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Hypomania and Mania in Bipolar Disorder

Bipolar mania, hypomania, and depression are symptoms of bipolar disorder. The dramatic mood episodes of bipolar disorder do not follow a set pattern -- depression does not always follow mania. A person may experience the same mood state several times -- for weeks, months, even years at a time -- before suddenly having the opposite mood. Also, the severity of mood phases can differ from person to person.

Hypomania is a less severe form of mania. Hypomania is a mood that many don't perceive as a problem. It actually may feel pretty good. You have a greater sense of well-being and productivity. However, for someone with bipolar disorder, hypomania can evolve into mania -- or can switch into serious depression.

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Karen Renken was just 14, but she knew something was terribly wrong. "I was a straight-A student, and suddenly I started failing in school," says Renken, now 45, of Long Island, N.Y. At high school, she would go from enjoying a seemingly normal mood to throwing a tantrum in the hallway. Her teenage response to normal requests, such as her mother's plea to pick up after herself, was dramatic. She would, she says, "shriek like a maniac." Renken was sent to a psychiatrist, who prescribed an antidepressant,...

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The experience of these manic stages has been described this way:

Hypomania:At first when I'm high, it's tremendous ... ideas are fast ... like shooting stars you follow until brighter ones appear... All shyness disappears, the right words and gestures are suddenly there ... uninteresting people, things become intensely interesting. Sensuality is pervasive, the desire to seduce and be seduced is irresistible. Your marrow is infused with unbelievable feelings of ease, power, well-being, omnipotence, euphoria ... you can do anything ... but somewhere this changes.

Mania:The fast ideas start coming too fast and there are far too many ... overwhelming confusion replaces clarity ... you stop keeping up with it … memory goes. Infectious humor ceases to amuse. Your friends become frightened ... everything is now against the grain ... you are irritable, angry, frightened, uncontrollable, and trapped.

If you have three or more of the mania symptoms below most of the day -- nearly every day -- for one week or longer, you may be having a manic episode of bipolar disorder:

  • Excessive happiness, hopefulness, and excitement
  • Sudden changes from being joyful to being irritable, angry, and hostile
  • Restlessness, increased energy, and less need for sleep
  • Rapid talk, talkativeness
  • Distractibility
  • Racing thoughts
  • High sex drive
  • Tendency to make grand and unattainable plans
  • Tendency to show poor judgment, such as impulsively deciding to quit a job
  • Inflated self-esteem or grandiosity -- unrealistic beliefs in one's ability, intelligence, and powers; may be delusional
  • Increased reckless behaviors (such as lavish spending sprees, impulsive sexual indiscretions, abuse of alcohol or drugs, or ill-advised business decisions)

Some people with bipolar disorder become psychotic, hearing things that aren't there. They may hold onto false beliefs, and cannot be swayed from them. In some instances, they see themselves as having superhuman skills and powers -- even consider themselves to be god-like.

WebMD Medical Reference

Reviewed by Joseph Goldberg, MD on October 02, 2012
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