Mania and Hypomania Vs. Being Happy: The Difference May Shock You

Below are descriptions of mania and hypomania copied from the Mayo Clinic website. I need you to read them.

Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization. Both a manic and a hypomanic episode include three or more of these symptoms:

* Abnormally upbeat, jumpy or wired
* Increased activity, energy or agitation
* Exaggerated sense of well-being and self-confidence (euphoria)
* Decreased need for sleep
* Unusual talkativeness
* Racing thoughts
* Distractibility
* Poor decision-making — for example, going on buying sprees, taking sexual risks or making foolish investments

This decontextualized list doesn’t offer much by way of severity, and I can say that for me personally, it excludes the effects of mania/hypomania on co-occurring disorders. (i.e., hypomania put my OCD in overdrive because I had the energy to act on every, single compulsion. I also had the abandon to spend or provide any resource necessary to carry out those compulsions to the fullest. In contrast, when I was depressed, I could hardly be bothered to care about my OCD.) They at least, however, provide a framework for understanding the side of bipolar disorder that is often caricatured, misunderstood, and scary to people who refuse to educate themselves.

Being close to someone who has bipolar disorder often means being vigilant in watching for warning signs because a hallmark of mania/hypomania is a sense of invincibility even when a behavior’s objective recklessness is acknowledged or, in the case of psychotic mania, detachment from reality such that one cannot even recognize a behavior’s objective recklessness.

But this is a slippery slope, and unless someone is severely manic or you are very close to someone with bipolar disorder, trying to pinpoint warning signs looks less like concern and more like a high-horse. It is, speaking from personal experience, deeply insulting and is tantamount to calling me “a psycho bitch.”

My diagnosis flat out sucks, and I cannot adequately convey through words alone how terrified I am of being alienated and reduced to a sensationalist stereotype when I say it out loud.

I am terrified of being viewed differently, of knowing people are scared to get close to me because of assumed unpredictability, and of wearing the mental health equivalent of a scarlet “A” on my sleeve.

I am terrified that me talking about mental illness in general will overshadow every other aspect of my identity.

I am terrified of people not wanting to be associated with me or of seeing me as nothing more than a good-time girl.

I am terrified, most of all, of people misattributing every thing I do, say, or write to a warning sign, of people not believing my diagnosis but also not believing that I am stable now, and of people thinking they know what is inside my head better than I do, especially when they weren’t there during the thick of things.

The truth of the matter is that no one was there with me in my room for the worst of it. People noticed when I suddenly emerged from my depression cocoon with an apparent new lease on life. People commented that I was more fun. People were relieved that I found something to talk about besides death.

But my hypomania (I have Bipolar II) was not fun. My mood can only rise so high before it becomes uncomfortable, before I can feel my blood, before the only relief would be to rip off my skin. I am no longer fun; I am consumed by the need to find a conduit for my agitation. I cannot eat. I have panic attacks. I am the incarnation of internal screaming.

Admittedly, I do still struggle with impulsiveness and an impaired ability to delay gratification, but it is nothing — nothing — like a hypomanic episode. I still like to go to the bar, and I still occasionally have one drink too many. But I am also able to hold down a job. I am able to do chores and run errands. I am generally calm. Given where I was during the fall of 2016, it feels nothing short of magical.

Outside of my disorder, I have changed a lot too, but it is nothing more than finally feeling comfortable in my own skin. To some, however, that looks like a warning sign, and it hurts — it is embarrassing — to think that my (or anyone’s) hard-won mental stability is still being viewed through the lens of “crazy.” I cannot be the only one who has experienced this.

We are allowed to be HEALTHY, goddammit. We are allowed to exist outside of our illness. We are allowed to be agents of our own lives.

Mania/hypomania is not something we endure for your viewing pleasure and so that you can have something to talk about.

If you are concerned about a loved one, please talk to them directly. Do not sit with others and wildly speculate. Chances are that anyone who has had a manic/hypomanic episode knows the first signs and wants to stop another one dead in its tracks. Do not take away someone’s dignity by disbelieving his or her wellness.

Mania or hypomania is not having a good time, and if you are not close enough to a person to see anything other than that during the throes of an episode and during recovery, consider that you don’t have a full enough picture of the situation to comment on his or her stability. Consider that you are the peanut gallery. Consider that you have not educated yourself enough on the disorder.

We can be happy, and we can be human. We can experience the full range of human emotion and human behavior without hurting ourselves. If that doesn’t relieve you of your suspicion, if you look for the underlying cause of our every move, and if you were not with us during the throes of an episode and want to play armchair psychologist when we are leading normal lives, consider that you don’t care for us as much as your feigned concern might have you believe.

Consider the human instead of the diagnosis.

/rant