I hope everyone’s weekend was a good one and that you were able to get some relaxation to start your week. If you have not read my Bipolar Breakdown: Overview post, I recommend reading it so that you have some insight on what some things are in this one. It is the first post in a series called Bipolar Breakdown that goes over bipolar disorder as a whole. There is a lot to learn with such a complex illness. I am giving you all of the information I know and have researched multiple times and of course as I say in every post, I am not a medical professional. My blog is used to discuss mental health in a way that is easier for people to understand. I make sure that my information is accurate and has come from many books, my personal healthcare providers, professors and reputable sources online. If you have any medical questions, please call a healthcare provider.
This post is going to talk about the mania side of bipolar. I feel as though both poles of bipolar disorder deserve their own posts. I want to be able to go into more detail on what they are really like and use real word examples from people who suffer from it.
I am going to start with the determining factor on weather you have Bipolar 1 or 2 by discussing mania & hypomania.
Mania. People love & hate it for so many reasons. A manic episode is a period of oddly elevated energy and emotion that interferes with the person’s functioning in their daily lives. If the episodes you have/had were qualified by a medical professional to be mania, you have bipolar disorder type I. Mania is the biggest difference in bipolar I & II, only bipolar type I patients have it. Experiencing SOME manic symptoms is not the same as having mania. There are four criteria that must be met in order to be manic:
- Distinct period
- 3 or more manic symptoms
- Functional impairment
- It cannot be caused by something else
Mania looks and seems to be “good” because of how focused, euphoric, and driven you are. People enjoy it because they are able to focus on things so much better than when they were “normal”. Unfortunately though, there is a bad side. With mania it can include psychosis and hospitalization. You are literally out of your mind and have no control over what you think, feel, and do.
I’m going to go more in depth on the four criteria needed to be met to have mania.
- Distinct Period
So in order to be fully diagnosed with bipolar I, you must have gone through a manic episode. These need to be met in order to have mania:
- the mood episode must last at least a week or require hospitalization.
- must be characterized by “abnormally and persistently elevated, expansive, or irritable mood and persistently increased goal-directed activity or energy” (Bipolar Disorder for Dummies, 2016) that is “present most of the day, nearly everyday.” So you need to be feeling “up” at least almost all of the time
2. Three or More Manic Symptoms
During the week of a manic episode, 3 symptoms are needed to be present. A fourth can be included if the mood is irritability rather than elevated or expansive. These symptoms must be “present to a significant degree” (Bipolar Disorder for Dummies, 2016) and changes the person’s behavior from how they are normally. I’m going to use these symptoms listed out of the book Bipolar Disorder for Dummies (highly recommend) because honestly, they say it best.
- A very much inflated self-esteem or grandiosity (the unrealistic sense of superiority).
- Less need for sleep and feeling well rested after only a few hours of sleep.
- Excessive talking or feeling the need to talk constantly.
- Racing thoughts, mental noise, flight of ideas, when the thoughts flow rapidly and topics change rapidly,
- Being unable to concentrate and being easily distracted by insignificant external stimulation.
- Significant increase in goal-directed activity(such as work/school, socially, or sexually) or significant physical movement or agitation (aimless activity)
- “Excessive involvement in risky, potentially self-destructive activities” These can be sexually, unrestrained shopping sprees, optimistic investments in pyramid schemes, driving too fast, use of drugs & alcohol, thrill seeking, lack of control, and gambling are just some of the examples.
Unfortunately, I have had all of these symptoms. I bought a workbook called The Dialectical Behavior Therapy Skills Workbook for Bipolar Disorder (also recommend) and in it had a page of manic symptoms I could check mark. Well, I check marked 31/34 of them. Not sure if you know but, I actually started this blog during a pretty severe manic episode. I ended up liking it so much that I stuck with it which is cool. A severe manic episode made me quit school, and a severe manic episode is making me apply for school again. I know my real passions, blogging & photography, because I stick with them even during a depressive episode.
Addiction is another symptom that mania can cause. It comes from the impulsivity and the need to take risks that you get from being manic. They usually partner together to make each other worse. It can happen in depression, too, but it’s more common in a manic episode.
3. Functional Impairment
For the mood episode to count as a manic episode, it must be severe enough to:
- Impair the person’s ability to be social and live their daily lives, or
- Require hospitalization to prevent any harm to themselves or to others, or
- Cause psychotic features (such as paranoia, hallucinations, or delusions) indicating that the person is out of touch with reality.
Such as psychosis. It really isn’t necessary to have in order to be diagnosed with bipolar disorder but, it can accompany mood episodes. This can also happen in a depressive episode, too, because psychotic symptoms usually reflect on which pole they are experiencing. So, in a manic episode, the symptoms should be more about super strength, abilities, and insides. I’m going to explain psychosis again so the previous paragraph is understood.
Psychosis is used to describe conditions that affect the mind, where there is some loss of contact with reality. A person’s thoughts and perceptions are disturbed. Understanding what is real and what isn’t real will be difficult.
4. Can’t Be Caused By Something Else
In order for a manic episode to count toward a bipolar diagnosis, it can’t be:
- Exclusively drug-induced or attributed to medical treatments. This means that a manic episode won’t count if you only experience it while under the influence.
- Is not attributable to another medical condition. When mania is caused by a medical condition, it is identified as a separate form of bipolar disorder.
I had the privilege of being able to speak with a few people about their manic experiences. Everyone is different and can experience mania in different ways and different severities. As always, I am going to let them explain their experiences for themselves.
I’ve had 4 major manic episodes in 33 years since exhibiting symptoms of Bipolar, and have been hospitalized 3 times. When I’ve experienced mania, I blackout in moments like people blackout when they drink too much. My emotions are off the chart and extreme. There was a time that I felt deathly afraid that my wife was abusing me (she wasn’t) and curled up in a ball in the corner of a room, and I begged her not to hurt me. It was childhood trauma that resurfaced, and I completely lost control. During another manic episode, I punched a hole in the wall, and started pulling my hair out, and lost control of my behaviors again. That time I was finally diagnosed as Bipolar 1. Since then, I learned DBT skills and started medicine. That was 3 years ago, and now I know how to manage my extreme moods through coping skills and medication. Hope this helps! Let me know if you need more? Thanks!
I was manic for like 2-3 weeks before it escalated to the point where I was hospitalized. What landed me in the hospital? I felt like I could feel what Mother Earth felt lol. Like she was angry and hurt with how she’s being treated and how her people are being treated. I thought I had to go get what I was owed ( I had a miscarriage in 2018), so I was trying to get into someone else new apartment, thinking it was for me. Like people prepared it for me. Yeah folks knew I was manic THAT day. Everyone saw that I couldn’t sleep for like 2 weeks at least. They knew I was super focused on spiritual stuff. But that was it. Like they could tell I was acting a little funny but that’s it. You can be productive. But it can be dangerous. Tbh I’m deathly afraid of going manic again lol. The most dangerous part is when you go outside with whatever is in your head. The police were called lol, I’m a black woman. That could’ve ended with me bleeding to death in the streets. I like how honest and open I was with myself while I was manic. I like the creativity. I like really being able to dig into my idgaf attitude lolol. But yeah being manic can put you in dangerous situations for real. Before I knew my diagnosis they just told me it was psychosis. It was intense. But I also got to see a lot of things from a different point of view. And it showed me a lot about the people in my life. Family and friends. So I’m thankful for that for sure. People act funny and dog you out and you have others who are genuinely concerned and want to help you. So I know who I want to have in my life with this diagnosis and this next chapter you know.
In hypomania, the intensity is not as strong as mania. That is really the only difference between the two. In order for a hypomanic episode to be considered toward a bipolar diagnosis, it must also have the same number of symptoms as mania (3 or more) and the same types of symptoms (such as a distinct change from a person’s usual behavior and this has to be observed by others) of a manic episode.
Besides the difference in the severity of mania & hypomanic episodes, there are some other differences:
- Hypomanic episodes are usually shorter (4 consecutive days us enough to qualify as a hypomanic episode.
- Hypomanic episodes do not cause severe functional impairment.
- Hospitalization is not required
- Psychosis does not happen during a hypomanic episode.
There is another difference, and that is that hypomanic episodes do not usually result in any type of behavior or actions that could be self-destructive. If it does happen though, they are usually able to control it.
I had the pleasure of talking to someone about their hypomanic episodes. I had stated in the Overview post that sometimes hypomania turns more severe and becomes mania. This is what is happening with this person. After a 2 year diagnosis of bipolar type I, the hypomanic episodes are starting to get worse.
I was diagnosed with Bipolar 2 two years ago, although I believe I’ve been dealing with it for most of my adult life (I’m now 37 years old). There’s been some discussion with my therapist of late whether or not I might actually be with B1, but that’s something that will need to be sorted out with time. Most of the time my elevated moods present as hypomania. I have laser focus, there’s a clarity to life, I get my whole list of chores done and then some. I have less need for sleep or rest, waking up around 3:30 am and staying up until 10 – 11 pm without stopping. This is particularly impressive for me, because on a “normal” day I need to nap for an hour to make it through the day. I love my hypomanic episodes because I feel such a feeling of accomplishment and general well-being. Now let’s skip into the question of could I be BP1? Sometimes the clarity moves further into chaos of the mind, and my thoughts come too fast to sort out. I have had times when I would go get an unplanned tattoo or piercing. I’ve also made major life altering decisions, such as going back to university (twice) and dropping out after a semester or two of trying to do school and coping with a mood disorder. I’ve also started a business that went nowhere. Which I essentially did again the other day, hopefully to less financial effect than the first business venture. But all that to say, I make life altering decisions on essentially a whim that can have bodily impacts or financial impacts long-term. With help from my therapist, I’ve gotten better at identifying when I’m trying to repeat these patterns, and usually I can work with him and my developing coping skills to keep from making these decisions. But sometimes things fall through the cracks.
This one was a fun one to write and I am so excited and thankful for the people who helped me out with this and told their story. Hopefully this post was insightful and that you learned something new! Thank you for reading my posts, I absolutely love talking about mental health with you all. The next post will be bipolar depression (yes there is a difference). See you guys then!
****Disclaimer: I am not a healthcare professional. My blog is used to discuss mental health in a way that is easier for people to understand. My information comes from a wide variety of books by trustworthy authors, my personal healthcare providers, and reputable online sources. If you have mental health related questions, I highly recommend you seek a healthcare professional.*****