Mania is a convenient go-to word prevalent in pop culture but problematic when blanketed socially, particularly in respect to psychosis and its potential to undermine patient integrity.

  • Hypomania / Hypomanic Episodes: Milder symptoms of mania in bipolar disorder without the presence of psychosis.
  • Psychosis: A severe mental condition in which thought and emotions are so affected that contact is lost with external reality.
  • Mixed Manic Episodes: Occur when a person exhibits symptoms of both depression and mania, or depression and hypomania.
  • Delusion: A false belief based on incorrect inference about external reality that is firmly sustained despite what almost everybody else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary (NIH).

My own providers have been incorrectly using mania as a blanket term in my treatments, myself included. Meanwhile, I experience mixed-hypomania almost exclusively. Zero psychosis or delusion. In other words, I never think I am Jesus walking incarnate when hypomanic… I just think I’m Kan(ye) instead.

Social Stigmas of Bipolar Are Not Good

The stigma bipolar mania can have socially is significant. Particularly if authorities get involved (like police). People expect me to be delusional when I’m not, leading to rapid (belittling) dismissals from friends, family and authorities.

The social expectation of mania is not great. Remember that not everyone “manic” is experiencing psychosis. I’ve never had psychosis in my life but suffer 3-5 mixed hypomanic episodes per week, even per day.

It’s exhausting. Unmercifully exhausting and emotionally befuddling. Imagine not knowing how you’ll feel 5 min from now, then having how you feel shift suddenly without influence or reason in the opposite direction. Like a comet into ocean tides I splash and spill; seasick from perpetual motion.

You can watch these earth-turning shifts twist on a dime just in facial expressions alone. “What just happened” and “Where did you just go” is commonly asked.

Holding on for dear life, that’s what. And nowhere good, that’s where.

Think you know your illness perfectly? Have a family member’s illness perfectly pegged? Test that theory with more knowledge. Often. Or just ask.

Bipolar Disorder: Type 1, Type 2 & Rapid Cycling

The reality of Bipolar is a wildly varying spectrum of symptoms not everyone experiences. Highlighting one of the key differences between Type 1, Type 2 and Rapid Cycling Bipolar Disorder is frequency and severity of symptoms. The respective day-to-day struggles within each type behave very differently person to person and illness to illness. In some cases looking nothing alike.

  • Bipolar I Disorder: defined by manic episodes that last for at least 7 days (nearly every day for most of the day) or by manic symptoms that are so severe that the person needs immediate medical care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. (NIH)
  • Bipolar II Disorder: defined by a pattern of depressive episodes and hypomanic episodes. The hypomanic episodes are less severe than the manic episodes in bipolar I disorder (NIH).
  • Rapid Cycling Bipolar Disorder (RCBD): is defined as four or more affective episodes (depression, mania or hypomania) within 1 year. RCBD has a high point of prevalence (from 10% to 20% among clinical bipolar samples) and is associated with greater severity, longer illness duration, worse global functioning and higher suicidal risk, but there is no consensus on treatment option (NIH).

The nature of RCBD makes it extremely hard to medicate. I experience symptoms daily, and hypomanic episodes sometimes cycling multiple times in any given day, far beyond the RCBD criteria. Of course, my entire diagnosis depends on the accuracy of one solitary “professional opinion” and could very much be wrong (despite their “100%” confidence level).

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