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.
People with bipolar disorder often have cycles of elevated and depressed mood that fit the description of "manic depression." When a person's illness follows this classic pattern, diagnosing bipolar disorder is relatively easy.
But bipolar disorder can be sneaky. Symptoms can defy the expected manic-depressive sequence. Infrequent episodes of mild mania can go undetected. Depression can overshadow other aspects of the illness. And substance abuse can cloud the picture.
Taken together, these factors...
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
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.
SOURCES: WebMD Medical Reference with The Cleveland Clinic: "Bipolar Disorder (Manic Depressive Disorder)." WebMD Assess Plus: Bipolar Disorder Assessment. National Institute for Mental Health: "Step-BD Women's Studies." Massachusetts General Hospital Bipolar Clinic & Research Program. MedicineNet.com: "Bipolar Disorder (Mania)." WebMD Medical Reference with The Cleveland Clinic: "Effects of Untreated Depression." American Psychiatric Association: "Practice Guideline for the Treatment of Patients With Bipolar Disorder."
Joseph Goldberg, MD on October 02, 2012