I have bipolar type 1, so have reached full blown manic several times, though I certainly can have episodes that only reach hypomanic level. Actually, when I was much younger, many of my episodes were extended hypomanias of several weeks or even months. Sometimes they died down. Sometimes they reached full blown mania. Back then, usually my full blown manic parts were somewhat short-lived (days to a couple weeks max). Later down the line, especially during my worst years, my full blown manias lasted a bit longer, but then I was usually in the hospital and/or Intensive Outpatient Program. In very recent years, well medicated, I've only reached hypomania and they are short-lived due to quick medication intervention. My illness still disables me, none-the-less.

Some of my hypomanias and manias were mostly of the elated type with occasional irritable bouts (i.e. from obnoxious arrogance to raging devil from hell). Many started with elated periods, but turned mixed. When my full blown manias were at their very worst, it was usually a mania with mixed features and psychosis. My psychoses mostly included delusions (some not as scary, some delusions of persecution). I also had hallucinations sometimes. Some were not scary (marvelous to strange/absurd). Some were terrifying (God was trying to kill me, I saw the devil), a woman poisoned me with anthrax). At my worst in the hospital, you might have found me screaming in terror or fury from delusions and/or having extreme screaming tirades where I was punching the wall, slapping myself, or kicking things. I was dragged at least four times by security to isolation rooms, and held down and given injections to calm me down - usually Haldol or Ativan. They'd leave me in the locked room until I settled down. Once I was allowed to return to a regular room, but they gave me my own room that time, likely because I scared other patients. That time a security guard sat outside of my room. When I walked out of the room, he followed me.

There were also times in and out of the hospital that I would walk around talking out loud to myself in front of people. Sometimes it was in response to the inner chatter in my mind. Sometimes it was a response to desperate feelings where I'd repeat things over and over again and maybe even stutter rapidly. I assume people were staring, but in that state I wasn't really concerned about what people thought. Once at work, I had an immediate ascent into mania where I was screaming at the top of my lungs. They dragged me into my boss's office and HR called my husband. The whole floor at work knew I had a severe mental illness and heard my screams. Some knew from before. Once six people as a group went to HR to wage complaints about my behavior (screaming, being a nightmare, punching things). Once on my way to the hospital with my husband, I attempted to jump out of the moving car, but hubby grabbed me. When I got to the hospital ER that time, I had a period of catatonia (mute and not moving). That ended after some minutes, at which time I was screaming at the top of my lungs. Again, injection. Once my old pharmacist threatened to call the police on me. I also had a therapist who called my psychiatrist and told her I "scared her". She refused to see me again until my psychiatrist reported I was "better". She eventually dropped me.

The "elated" times I remember were not so very bad at all. In fact, they were marvelous. I traveled around parts of Asia on my own (sometimes in a blur). Hypersexuality was a key symptom I associate with that mania. It was like I was some queen of the world and everywhere I went, everyone (particularly men) saw me coming and was wowed. I recall dancing for hours on end at clubs. Often until 3 or even 5 am. I did some quite wild things. Once I convinced myself that I was good friends with Bono of the band U2.

I experience most of the usual manic symptoms: talking fast and loud (sometimes to the point of almost gibberish), not letting others get a word in and basically not able to pay attention to them, racing thoughts, disjointed and other language features, disinhibition (saying things and doing things I'd NEVER otherwise do, and sometimes drinking heavily), grandiosity, impulsivity, being physically fast or psychomotor agitation, starting multiple big projects that I create for myself (usually with the intent to achieve greatness), not needing any sleep (full blown) or little sleep (hypomania). The insomnia is rarely an issue then because I am happily up driving places, writing furiously, baking, or things like that.

I, too, often get physical symptoms with hypomania/mania. I think they mostly revolve around anxiety and panic attacks that sometimes come with mood states. Also, one's whole system is in extreme overdrive. A long period of manias gave me tachycardia. A number of times I injured myself, but didn't really feel that much pain. For example, once in a fury, I decided to run down a steep hill. [Yea, that was smart of me!] I fell quite hard and got a black eye, bruised and scraped arms, and legs and knee so injured that they swelled up. And yet I wasn't that bothered by it. I've twisted my ankle a couple times and walked on it without complaining. The trouble is, when manic and in furies, I am careless and violent with myself.

I've come a long way. I'm OK if I keep taking my meds, take "as needed" meds, call my pdoc/tdoc pronto, and generally avoid triggers and use coping skills. The illness does still scare me. I think if I stopped any of these preventions, bipolar disorder would totally overtake me.