[usehername]

I was just wondering... where is the line between hypomanic and full blown mania? My current shrink seems to thin that if you've never been hospitalized for it, it isn't mania. I think he's a bit of a quack, and I'd fire him if I could, but that isn't the point.

For example, when I am manic, I am hyper-productive for the first couple of days, and then I'm moving so fast I can't get anything done. I don't really have that functionality that so many of the BPIIs seem to speak of... It is usually euphoric, and I get accused of being on drugs when I'm not because of it. I fly around everyone, talk 90 miles an hour without letting anyone get a word in, take on way too much, drink to excess, find interesting ways to nearly get myself killed by accident, get stranded in unsafe places and get into trouble with everyone around me, including incidents like screaming at people and getting into fights. I once crashed into a guy because he wouldn't let me merge... All in all, I'm NEVER proud of myself after a manic episode, but I've only been hospitalized for it once, and it was for trying to self-medicate it away because I was FREAKING OUT (it doesn't show up on my records as"acute mania", in other words, it shows up as an OD - they even asked if it was a suicide attempt! I told them I'd do better). I also don't have "normal" periods, and my mixed states are basically dysphoric mania with SI and planning and NO euphoria... I'm really not trying to complain here, just giving examples so I can understand better...

So where is the line between hypo and full blown? My favorite shrink told me that it's full blown when it becomes destructive to your life... I guess I never knew there was a mania that wasn't??

[BipolaRNurse]

My pdoc and I had a discussion about that just last week. It was the first time he'd ever really made those distinctions, but he basically said "This (described symptoms) is what you're like when you're hypomanic, and then x happens when you're manic." I've never been hospitalized---at least, not yet---but my mania has been destructive enough that it's cost me jobs and a lot of respect and good will.

A doctor who says you have to have been hospitalized to qualify for a bipolar 1 diagnosis is being intellectually lazy, IMHO. You may or may not be BP 1, but a good doctor treats the symptoms, not the diagnosis.

For me, hypomania is when I feel GREAT and the world is SPECTACULAR and I love EVERYBODY and every day is the BESTEST DAY EVER!!! I'm breezy and giggly and I'm like, wow, look at all the COLORS! I can do anything and everything, I spend lots of money and treat everybody within shouting distance to a meal. I'm also super-creative and super-productive, and I'll do things like sing out loud (I have a terrible voice) and dance in the rain.

THEN it turns ugly. When I'm full-blown manic I get paranoid, angry, scared, irritable, and argumentative. My thoughts race all day, all night. I'll pick fights when I think someone's trying to ruin my "fun", drive way too fast and too aggressively. I can't sleep, can't sit still, feel like I want to crawl out of my skin and like I can't find a place for myself. I pace and yell into the phone when I'm talking to someone (usually by the time I'm this bad off, I'm calling my pdoc), I can't focus, and sometimes I even have auditory hallucinations. When it's over I experience blackouts, kind of like when you drink too much only it's with the mania---I can't remember a lot of what happened during the manic spell.

Don't know if that's helpful, but I thought I'd throw that out there as an example of two different types of manic states. FWIW, I think you're BP 1 but of course I'm not a doctor so I can't diagnose you.

I have always been told the line is very fluid. So it could be at a point that requires hospitalization, or at the point that you are being self-destructive without a second thought as to why you are doing it. (For example maybe you are spending all of your money at the casino, or you just found yourself on a road trip to some place without out reason, or perhaps you just got into a fight for no reason).

What you are describing sounds like me so much. I also have been accused of being on drugs, talk 90 mph, take on these crazy projects, getting into shouting matches with people who control my future, and so on. These were things that I have worked out to be associated with my manic episodes.

My hypo episodes just seem to be more of an inflated self-esteem, everything is peachy, just not really caring about what others think, lots of energy, and not really needing a whole lot of sleep.

I hope this makes sense and helps somewhat.

[Curiosity77]

I wonder about the line between hypo and full blown fir me too. My diagnosis is BP 2, but i've had some pretty extreme hypomanic episodes which were very destructive to my life, so i wonder if they were actually manic episodes. I have also been accused of being on drugs when in that state. You described it well userhername, i am like that too. I don't get psychosis, but i get most of the other symptoms of mania, and i have cheated in my marriage, gotten myself in serious trouble at work, and done a bunch of dangerous things. I was hospitalized with a mixed state, but never with a purely elevated mood. So mildly manic or extremely hypomanic, i don't really know. I just know i do damage in that state.

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[Skitz13]

Originally Posted by BipolaRNurse

My pdoc and I had a discussion about that just last week. It was the first time he'd ever really made those distinctions, but he basically said "This (described symptoms) is what you're like when you're hypomanic, and then x happens when you're manic." I've never been hospitalized---at least, not yet---but my mania has been destructive enough that it's cost me jobs and a lot of respect and good will.

A doctor who says you have to have been hospitalized to qualify for a bipolar 1 diagnosis is being intellectually lazy, IMHO. You may or may not be BP 1, but a good doctor treats the symptoms, not the diagnosis.

For me, hypomania is when I feel GREAT and the world is SPECTACULAR and I love EVERYBODY and every day is the BESTEST DAY EVER!!! I'm breezy and giggly and I'm like, wow, look at all the COLORS! I can do anything and everything, I spend lots of money and treat everybody within shouting distance to a meal. I'm also super-creative and super-productive, and I'll do things like sing out loud (I have a terrible voice) and dance in the rain.

THEN it turns ugly. When I'm full-blown manic I get paranoid, angry, scared, irritable, and argumentative. My thoughts race all day, all night. I'll pick fights when I think someone's trying to ruin my "fun", drive way too fast and too aggressively. I can't sleep, can't sit still, feel like I want to crawl out of my skin and like I can't find a place for myself. I pace and yell into the phone when I'm talking to someone (usually by the time I'm this bad off, I'm calling my pdoc), I can't focus, and sometimes I even have auditory hallucinations. When it's over I experience blackouts, kind of like when you drink too much only it's with the mania---I can't remember a lot of what happened during the manic spell.

Don't know if that's helpful, but I thought I'd throw that out there as an example of two different types of manic states. FWIW, I think you're BP 1 but of course I'm not a doctor so I can't diagnose you.

Thanks for that, even though your reply wasn't for me. A few weeks ago I did my first life timeline with BP. I could recall most of my depressive period but had a hard time recollecting my highs and I have blocks of time that are missing so maybe those were my manic episodes.

[Skitz13]

Originally Posted by usehername

I was just wondering... where is the line between hypomanic and full blown mania? My current shrink seems to thin that if you've never been hospitalized for it, it isn't mania. I think he's a bit of a quack, and I'd fire him if I could, but that isn't the point.

For example, when I am manic, I am hyper-productive for the first couple of days, and then I'm moving so fast I can't get anything done. I don't really have that functionality that so many of the BPIIs seem to speak of... It is usually euphoric, and I get accused of being on drugs when I'm not because of it. I fly around everyone, talk 90 miles an hour without letting anyone get a word in, take on way too much, drink to excess, find interesting ways to nearly get myself killed by accident, get stranded in unsafe places and get into trouble with everyone around me, including incidents like screaming at people and getting into fights. I once crashed into a guy because he wouldn't let me merge... All in all, I'm NEVER proud of myself after a manic episode, but I've only been hospitalized for it once, and it was for trying to self-medicate it away because I was FREAKING OUT (it doesn't show up on my records as"acute mania", in other words, it shows up as an OD - they even asked if it was a suicide attempt! I told them I'd do better). I also don't have "normal" periods, and my mixed states are basically dysphoric mania with SI and planning and NO euphoria... I'm really not trying to complain here, just giving examples so I can understand better...

So where is the line between hypo and full blown? My favorite shrink told me that it's full blown when it becomes destructive to your life... I guess I never knew there was a mania that wasn't??

I think your shrink has a point. Although I have hypomania, It has caused a lot of problems in my life. It cost me a marriage, friendships, 8 evictions in 12 years, my car, my home and my job. So as far as I'm concerned mania and hypomania can do just as much damage.

[pawn78]

For me, hypomania and mixed states are very common.
Mania is very rare for me, but I end up in the hospital eventually. Only twice in my life, but mania is WAY more extreme than hypomania...

[pawn78]

Here is a good example:

Hypomania: "I have so much energy, and I want to do all this fun stuff!!!"

Mania: "I am controlling the entire universe with my thoughts."

This is just an example , everyone is different, but the "line" is when delusions start to manifest and the ego goes into overdrive, totally out of control.

With hypomania, there is still some self-control and rational thinking going on somewhat.

With mania, all bets are off... Anything can happen.

[Skitz13]

Originally Posted by pawn78

Here is a good example:

Hypomania: "I have so much energy, and I want to do all this fun stuff!!!"

Mania: "I am controlling the entire universe with my thoughts."

This is just an example , everyone is different, but the "line" is when delusions start to manifest and the ego goes into overdrive, totally out of control.

With hypomania, there is still some self-control and rational thinking going on somewhat.

With mania, all bets are off... Anything can happen.

You summed it up really well. Thanks

[outlaw sammy]

I have a theory about bipolar insanity - the labels of hypomania, mania, manic-psychosis, mixed, mild depression, medium depression, deep depression cannot be compartmentalized or categorized by lines or boxes. Instead, they are overlapping and obscure. Worse yet, these definitions are transient (defined by surrounding consensus).

Think of it like temperature: if someone says, "It's hot outside," then you might ask what temperature is their "hot." Someone else (another pdoc) may say "It's warm, but not hot." In other words, the definitions are not either-or with some definitive "line." They over-lap and vary based on the unique symptoms of each individual in the moment.

So, when another BP1 says to me, "I've never had a manic episode, but I've had 'manic-like symptoms,' " I say simply that "you don't really know that for sure, because you have no way of evaluating yourself." They can only suspect that they "have never had a manic episode."

[Victoria'smom]

I can't tell my (hypo)manic. I can tell when I'm paranoid , or when ' I can't say that out loud' but mania/depression is just me.