash the brightest smiles at everyone I see. I'm charismatic and witty, I use big vocabulary because I'm super smart and I like to show off. I can do anything and I can make anyone do anything I want.
And then my depression kicks in and I'm never going to do any of those things because I'm lazy, they take too much effort. I'm just going to lay in bed because I fail at everything. I'm ugly and I don't even shower because what's the point. I wear sweats when I'm forced to out in public and I don't look at anyone. I'm irritated and when I have to interact with people, I'm detached from everyone and I loathe every second of the day. Super fun.
Then I'll be doing great on my Lamictal and acting almost like I imagine a normal human being acts, and out of nowhere one day I'll decide I don't want to take my meds. For no reason at all, I just don't feel like being on this shit anymore, I don't feel like having to remember to take a pill. And the spiral begins...

sharon
says:
January, 27 2013 at 9:04 pm

Thank you Jill. I've been dx'd since last summer and I'm an older adult. What you expressed is exactly what is happening for me! I am on Lamictal too and now Psychiatrist says Wellbutrin which is what I've had for 12 yrs but was withdrawn when Lithium was introduced. I am so angry about how this came about and probably was misdiagnosed as only depression even though I knew racing thoughts and talkative highs were different from how others behaved.

Anyway, thanx for your input. Now I know why I don't like to shower.

Jill
says:
January, 29 2013 at 11:19 am

I'm glad to help, Sharon! :) I've been misdiagnosed several times as well, it is infuriating. When I was diagnosed as BP 2 I was really angry, Bipolar is a hard thing to hear. People make off-handed jokes about us, how crazy we are.
They say people with BP have several manic/hypo episodes a year. I have several a week, I go up and down so fast it's absurd. I'm all over the place. I'll post 10 status updates on Facebook in 3 hours, then I won't post for 3 days. I have anxiety about making plans more than a day in advance because I don't know what state of mind I will be in. On a Wednesday I can't make plans with friends for the weekend, because what if I don't want to leave my bed? If I let people down I will plummet even further into depression because now I've disappointed friends all due to my crazy. I never, ever know how I will be feeling tomorrow.
Oh, and the hypomanic over-sharing is a blast. I'll have met you an hour ago and I'll be chattering away ..and then I'll go into great detail about how I almost killed myself after my cat died. Or the time I went to rehab for a year due to drug abuse. OR that I'm bipolar! Because everyone wants a bipolar friend!!!!! YAYYYY ;)

Brad Fern
says:
February, 10 2013 at 4:35 pm

Hi,
Great blog! Thanks so much.

One addition, however. "Mania" requires a week of symptoms to qualify as mania, unless there is hospitalization or psychosis. If less than a week, it may just be hypomania.

Brad

Brad Fern
says:
February, 10 2013 at 4:37 pm

Hi,

Oopps. Read on and saw that you did make the seven day qualification. Sorry!

Great blog! ! !

Brad

Katherine
says:
February, 11 2013 at 8:05 pm

Jill and Sharon, I was SO GLAD to read both your posts! I am also experiencing more of the same. I was diagnosed (unspecified bipolar disorder, leaning toward bipolar II) early this fall. The first actual doctor I saw for my psychological problems told me I could be classified as bipolar based on the diagnostic test I took, but he "didn't think that was right," whatever that means. He diagnosed me with general anxiety disorder and sent me home with some relaxation exercises. Now, nearly seven years later, I'm looking at my symptoms through this new bipolar lens and trying to make new accomodations for it in my life, both of which can be so frustrating. So I was really relieved to see so many parallels between my experience and yours. I actually copy/pasted them into my journal because I identify so highly with what you said. So THANK YOU for sharing!

A question: do either of you (or anyone else!) experience difficulty eating when you are hypo/manic? I often don't eat more than a few bites a day, both because I forget to eat and because I don't get hungry or am nauseous. When I pair this bad habit with a 4 or 5 hours of nightly sleep loss, it's no surprise that I become depressed shortly afterward. It's like being my own trigger. Luckily, my hypomanic episodes don't usually last more than five days. I'm in one right now; otherwise, I wouldn't post anything online, and I certainly wouldn't have so much stuff to say :)

For others with bipolar disorder who are looking to improve their mood regulation, I highly recommend a mindfulness meditation practice of some kind. I've been using Dr. Kabat-Zinn's stress reduction training version of mindfulness meditation, and it has been truly awesome. I've felt victimized by my thoughts and emotions for a long time, and now I'm starting to be able to put them back in their place. It absolutely takes time and commitment, but the good stuff usually does.

Also, thanks to Natasha for the lovely blog!

J.R.
says:
February, 13 2013 at 8:34 am

Can you have persecutory delusion if you are dx Bipolar II? Can you have mania without the increased energy? I was dx Bipolar II, but have had persecutory delusion. I don't get Mania, it's hypomania, but now this weird delusion thing is troubling. It would exclude BPII, but then there is no increased energy. I don't want to speak to the Pdoc about it, it concerns him. If anyone can answer this, that would be great. A PP said she has feelings of paranoia, this might fit with what I have been thinking. Comments? Love the blog btw.

Jill
says:
February, 13 2013 at 9:37 am

Katherine, I'm so glad I helped you! That maqkes me feel good. I'm slipping away today and trying to hold on. Yesterday was my birthday and I created a great plan so I wouldn't be depressed about it, I had a nice time. Now it's over and I have nothing to look forward to, tomorrow is Valentines Day and I know my husband won't do anything special. So I'm kinda in a pissy/pity party. Last week during my hypomania I got Lasik eye surgery! And although it was worth it I'm now a little freaked about having spent so much money. I need to try to keep moving today and keep myself distracted, I'm right on the edge of getting pissed off by everything I see.
To answer your question, I do "forget" to eat during hypomania. I've found I can combat that by becoming obsessed with cooking something delicious, so of course I make like 6 things because who can decide on just one when you're so excited! And I can't cook without drinking an entire bottle of wine and dancing during the process. I really have quite a lovely time, until I screw something up and get angry.
Thank you for the information on Dr. Kabat-Zinn, I'm going to look into that! I hope that you have come down safely from the hypomania today, and if not hopefully you are enjoying yourself! ;)

Steven
says:
February, 19 2013 at 9:58 am

I am glad to hear that other people enjoy the hypomanic state. My psychiatrist does not seem to like to hear that I had an "episode" between appointments. I think she is afraid that I may have a truly manic episode. Never had one, not sure if I ever want to...However, when I am hypomanic I sleep less than 4 hours a night, but I get a lot done. Since I am a list person, I usually finish each task before moving on to the next. Unfortunately, I almost never include cooking and eating on my list. Therefore, after reading Jill's post I have decided to add cooking "fun" food items to my lists when I am hypomanic. Of course the up side of not eating for those 5 to 6 days and being so active is that I tend to lose weight. Who needs a diet when I can lose weight at least once every other month. Of course, I tend to eat too much when I am depressed.

Lilian
says:
February, 21 2013 at 11:33 pm

Thank you for your great blog Natasha :)

(sorry for my English...)

I really try to read everything I find about bipolar now, cause I am almost 100% sure I am bipolar 2 or at least somewhere in the bipolar spectrum. I have been diagnosed with depression and anxiety and the doctor did not take my other symptoms seriously, like racing thoughts that gets my crazy, periods I act strange and maybe wan´t to leave my husband to be single and have sex with other people. Also my mood sometimes cycles very fast from depression where I don´t want to leave the bed, to be happy and active and then I f.ex. clean the hole house. I have had a depressed episode now since December last year, but before that I was in a lot of stress that I think is my trigger and then I had anxiety and paranoia and was constantly thinking of leaving my husband, everything was so confusing, I could not concentrate, I drank more alcohol than usually, I also flirted and was really aware of my look, to be sexy all the time and have attention from men. That ended in one night affair and my husband found out. So our relationship was in danger, but we have worked that out somehow.

Now I only take sertraline cause my doc thinks I am only depressed, but all I wait for is to get out of the depression and get "high" or at least be normal. But I don´t think the med works cause my days change alot, up and down, I also think way to much now...

nancy baisley
says:
March, 22 2013 at 5:40 am

wow. reading these stories is like reading my mind. diagnosed with bp two days ago after years of treatment for depression. I just can't get over the similarities in other people's thought patterns. I am not alone!

Chip
says:
April, 3 2013 at 8:12 am

Iv been diagnosed bp2 about a year ago . They prescribed trileptol , Wellbutrin , and Xanax for my anxiety . My worst problem is anxiety, and lots of racing thoughts ! Lots of them. When my wife goes out with her friends , all I do is picture her talking to guys , or guys trying to get with her . I am really paranoid . I guess it's because of the mirror effect , where you think that everybody acts like you . ( used to be very friendly with girls before I got married ). When I enter a restaurant or an event with my wife , my hurt starts beating very very fast , I have the impression that everybody there are checking us out , and that I have to act a certain way , because everybody is watching . When I take Xanax it seems that my thoughts are slowing down and I feel better , but I would like that to happen naturally . I make scenarios in my head all the time and I get mad very easy . It seems that when I am arround friends I am very hyper and happy and talk a lot . And I think I'm trying to hide my anxiety with my sens of humour . I really want the paranoia to stop and the racing thoughts also . Thank you and sorry for my grammar .(English is not my first language )

Desirae
says:
April, 14 2013 at 4:51 pm

Hi Natasha!
I seriously think I have bipolar 2 and social anxiety. I have taken multiple online tests for both, and always get severe-very severe as my result. I really want to tell my parents about this, but I don't think they would believe me. My dad doesn't believe in mental disorders at all, and I always tried to act normal in front of them. I have had multiple panic attacks before, and long periods of depression where it has felt like my only escape is death. I tried to tell my best friend about this, and she didn't even believe me... So how can I tell my parents about this?

Julia
says:
May, 1 2013 at 11:31 am

Definitely hypomanic. I prefer it any day over depression, mania, or mixed states. Of course stability would be preferred over all of them.

My hypomanic is the same as the mania, except I sleep better. And I believe it is that sleep that allows me to function. I'm very sensitive, but I can sort of manage a stressor if one comes my way. Only one. I also don't tend to experience any depression with hypomania, but when I'm manic, I do.

So with mania, I'm really experiencing a mixed state, which is absolutely the worst. The fun part of mania doesn't last long for me. When manic, I sleep 1-3 hours at most and often in shorter segments; in hypomania, I sleep 4-6 hours.

I am an extremely fast rapid-cycler. Last week was a manic week; I've come down a little (probably because I started taking certain meds again a couple days ago). The week before last was a good, solid, normal week. It was awesome. I hadn't felt that good (good in the ‘right kind of good‘ way) in a loooong time. So who knows. I don't know when I'll hit that 'normal' again, but I'm managing for now. It will pass and I can get through it. I don't have to accomplish a whole lot; I just have to be patient enough to get through to the other side.

kathy lou
says:
May, 30 2013 at 10:44 am

Just started learning about bp2 because I was just diagnosed with it. Have been depressed for years, but these last 6 months have been hell. My suicide plans were so detailed they include a "works cited" page, and I was scaring myself. Feel a little better just knowing I have support now. Abilify is the new drug of choice, and am anxious to see if i can be "me" again.
Have any of you felt like your brain was in a big clamp or vise? This is how I've felt this past 6 months. Old habits and hobbies seem so difficult for me, and favorite things seem to hold no meaning. It's like I'm not me anymore. Can I ever "come back" and feel normal again? and is this "muddling of the personality" from depression?
thanks for your thoughts.

Bruce
says:
June, 4 2013 at 6:42 am

Great blog! I am just accepting that I really need to address the bipolar disorder I have known about for 20 years, and been diagnosed with twice formally and informally by two therapists, my acupuncturist, my nurse wife and nurse daughter.

I have not looked for something on mixed episodes, but that is the basis for my diagnosis of bipolar 1 (in addition to one manic episode that bordered on psychotic, included some delusions and in which I endangered myself several times with reckless behaviors). However, I experience bipolar disorder much more like someone with bipolar 2, being mostly depressed, with occasional hypomania or a mixed episodes. I would say about 1/3 of my manic phases are mixed. I've had enough of them to fear them considerably as they are awful. For this reason, whenever I feel even hypomania coming on, I begin (consciously and otherwise) to act in ways to bring the energy down. I overeat (and used to drink) mostly, but sometimes overexercise or overwork, or anything to burn out the energy that will only amplify the despair of depression in a mixed episode.

I just wonder if there are others with similar experiences who would like to share how treatment with Lamictal (or other meds) has worked and whether it has helped with the mixed episodes.

Vanessa Castellanos
says:
June, 21 2013 at 11:05 am

I experience hypo mania about 2-4 times a week and I love it cause its way better than being sad and quiet and negative. But I seem to notice its an extreme happiness which I don't notice in others. Other people don't notice it but I do and I know it's not a normal happiness. I looked up what it was cause I didn't understand it but I'm happy to know there's others who have it and I am not the only one. The only problem I seem to have is my ups and downs are very dramatic and take a toll on my relationships with people. Any advice on how to treat this disorder on my own would be helpful. I don't have the money for a psychologist at the moment.

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