During and after periods of depression, it can be difficult to remember what “normal” feels like. What do you do without the aches and pains, apathy and hopelessness? Coming out of depression is like waking up from a bad dream. It’s disorienting and it takes some time to adjust. It can be difficult to change behavior and thinking patterns during this time. You slowly become more sociable, more involved, more likely to complete projects and take care of yourself. At this point, doubt can creep in and ask if this change is not an adjustment back to normal, but a swing into a state of hypomania.
People with either type of bipolar disorder spend 50% of their time experiencing depressive, hypomanic or manic episodes. People with bipolar II do not experience full mania, but people with bipolar I do experience hypomania, if less often. The average time spent in hypomanic episodes is about 12% for those with bipolar II and 10% for bipolar I.
The symptoms of hypomania are not really different from those of mania. It’s all about impact. Periods of hypomania are mostly shorter than mania and have less of an effect on those experiencing an episode.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), those symptoms include:
- Inflated self-esteem or grandiosity.
- Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).
- More talkative than usual or pressure to keep talking.
- Flight of ideas or subjective experience that thoughts are racing.
- Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
- Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation.
- Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).
When returning to normal, you may experience some behavior that feels like hypomania, but isn’t. For example, excessive sleep can be a symptom of depression. When moving out of depression, you may go from sleeping 10 hours to only sleeping seven or eight. That is not a decreased need for sleep. That is a normal sleeping pattern.
If you’re feeling well you’ll also have a higher self-esteem than when you feel worthless during depression. This is not necessarily grandiosity. Thinking will also speed up because brain fog will lift and you’ll be more likely to get involved with school, work, social activities or sports. This is all normal behavior and it feels good.
However, hypomania can also feel good. It can feel really good, which is why a lot of people actually like having periods of hypomania. It’s when behavior becomes a problem that you need to worry.
Questioning possibly risky behavior can help. It may not always be blatantly obvious. Do you normally spend $50 randomly on items you want but don’t really need? Are you starting multiple projects and not finishing them? Are you having trouble sleeping but not necessarily feeling tired because of it?
If you ask yourself (and others) whether your behavior is a problem and you find it is, then it may be a good time to call your doctor. However, if you find your behavior is not problematic, just enjoy your time feeling like a normal human being.
Image credit: Ray Tsang