Hypomanic Episode, Manic Episode, or Bipolar… What’s the Difference?

Are You Hypomanic or Bipolar? What is a Hypomanic episode?

The question is really misleading, because having a hypomanic episode is not a diagnosis. You don’t have a hypomanic disorder, you may have been through periods of hypomania, and based on that you could get a diagnosis of Bipolar 1 disorder, Bipolar 2 disorder, Cyclothymic disorder, Bipolar NOS disorder.

(This is going to be educational but don’t worry, I’ll put in a story or an angle soon. You know me. 🙂 )

So the DSM IV-TR categorizes different mood disorders (mood based mental illnesses). Major depressive episodes, manic episodes, mixed episodes, and hypomanic episodes (hypomnia) are the “building blocks” for a diagnosis of a mood disorder, be it unipolar depression or bipolar disorder.
The diagnosis – the description of the mood disorder – depends on the type, length of time, and frequency that a person has had one or more mood episodes. Having these “boxes” to put a person’s mood disorder in makes it easier to communicate with other doctors about the condition for purposes of research, statistics, and of course – bipolar treatment. They give you an idea of what to expect.

So What is Hypomania?

All of the different “mood episodes” are a series of abnormal behaviors and extreme moods. They are “altered states.” In a hypomanic episode a person’s mood is persistently elevated in an abnormal way (it has to be very different from the way they usually are when not depressed), or they could be extremely irritable. (Some bipolar people experience bipolar anger and rage instead of bipolar mania.)

The episode needs to last four days to be considered “official,” and there have to be three of the bipolar symptoms listed below – four if the major mood change is irritability. Here are the symptoms:

  • Inflated self-esteem – A much bigger ego. I’m God’s gift to the world.
  • Decreased need for sleep. Not necessarily insomnia, because you aren’t trying to sleep. You just might feel all rested after three hours.
  • Very talkative. Blah blah blah. Feeling a need to keep talk.
  • Racing thoughts… mind jumping from idea to idea, very rapidly.
  • Distractibility. Getting distracted by random unimportant things. “Whoah, the paisley on your tie is so cool…” While in the middle of discussing a business deal.
  • An increase in goal directed activity, whether socially (going to tons of parties all of a sudden, calling everyone you know to say hi) at work (never ending projects, making tons of commitments) or school (same thing), or sexually (you get the picture). Excessive movement.
  • Being excessively involved in pleasurable activities that could get you into a whole lot of trouble, like: crazy shopping sprees, unsafe sex, gambling, and bad business investments.

Basically, it seems like they might be on drugs, but they’re not. (But hypomanic episodes, and extended bipolar like symptoms can be caused by drug abuse. That’s called Substance-Induced Mood Disorder, and I think that’s what Charlie Sheen has. I don’t think Charlie Sheen has bipolar disorder. Not the typical kind.)

So How is that Different From Being Manic?

Ah ha! You may have noticed that the symptoms for a manic episode and a hypomanic episode are identical! That’s right… one difference is that a manic episode has to last a week, three days longer. But the main difference is how extreme it is. (See the manic episode page for more clarification.)

A hypomanic episode doesn’t land someone in the hospital. Someone in a hypomanic episode can be very high functioning. There’s a new movie out: Limitless. (Ok, it may be old by the time you read this.) I think the main character’s behavior qualified as a drug induced hypomanic type episode. The character ends up running for office in the end.

A manic episode starts as hypomania, but then it goes very, very wrong. As I’ve said before, I’m jealous of people with extended hypomanic episodes. They can be super productive, and have a super great time. But… take a look at the Bipolar 2 disorder and Cyclothymic disorder pages for more on the ups and downs, and stories of my friends and relatives having hypomania.

My uncle just had a mild hypomanic episode, with insomnia, rapid speech, racing thoughts. And he sold a property at a very low price… But it didn’t last for four days, and he had been on antidepressants, so it may not qualify for those two reasons. Antidepressants sometimes cause the same symptoms, and then the episode is considered substance induced. But he felt hopeful and good for a bit too. It’s a mixed bag.

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