TheSeaCat, I imagine that is confusing!

Is it possible to get another opinion from a psychiatrist? Or if from another therapist, a clinical psychologist with a PhD?

Over the years, I have noticed reading that peoples' hypomanic episodes seem to be presented in various ways. There is no cookie cutter presentation. A hypomanic or manic person does not need to be a hyperspender or gambler or drug/alcohol abuser, etc., but may present some other type of symptoms dominately in the list or in the "impulsive" or "self-medicating" categories. I have bipolar type 1 and hyperspending has never been a major issue for me, but impulsive actions in public, sometimes to the point of almost having police called has. Or other similar symptoms.

According to the DSM-5, if a pure elevated episode results in psychiatric hospitalization, the episode is considered full blown manic. I've never heard of hypomanias resulting in hospitalization unless maybe if they were mixed, with severe depression dominate, or maybe a drug/alcohol issue involved.

I imagine guaging hypomania vs. non-hypomanic charged behavior or anxious behavior can be difficult for some mental healthcare professionals, especially if they don't directly witness the "mood elevation" or have experience seeing it in others (not just themselves). I will say that full blown manic episodes are almost always undeniable. They are very severe.