Mania Versus Hypomania

Patient Expert

Do you know the difference between Bipolar I and Bipolar II Disorders? It's that people with Bipolar I experience mania, while those with Bipolar II experience hypomania. But once   you know that, you then need to know the differences between manic and hypomanic episodes.

Both mania and hypomania have many of the same symptoms, such as:

  • A high-flying feeling
  • Less need for sleep
  • Racing thoughts
  • Grandiose and/or flamboyant behavior
  • Increased sexuality
  • Fast talking
  • Reckless spending
  • Irritability, aggressiveness, hostility
  • Easily distracted

But if any of the following symptoms are present, it's mania rather than hypomania:

  • Hallucinations, delusions and/or paranoia
  • A seriously elevated or irritable mood - well beyond the norm of a very good mood
  • Normal day-to-day functioning is significantly disrupted
  • Hospitalization is necessary

Mania with psychotic symptoms, for example, can be a fundamentally dangerous state. Hearing voices that tell you to do something you would never normally do can have severe consequences. The paranoid delusion that people are always watching you, talking about you, following you, can cause massive disruption to your daily life.

Of course, hypomania can be a serious state, even though it isn't as extreme as mania. A person who, in a state of hypomania, goes out and spends thousands of dollars on clothing, buys a car, or engages in other foolish spending without having the money actually to pay for the purchases, is in just as much trouble as a manic person who does this. It doesn't matter whether you're manic or hypomanic if you tell your boss off in a burst of fast-talking hostility and are fired.

Yet many people enjoy the "high" side of mania and hypomania - the elation, the energy, the creativity (which may or may not produce good results) - that they resist or stop taking medications in order to feel those things. This is virtually always a bad idea. If you feel over-drugged, the best thing to do is discuss the situation with your doctor. When you stop or refuse medications, there is always a risk of having symptoms that could have serious long-term effects, as well as of plunging into a depressive episode.

What else do you want to know about mania and/or hypomania? Leave me a comment.