Mania is the more severe state experienced on the up swing, characterised by high energy, high impulsivity, grandiosity, delusions, huge spending sprees, poor judgements in business/relationships/home life etc.
By comparison hypomania has always been thought of as a milder version of mania. However what I have experienced in the past has been anything but “mild” to me.
The wonderful euphoria that wafts through my spirit during early-phase hypomania is just such an amazing experience. Everything feels so “right”, I feel I can do anything in the world I want to do and be mega-successful at it. I feel “special” and at one with the universe. I feel I have a divine purpose. My body feels as if it has blazing energy bursting out of each cell. I talk too much, talk over people, don’t listen, think I’m right, everybody else is wrong, I must win every discussion, I must have the most attention- I’m funny and witty and people love me!! That’s honestly how you think when you’re hypomanic! You cannot possibly see how anything could go wrong in your life.
After a while though, in the background, is a droning pressure to keep moving, keep doing, keep talking, talk louder, don’t stop, DON’T STOP! You have a nagging inkling that if you stop, your whole world could fall apart.
Of course eventually it does fall apart and soon the arguments come, the tears, the extreme irritability which can easily turn to rage. Sleep is in fits and starts. There’s a grating restlessness that is insatiable and feels extremely uncomfortable. The intense urges to self-harm and aggressive impulses to tear at your arm with a knife are torture. Sometimes I don’t think I really realised at the time how ill I was until after I got better. Then I would realize what a total arse I had been to people, how horribly I had treated people I love and how much disruption had been caused in my life at work (I have been fired before when I was hypomanic) and at home.
The fall-out of hypomania is also painful: relationships may have suffered, sometimes fatally, debts may have been racked up. I’ve done some silly and sometimes dangerous things when hypomanic. You have no sense of risk.
So when the hell does all of this turn to mania? Because it seems to me that my moods were pretty intense. Do you, on impulse, need to have racked up thousands of pounds worth of debt, or think you’re Jesus? Do you have to have been hospitalized? (Thankfully I never have been).
At what point does a psychiatrist say this patient is manic?
I guess in my head I’ve always thought this depends more on the patient’s awareness. If he is spouting off gibberish over and over, or thinks he’s Simon Cowell’s best friend and seriously, seriously believes all this stuff, I guess this is true delusion and would be classed as mania. In my head I’ve always thought that if someone needs to be hospitalized with an upswing, the patient must have lost touch with reality and is now unable to look after themselves.
This is all my personal opinion, so please don’t take as fact!
Related post really worth reading by Purple Persuasion: Installing Bipolar v1.5.
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