Mania vs hypo mania

How do you know the difference? Is it a felling or what are the certain signs? My ups have progressively gotten more out of control like today the hostility coupled with super sexual surged thoughts. I guess we'll see what torture brings.

Tig

I am learning that by the time I'm manic, it wouldn't even occur to me to ask the question "am I manic or hypomanic?" lol.

I think that the line between mania and hypomania can get blurry. The DSM distinction is more to distinguish between BP1 and BP2, and to aid the intensity of treatment. Personally I think that the distinction can get quite arbitrary at times, and might not always be useful for the sufferer.

What is the Difference Between Mania and Hypomania? | Breaking Bipolar

Are you in control? No. mania.
Are you in control? hypomania

I might be wrong, but I think that psychosis can only happen during mania, but not hypomania.

This is similar to the post above, to some extent.

That's correct, according to DSM classifications. A psychotic episode during mania is enough to get someone a BP1 diagnosis.

However, not everyone who experiences psychosis has BP1 or some form of BP. I have BP2, and I had a psychotic break once (during a severe illness that required hospitalization; not related to BP however).

I think there is what is called a psychotic depression, and bp2 is more depressive, so maybe that is the connection?

That was my understanding as well.

So its the control factor and psychosis. If one is present the other isn't?

Tig

Mania does not need to have psychosis.

Mania will have a significant impact on your life. Hypomania might have an impact, or it might not.

I've never been manic. My hypomanias are great though - I'm more impulsive but I've got various rules for myself set up that I follow to help curb that. But I don't lose touch with reality or my life, and I can maintain my life - my job, my home life, my social life, my finances - none of those will be significantly impacted by my hypomania.

To me it's probably the biggest distinction - mania will often cause lots of difficulties with your normal life, but hypomania won't have such large consequences. I also think that hypomania can be fairly easy to "hide" whereas mania... will likely be a lot more noticeable.

Can a BP II have mixed episodes?

The DSM says no, but many BP2 people here on this board including me have had mixed episodes...

On my discharge papers my diagnosis was written as Mixed Bipolar Affective Type 2... so some pdocs know its possible too.

I must agree. I have only been what I consider manic a couple of times, all medication induced. I left to my own devices I spend the majority of an episode hypomanic, wih maybe a couple of days fully manic, which doesn't count toward diagnostic criteria. I don't think med induced manias count either. When I am hypo no one is usually the wiser, though I do get comments on how fast I'm talking/walking and how restless I seem. But when I get a comment I make a conscious effort to dial it back, which I doubt I would do if I were fully manic.

Right now my BP 1 dx is hinged on the presence of mixed states, which I understand many BP 2 people here experience. I also had an episode of full mania with psychosis, but it was med induced, so I can't be sure whether I really do have BP 1 or 2. But I also don't think it really matters for me. I'll treat then both the same regardless of which one.

For me :

Hypo ... Happy puppy rainbows
Manic .. Angry hateful hot mess.... I never lash out to others I turn everything inward.

You can shop till you drop maxing out credit cards - that would be not being in control without suffering from psychosis.

I experience mixed episodes too, even though it seems to be a no-no on the DSM. The DSM can oversimplify things for "convenience" :P

I think that the excessive, unbridled shopping might also happen in severe BP2 hypomanias. It's certainly happened to me. When my episodes stabilize, I'll ask, "who was that person?" Again, this is why I think that the distinction between hypomania and mania is so blurry. I like to think of the two as being part of a spectrum, rather than two categories altogether.

Thanks everyone. Is there a difference in how the types are treated? Or are they treated the same?

Tig

Many of the same drugs are used to treat BP1 and BP2. This particularly applies to Lithium and mood stabilizers like Lamotrigine, Trileptal, Depakote, and Tegretol. Dosages are person specific. Most of these mood stabilizers are also anticonvulsants that are used to treat epilepsy.

People with BP1, or anyone with manic and/or psychotic tendencies really, are more likely to be prescribed antipsychotics (including "maintenance" APs). I prefer the terms neuroleptics or major tranquilizers to the term antipsychotic. These drugs include Abilify, Zyprexa, Risperdal, Latuda, and Seroquel. Most of these APs are also used in the treatment of schizophrenia.

Bipolar 2 has no mixed episodes?! DSM fail.

Ok. That makes sense. Might explain why seroquel and zyprexa aren't/didn't work for me. Seroquel just makes me tired zyprexa made me slightly suicidal. Maybe I need a mood stabilizer instead hopefully my pdoc will figure things out quickly when I see him on the 21. This appointment can not happen soon enough. Fingers crossed. Thinking about making a time line to take with me to the appointment with approx times and things I can remember. Once again thank you everyone.

Tig