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?
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
- 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 “marked impairment in... functioning... or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.”
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.
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
- 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."
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 on 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.
Tracy, N. (2010, August 30). What Is the Difference Between Mania and Hypomania?, HealthyPlace. Retrieved on 2019, August 18 from https://www.healthyplace.com/blogs/breakingbipolar/2010/08/what-is-the-difference-between-mania-and-hypomania
Author: Natasha Tracy
The depression is real obvious but I've mostly been medicated so haven't experienced hypomania til recently when I came off meds to try for a pregnancy.
As a teen I was always reckless with sex and cigarettes and alcohol, self harming and often had fits of rage that resulted in hospitalisation. I had very little concern for consequence. I would stay at random peoples houses, hook up with people I didn't know..
I am 26 now and married with a child. I've only started feeling what could be hypomania this week after stopping meds (the reckless symptoms were never apparent when I was on any kind of meds). I only really felt agitation, and this awful feeling of needing a "fix". My skin crawls and I have horrible cravings for something but I don't know what. I guess it feels like drug cravings but I'm not addicted to anything and never have been. But its awful. I feel like bursting out of my skin. And then the next day I will feel happy and fresh and free and a little bit silly. Full of energy but I can still usually sleep at night.
Its a stark contrast to how I usually am. But I haven't read too many similar symptoms for hypomania. But kind of have. Its so hard to tell.
I realize everybody's situation is a bit different but...
I find as long as I'm willing to keep fighting and not give in to the bipolar (rage against the dying of the light as poet Dylan Thomas says) there is always hope. I'm 54 and have been able to hang on thus far, but some days just barely by my fingernails. It takes grit and determination and for me huge amount of patience that does not come easily
I've been pretty stable on medication for the the past 2 1/2 years. Through the WRAP program I've learned how to recognize my warning signs and keep myself well by making the effort to ask for help early on instead of waiting until it's too late
I too have burned through countless relationships but even they can be mended I'm finding when given time. I haven't spoken to my brother in years and out of the blue he called me tonight all philosophical. I damn near fell out of my chair. It was so unlike him. He still wants to have a relationship with me after all I put him through. He's also helped to open the door for me and my poor mom so maybe we can at least be on speaking terms again.
There are good days and bad days with this disorder and today is definately a good day.
My question is how long will this last until he falls??
This is great to read. My boyfiend is bipolar and it is really hard sometimes. Of course I want to support him and sometimes it goes really well but some days it is just incredibly hard. In a few month we'll move to a new house and as a designer I was hoping other people could give me some advice of what they like/dislike about their environment and the way they interact with their environment in states of manic and depressive episodes. Any ideas can help. It is already great to read how everyone experiences this. He has bipolar II. Thanks for all the input already....
Unfortunately, it doesn't allow me to see the reality of the world (who wants to see that anyway?!) and I can get awfully spendy - within my budget, thankfully I don't have credit cards, and I can get crazed ideas about businesses I could start etc. yech
Once I spent all day buying so many clothes from one store that they sent me some costume jewellry with a thank you card.
I also used to buy so many movies that the store clerk once asked me if I was filling an insurance claim.
And then there was the time I bought so many self help/psychology books that the store clerk asked me if I was a therapist. I said no I'm just working on creating a library.
I had so much stuff that I was beginning to run out of space for it so I'd either throw it out or give it away and start all over again.
I was ALWAY in debt. I knew that what I was doing was not normal but I just felt so driven.
Then I inherited a large sum of money and really went to town coming home from the malls daily with something over a 6 month period. It was actually so exhausting but I just couldn't seem to help myself. And of course I never buy just one of anything.
There was also one time at work I spent over $1,000 on food toward a family we sponsored from some charity during Christmas
Then I would cycle downward and it would be difficult to concentrate at work so I'd have to stay late to get the work done. My hours of work were only 8 AM to 4:30 PM but I usually wouldn't go home until 11:30 PM. Somehow I'd get my second wind. After I got my work done I'd be organizing the office. Then I'd go home and sometimes clean my place from top to bottom
I could go on and on but you get the point. It was not normal
It's really quite funny now that I think about it but what I wouldn't do for some of that energy and drive these days...
mate human state of cognitive function, creativity, energy, lust for life and the ability to enjoy everything. Thanks to valproate, I no longer experience mania or hypomania. Too bad, so sad. Mania feels good on the way up but then it rapidly becomes scary, out of control and bad. I don't really miss those because I never want to clean up my life again afterwards.
Bipolar Disorder really blows in every way except I do dearly miss my hypomanias. Those were the only periods of time in which I felt truely alive.
Maybe somebody can help me how to understand or how to deal with a person who is having a Bipolar Mania Disorders. I love him very much inspite of his defect but I don't have any idea of how to handle him. Sometimes I have a doubt that he is cheating on me because he don't want sex anymore. My friend told me that people with bipolar disorder lost their Sex? Is it true? And she told me not to marry my boyfriend because he will put me into trouble. Is there anything that I can do to help him have a happy life with me? He is 46 years old and Iam 49 years old.
Thank you in Advance
Even when I try to ward off the behavior, it happens and quite regularly. The truly excessive behavior thankfully occurs only once a month usually in conjunction with a full moon (sounds lame I know) but can lead to dangerous activity at times, so I try to stay away from situations where I'm without a "wingman" during those periods.
While it helps with work, it's destroying my family life, as I continue to embarrass my spouse even when she begs me not to let it happen. It's a setup every time we do anything socially because I play right into the hands of the audience whenever I have the chance. Once it starts, the crowd (usually eggs me on) and then away I go, the life of the party, and to the disappointment of my wife.
It doesn't matter who it is or what the occasion, I get this way as soon as I sense an opening in the gathering to steal the stage and take over the event. It helps at first (at least in my mind) to break the ice and get things going, but by the end of the evening you can tell people are tired of it.
I try to avoid going to the events, to allow her to have fun without me, but she would prefer I be there, until it happens, and then I'm sure she wishes she had not included me.
Fun for first time viewers not so much for an every day occurrence.
I don't always think hypomania is fun because it is normally accompanied by severe irritability, ADD like behavior and racing thoughts that make it hard to function or be around people. I have had several diagnoses over the years. I grew up with social anxiety as well as GAD. When my dad committed suicide during my freshman year of college (almost 12 years ago to the day--he had bipolar 1 diagnosis) I started antidepressants. I don't even remember the number of GPs, psychiatrists, nurse practitioners and psychologists I have seen but I would say medication and myself seldom get along for long. 12 years of medication trials, 4 hospitalizations, and ECT treatments have led to lots of missed work culminating in a sad looking resume and the realization that it's never going to be "easy".
I just started seeing a new psychiatrist a month ago. He seems okay. In some ways I need to take more accountability with my treatment than I have previously. With my severe moodiness from bipolar 2 disorder and borderline personality disorder I have a hard time maintaining relationships even with docs because I tend to not trust them. Anyhow I am still fighting the fight. Right now I'm having a hypomanic episode with the irritability and had to jump out of bed because I just couldn't sit still and was afraid to bug my husband too much. Thanks for sharing your stories. Regardless of the circumstance it is worth the fight. I believe I am fighting this for a reason and my faith tells me that one day I will understand my broken road. God bless.
I hear you. In other words Your experiences resonate with me. I wish I could go into detail but I don't have the energy today. Get some expert help. You are worth it . My thoughts are with you
From my adolescence through my twenties, I struggled with depression and difficulty concentrating, without knowing it and thinking it was just "me" (and not liking myself of course). My mother raised the depression question for me during a "deep" phase when I was in my late 20s. She gave me a book on depression that was a revelation for me. I felt I was reading about myself. I then started taking Prozac and feeling so happy to be out of the dumps and not thinking about death, that I didn't want to think about any chances of my euphoria being due to hypomania/mania ... since I did not know what they were in the first place --and since it felt so good. So, for years, when I got out of deep depression bouts with Prozac, I would wean myself off of it when I felt euphoric and happy, thinking I was cured. This "on and off" antidepressants went on for years. After a continuous series of crippling depressive episodes followed by "boosts" during my career in luxury goods, each one resulting in some promotion or being head-hunted, I stopped working thinking I would get my depression straightened out and gave myself a year. At age 47, after being unemployed for 4 years, I found a part-time teaching job and had much success with the students (more for my cheeriness I think). When I was hired full-time, I went into a grand tizzy. I thought I could revolutionize the teaching world and be the best teacher in the whole state (or the universe). I got so lost and overwhelmed with the goals and tasks I made for myself, that a small comment from one of my students triggered a total breakdown, leading to a week of being almost catatonic and having to accept to resign from my job. This job had given me insurance coverage, and this allowed my to receive my first diagnosis of Bi-Polar II, later to be revised into Bi Polar NOS (before that I had lived in France for 17 years and had only depression diagnoses, made mostly by myself). I had to leave the US and go to Africa about 8 months after my diagnosis, and since 2012, I have not had a psychiatrist or any doctor to work with me. I am now 51. I get my meds prescribed by my medical GP in France, and he knows nothing about mental health so has trusted the diagnosis and prescribed medicines that I brought back with me and shared with him. I take Fluoxetine (Prozac) 40 mg/day, Lamoctil 275 mg/day, and occasionally Xeroquel 50 mg or 25 mg. I can just feel that I can use some tweeking in those, and have been doing it on my own. I know I need to look for a new doctor, in France, where I am covered by insurance, or in Spain, where I am currently living. But I just don't know where to start. I think I am in a hypomania phase now and have been cycling one to three days each way (up and down) for the last year or so. My short term and medium term memory are quite impaired, my visual recognition capabilities are almost nil (I might have met you 20 minutes ago but won't recognize you) - my libido has been absent for 10 or so years ... I am often confused and distracted, and now I am having extreme eye dryness (from the Lamictal I think) to the point of not being able to open my eyes if I wake up in the middle of the night.
What am I trying to say here? I am just so relieved to be able to express myself to a group that understands. Except I am sure my explanation is so long that most of you are probably running away from your computer right now. Sorry ! I guess I just need to find a doctor who is good, and I am traumatized by having been misdiagnosed for so many years. I would like to have a sex life again ... and not feel so handicapped or afraid that I look crazy.
Thanks for listening.
Right after 9/11 heavy drinking killed the Symptoms and almost me. Obviously I've been on a lot of different Meds. I was put into zombylike states with high doses of anti psychotic Meds. Geodon, 900 MG's of Serous,Lithium. The Haldol and Thorazine they shoot you with at the Psych.Wards are just to put me out. I've had periods of not sleeping for five days before. Then I once locked myself into my bedroom for close to 3 months. With Anxiety attacks over having anxiety attacks if anyone can relate. Horrible with a 10 year old son knocking on the door asking me to come out and if I was mad at him that's why I wouldn't come out.
All the MDs PhDs Hypnotherapy MMDR(the two finger waving thing).
Through all this and a decade later a RNP asked me one question " do you spend exorbitant amounts of money for no reason?" That's what it took for me to understand my Bipolar. An extreme example My wife had a year old Volvo. One day just driving to the store turned into me coming home in a new Cadillac for her. I thought she'd love it she said I was an -------!
So reading this blog (if that's what it's called). I understand everything everyone has said. Obviously my swings were extremes. But finally really understanding and truly accepting, I slowly started to function better. At one point I slept on an air mattress on the kitchen floor of my parents apt. and told when to eat,sleep, shower and dispensed a wheelbarrow full of Meds. By mom.
After that RNP opened one eye I Met my 29th MD and Board Cert. Psychiatrist.
I walked in his office older man tall and thin looked up at me for 3 seconds put his head back down and said" boy your a fat puggy ----, and you have no memory ( I forgot my wife's birthday one year) and the he said " and how are those nightmares working out for you (a little PTSD thrown into this blog). I met him in the last Institution I've been in a year and a half ago. He completely changed my Meds.from heavy anti psychotics to low amounts of mood stabilizer, only 150 MG's Seroquel from 900 at nite 300mgs morning and 300mgs noonish, small amount of anti anxiety meds. And a medication called Mini press or Prozosin and not a nightmare since that day. So I'm like what happened to the first 28 docs. For the nightmares?? I actually don't dream at all which is better than violent nightmares could sleep with my wife for years. I would yell and scream and flail around causing bodily harm to her. He put me on ADD Meds. Which usually take me down to Hypo. I used to live in I thought it was called Hypermania my bad, the high level is called just Mania.
I sleep a few hours a night. I eat when I'm hungry, I shower every night. I can function enough to stay out of Institutions and haven't been Bakker Acted in a couple years. (Committed).
My Symptoms can get intensive but WE decided my Doc. And I that no more Heavy doses of Meds. I've learned other ways to deal with my illnesses. That are not harmful to me or anyone else. I saw a new Psychologist last week for the first time. I asked her the two stages of Mania were and she couldn't tell me. I ask her what type of modality does she tend to utilize. She didn't know what I meant. She has PHD after her name I never finished high school. I went from coffee boy to Managing a multi-million dollar Company. Hands on experience and thinking outside the box. Before 9/11 made me successful. And a little Hypo mania didn't hurt my climb up the ladder....
Sorry so long but today I have hope I won't end up Committed the rest of my life.
All the progress was Awareness finally and Accepting the cards I've been felt. I interview The docs now. Dallas Buyers Club good flick. Medication isn't the complete answer. Definitely different for everyone. My wife and I have been separated for like 4 years she asked me last week why I didn't return her call the day she called me o said "I was feeling a little depressed I didn't want to talk to anyone" she said " what do you have to be depressed over" somethings never change....Good Luck All There's Always HOPE!!
I feel depressed every mornng and feel good every late afternoon.
Thanks for listening.
1. My girlfriend sees her Psychologist twice a month. He is a M.S., L.M.F.T.
2. She has not seen a Psychiatrist. Her Psychologist recommended Zoloft and had her family Dr write the prescription. I am very concerned about this because I think she needs a Psychiatrist that specializes in antidepressants.
3. My girlfriend’s attitude toward her illness is fair to poor. She says she has had this for over ten years and tends to blame everyone else for making her crazy. She does not seem to have the capacity to take responsibility for her own illness. Two weeks ago I visited her condo and found her in a deep depression state. She once again talked of suicide. She said she had not sleep all weekend and had not eaten in two days. I fixed here a good BBQ chicken salad and made her eat with me. Her energy level improved and she fell asleep in my arms for about 3 hours. When I left her condo I told her she needs help and she said, do not tell my family. On my way home my conscience was bothering me. I felt it was my obligation to tell someone what I had observed. When I got home I called her best friend who she as known for 30 years. Her friend said this is typical and has seen this many times. She said don’t worry and hung up. Within 10 minutes my girlfriend called me screaming on the phone that I had betrayed her trust. Her anger tirade was so bad I hand to hang up. Later I received an email from her stating she never wants to see me again or talk to me again. I tried calling, texting and emailing and she has not responded. At this point in our relationship I cannot continue. She hid her mental issues from me for over a year and now her depression fallout has ended our relationship. The relationship is out of balance. She does not have the capacity to love me back and takes no responsibility for her actions. It’s painful and frustrating to love someone and then find out they have mental issues that are beyond your help. I’m trying my best to move on and put this behind me. I hope she gets the treatment she deserves and someday finds balance in her life that will help her love again. My girlfriend is not the same person I dated for 4 years in collage. 40 years later we reconnected in 2012. I kept looking for the person I knew and not seeing the person she is today. Now maybe you see why I stuck by her side until I began to see the real issues.
I don't know where you're from, but I would more than highly recommend you see a dr. Even drs can't be drs for themselves. There is of course a difference between being your own dr and being highly involved in your care and educating yourself on possibilities. But truly, I cannot say this strongly enough, do NOT be your own dr. Natasha??
Iam thinking of starting drugs like sertraline or venlafaxine by myself. but iam worried about the switch to manic episodes if dont start lithium with this.
Iam not sure weather i have hypomania are not. Only time i feel happy with friends is when iam the centre of attraction, when they encourage me. i feel elated when iam given more preference, when they eagerly listen to my talk. But still i dont think these counts to hypomania.
I may be also a case of borderline personality disorder.
My plan is to start sertraline/venlafaxine alone and continue it for whole 1 year.. i need opinion on this.
Unfortunately when I get manic, or mixed this is when things tend to go wrong. Gave blow ups with friends get too full of myself and upset people because I am the inky one who can do the job properly.
My depressions are the worst. Crying all day and in physical pain from the crying I do. Thankfully my medications have evened me out some what, but I still get the odd mood swing, especially when triggered.
I can hear your frustration and concern. I have a few questions more than any answers, I think.
1) About the therapist. How often does your girlfriend see her therapist? Have you met the therapist? What kind of credentials does the therapist have--are they a Liscenced Professional Counselor (LPC), a social worker, a psychologist (PsyD or PhD)?
2) Has your girlfriend ever seen a psychiatrist? or psychiatric nurse practictioner? Who is prescribing the Zoloft?
3) What is your girlfriend's attitude toward all this? For me, I think this would be the most important piece in determining what I as a significant other might do.
The bottom line is that you want her to get the help she needs. If she wants it, that's great. If she doesn't, your hands are more tied, you may have some decisions to make, but you can still talk to her and offer suggestions.
I don't know her diagnosis, none of us do. She needs to see a specialist in this field, which would be a psychiatrist or clinical (preferably) psychologist. They're the only ones that can diagnose. Also, a diagnosis is just a label, but its symptoms are what guide treatment. Your girlfriend may, and probably does, have more than one psychiatric disorder and possibly a personality disorder. I have four psych diagnoses (adhd, bipolar I, ocd, gad) and I take medication for 2-3 of them. The others I just do the best I can.
Your girlfriend is lucky to have you, and I hope that you are able to help her find the treatment she needs.
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.
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!
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.