People with bipolar disorder experience elevated, exuberant moods that can significantly impact their lives. These moods can vary in intensity and in the amount of disfunction they cause, and can lead to very different outcomes and treatment.
These moods are diagnosed as either mania or hypomania.
According to the Johns Hopkins Psychiatry Guide, symptoms of mania include:
- Elevated/irritable mood and increased activity, as well as other symptoms that can include inflated self-esteem, decreased need for sleep, pressured speech, racing thoughts, increased distractibility, and increased, reckless involvement in pleasurable activities like spending sprees, sexual activity, and substance abuse.
- Patients may not have insight regarding their elevated mood, but they may notice that they are having trouble controlling their drinking or drug use, or that they are having relationship problems.
- The hedonistic triad of spending sprees, sexual activity, and substance abuse can have catastrophic financial and personal consequences.
- Patients can have delusions or hallucinations during manic episodes.
- The most common delusions are delusions of grandiosity (often with a religious theme) or paranoid delusions.
- Hallucinations are less common than delusions; when patients do have hallucinations, auditory hallucinations are more common than visual hallucinations.
- Although the beginning of a manic episode can be experienced by the patient as pleasant and is marked by elated mood, a severe manic state can be very unpleasant for the patient and can involve bizarre delusions, frenzied activity, and disorganized cognition.
- Severe mania is dangerous due to agitation and an increased risk of violence toward both self and others.
Indications of hypomania include a period of elevated mood, including elevated self-esteem or self-confidence and uncharacteristic physical and mental energy. The most significant difference between hypomania and mania is that hypomania is less severe and does not cause impairment in functioning, require hospitalization, or have psychotic features.
Bipolar Disorder 1 is diagnosed when a person has a manic episode of at least seven days that results in a hospitalization. People with Bipolar Disorder 2 experience periods of hypomania and depression, sometimes occurring together in a mixed episode.
Hypomania can be a tremendous, seductive experience. When I’ve experienced it it was as if I was at my most creative and charismatic best, full of ideas and energy. If I could bottle it I’d be a billionaire. Unfortunately, the episode always ends, sometimes badly, and often hypomania is followed by a crushing depression.
My experiences with mania were very different. I destroyed relationships, jobs and bank accounts following every impulse without regard for consequences. Psychosis often kicked-in, and hallucinations and suicidal taunting pulled apart my life and landed me in the hospital several times.
While the results of these episodes seem desperate, people with either Bipolar Disorder 1 or 2 can be successfully treated. Treatment effectiveness rates approach 85%, and medication, therapy and sensible lifestyle adjustments can reduce or even eliminate the negative influence of mania and hypomania on a person’s life.
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