Mania v. Hypomania

There are two major differences between mania and hypomania. The first is one of degree; the second is psychosis.

Hypomania can do damage. It can fuck up relationships, end jobs, empty bank accounts, and all kinds of other outcomes of impaired judgment and lack of control. Mania blasts right through that stuff and into immediate extreme consequences like violence, jail time, and/or hospitalization. Complete detonation.

And if there is any kind of deviation from reality, that is, by definition, mania. Delusions, hallucination, extreme paranoia—any form of psychosis that can’t be attributed to another diagnosis like schizophrenia or schizoaffective disorder—that’s mania. And mania means bipolar 1.

But again it might be a matter of degree. During the worst of my episodes, I experienced paranoia and inflated self-esteem (delusions of grandeur), but not enough to get my label switched from 2 to 1.

Bipolar 2 is like a thunderstorm—there’s lightning, wind, a deluge even. It’s a little scary and bad things can happen. Bipolar 1 is a thunderstorm followed by a hurricane, leaving behind nothing but wreckage, with not just a life but a brain needing to be rebuilt.

And either one can be rapid cycling.

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