Did you know that you can have Bipolar I and have a hypomanic episode?

Which doesn't seem natural cause if you have Bipolar I, there should be MANIA... but then there is a graduation of mania in Bipolar I... there is hypomanic, mild, moderate, and severe.

But then Bipolar II is supposed to be all about the hypomania, not mania.

Except that... you can have mild-moderate mania in Bipolar II, and not necessarily hypomania.  Yeah, try twisting that around your tree of knowledge for a bit.

Oh and you can have psychotic features in both Bipolar I and Bipolar II, whether while depressed, mixed, or manic.

But it is all okay... they have meds for all of it... many many many meds.

I dabble, a bit on the side, doing transcription for a psychiatrist and with that - you have to code the diagnoses.  That is, the doc (the MD) officially diagnoses the patient and you have to find the appropriate ICD code that insurance and disability, etc... use.  The doc, follows the DSM - which is the Bible of Psychiatry.

So... turns out, you can have a hypomanic episode while having Bipolar I, as well as having Bipolar I with mild mania.  Now isn't mild mania hypomania?  Or is hypomania not supposedly mild mania?  Isn't hypomania Bipolar II whereas Bipolar I is full on mania?  Uh.. NO, apparently.

With psychotic features... argument has been that those with Bipolar II do not have psychotic features.  WRONG.  Many with Bipolar II have psychotic features regardless of whether in a depressed episode, mixed episode, or hypomanic episode. 

But wait... hypomania is mild mania, right?  I dunno know, I'm confused.

You can have Bipolar I and have a hypomanic episode, which is different than a "mild" manic episode.  Okie dokie then...

So... what is "mild" mania, if it is not hypomania and if it is hypomania then how can you have Bipolar I and have hypomania when hypomania is Bipolar II and mania is Bipolar I? 

I dunno... my head hurts and I is confused.

Well... let's see if I remember the old school - uhm, with Bipolar I it's all about the mania, with shorter depressions.  Bipolar II is all about the depressions, with shorter and less intense manias.

Except that many with Bipolar I have as bad, if not worse, depressions as they do manias and those with Bipolar II can have as bad, if not worse, manias as depressions.  It's about severity and life dysfunctioning/de-railing.

Okay... Bipolar I is if the episodes are so bad you require hospitalization.  Uh no, that doesn't work because many with Bipolar II also require hospitalization due to episodes.

Well... Bipolar I is worse than Bipolar II and it's just a given.  That's like a momma telling a child to do something, the child asks the eternal question as to why?  the mom responds with the eternal answer "cause I said to, that's why!"