Bipolar Support Groups.com blog

What does Hypomania actually feel like? (revised 3/2010)

It’s true that hypomania is a milder version of mania – just how mild, you’ll see in a moment. Mind you, Bipolar II is not a milder version of Bipolar I, though it is very often described that way, to my utter dismay. The suicide rate in Bipolar II is the same or higher than the rate for Bipolar I, for example. Dunner So the BP II version is definitely not a “mild” illness. The depression phases are as bad as in BP I, and often more common (that is, they occur more frequently and represent a more dominant part of the person’s life).

Nevertheless, hypomania can indeed by subtle, certainly by comparison with full mania, as shown in this graph (from Smith and Ghaemi). Here are the symptoms which people with clear-cut hypomania actually experience — and how often. For example, at the bottom of the graph you see that nearly 100% of people with hypomania will have an increase in their activity. By comparison, optimism is prominent only about 70% of the time in hypomania.

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As you can see, these “symptoms” are not clearly abnormal. Everyone experiences these feelings from time to time. When they are extreme; and when they show up over and over again in cycles of mood/energy change; when they are accompanied by other signs of bipolarity, such as phases of depression; that’s when we should think of this as “abnormal”, or at least as warranting caution if someone wants to treat those depressed phases with an antidepressant.

However, hypomania is not always positive. Just as manic phases can be very negative (so-called “dysphoric mania”), hypomania also can be very unpleasant. Here is an example of how hypomania can change from a positive experience to a very negative one (from a blogger who writes eloquently about bipolarity).

First, the positive phase:

Increased energy. A extraordinary feeling of happiness with myself and the world. A very loving feeling towards the people I care about. An uncommon ability to get things done. A huge burst of energy from the moment I awaken until I go to bed. An expanded ability to multi-task. An organizational acuity that is second to none. A willingness to engage with people. A desire to spend more time with people I care about–and even those I don’t.

Then, the negative phase of hypomania (still pretty subtle):

I start feeling burned out. While I still have a lot of energy, I don’t have that “I love the world” feeling. If I’ve been playing my Autoharp at my mother’s assisted living facility, and jumping up and down to help all the participants turn the pages and stay with me, I suddenly feel that the staff should be more helpful in doing this.

… things don’t just slide off my back. While I try not to “snap” back at people, I am not always successful. I am certainly less willing to ignore things that days or weeks earlier wouldn’t have bothered me at all.
I become far less happy, joyful, and kind. I dislike being criticized in any which way.

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For People with Mental health Problems

If you have, or believe you may have, mental health problem, it can be helpful to talk about these issues with others. It can be scary to reach out for help, but it is often the first step to helping you heal, grow, and recover.
Having a good support system and engaging with trustworthy people are key elements to successfully talking about your own mental health.

Build Your Support System
Find someone—such as a parent, family member, teacher, faith leader, health care provider or other trusted individual, who:

•Gives good advice when you want and ask for it; assists you in taking action that will help
•Likes, respects, and trusts you and who you like, respect, and trust, too
•Allows you the space to change, grow, make decisions, and even make mistakes
•Listens to you and shares with you, both the good and bad times
•Respects your need for confidentiality so you can tell him or her anything
•Lets you freely express your feelings and emotions without judging, teasing, or criticizing
•Works with you to figure out what to do the next time a difficult situation comes up
•Has your best interest in mind
Find a Peer Group
Find a group of people with mental health problems similar to yours. Peer support relationships can positively affect individual recovery because:

•People who have common life experiences have a unique ability to help each other based on a shared history and a deep understanding that may go beyond what exists in other relationships
•People offer their experiences, strengths, and hopes to peers, which allows for natural evolution of personal growth, wellness promotion, and recovery
•Peers can be very supportive since they have “been there” and serve as living examples that individuals can and do recover from mental health problems
•Peers also serve as advocates and support others who may experience discrimination and prejudice

You may want to start or join a self-help or peer support group. National organizations across the country have peer support networks and peer advocates. Find a local organization or a online support group for help.

Participate in Your Treatment Decisions
It’s also important for you to be educated, informed, and engaged about your own mental health.

•Find out as much as you can about mental health and wellness and information specific to your diagnosed mental health problem.
•Play an active role in your own treatment

Get involved in your treatment through shared decision making. Participate fully with your mental health provider and make informed treatment decisions together. Participating fully in shared decision making includes:

•Recognizing a decision needs to be made
•Identifying partners in the process as equals
•Stating options as equal
•Exploring understanding and expectations
•Identifying preferences
•Negotiating options/concordance
•Sharing decisions
•Arranging follow-up to evaluate decision-making outcomes

Develop a Recovery Plan
Recovery is a process of change where individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. Studies show that most people with mental health problems get better, and many recover completely.
You may want to develop a written recovery plan. Recovery plans:

•Enable you to identify goals for achieving wellness
•Specify what you can do to reach those goals
•Can be daily activities as well as longer term goals
•Track your mental health problem
•Identify triggers or other stressful events that can make you feel worse, and help you learn how to manage them

You can develop these plans with family members and other supporters.

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Recovery is Possible Most people with mental health problems can get better. Treatment and recovery are ongoing processes that happen over time. The first step is getting help.

What is Recovery?

Recovery from mental disorders and/or substance abuse disorders is a process of change through which individuals:

•Improve their health and wellness
•Live a self-directed life
•Strive to achieve their full potential

Four Dimensions of Recovery

Four major dimensions support a life in recovery:

•Health: Make informed, healthy choices that support physical and emotional wellbeing.
•Home: Have a stable and safe place to live.
•Purpose: Engage in meaningful daily activities, such as a job or school, volunteering, caring for your family, or being creative. Work for independence, income, and resources to participate in society.
•Community: Build relationships and social networks that provide support.

Develop a Recovery Plan

If you are struggling with a mental health problem, you may want to develop a written recovery plan.
Recovery plans:

Enable you to identify goals for achieving wellness

•Specify what you can do to reach those goals
•Include daily activities as well as longer term goals
•Track any changes in your mental health problem
•Identify triggers or other stressful events that can make you feel worse, and help you learn how to manage them

Get information about Partners for Recovery , which provides technical resources to those who deliver services for mental health and substance abuse conditions. Recovery is Possible Most people with mental health problems can get better. Treatment and recovery are ongoing processes that happen over time. The first step is getting help.
•Help yourself down the path to recovery.

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Borderline personality disorder (BPD) is a mental health condition in which a person has long-term patterns of unstable or turbulent emotions. These inner experiences often result in impulsive actions and chaotic relationships with other people.
Causes Cause of borderline personality disorder is unknown. Genetic, family, and social factors are thought to play roles.
Risk factors for BPD include:
•Abandonment in childhood or adolescence
•Disrupted family life
•Poor communication in the family
•Sexual, physical, or emotional abuse
This personality disorder tends to occur more often in women and among hospitalized psychiatric patients.
Symptoms Persons with BPD are often uncertain about their identity. As a result, their interests and values can change rapidly. They also tend to view things in terms of extremes, such as either all good or all bad. Their views of other people can change quickly. A person who is looked up to one day may be looked down on the next day. These suddenly shifting feelings often lead to intense and unstable relationships.
Other symptoms of BPD include:
•Intense fear of being abandoned
•Cannot tolerate being alone
•Frequent feelings of emptiness and boredom
•Frequent displays of inappropriate anger
•Impulsiveness, such as with substance abuse or sexual relationships
•Repeated crises and acts of self-injury, such as wrist cutting or overdosing
Exams and Tests BPD is diagnosed based on a psychological evaluation that assesses the history and severity of the symptoms.
Treatment Individual talk therapy may successfully treat BPD. In addition, group therapy can sometimes be helpful.
Medications have less of a role in the treatment of BPD. But in some cases, they can improve mood swings and treat depression or other disorders that may occur with this condition.
Outlook (Prognosis) Outlook of treatment depends on how severe the condition is and whether the person is willing to accept help. With long-term talk therapy, the person often gradually improves.
Possible Complications •Depression
•Drug abuse
•Problems with work, family, and social relationships
•Suicide attempts and actual suicide
When to Contact a Medical Professional See your health care provider if you or someone you know has symptoms of borderline personality disorder. It is especially important to seek help right away if you or someone you know is having thoughts of suicide.
Alternative Names Personality disorder – borderline

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People with bipolar disorder vary significantly from their unaffected relatives, and from healthy controls, on several measures of personality, a study shows.
Furthermore, genetic analysis revealed suggestive linkage peaks for those traits that were heritable, potentially proving useful for the identification of genes underlying susceptibility to bipolar disorder.
“The results of our analyses suggest that personality dimensions may have utility in dissecting the genetic architecture of BD [bipolar disorder],” the researchers write in the Journal of Affective Disorders.

Personality scores on the Temperament and Character Inventory (TCI) were collected from 428 members of 101 families in which one or more people had a bipolar diagnosis or major depressive disorder. An independent sample of 53 control participants with no personal or family history of mental illness was also recruited.

The TCI is a self-administered true/false questionnaire that assesses personality in seven dimensions. It assesses four temperament dimensions – novelty seeking, harm avoidance, reward dependence and persistence – and three character dimensions – self-directedness, cooperativeness and self-transcendence.
Lead researcher Tiffany Greenwood (University of California, San Diego, USA) and team found significant group differences between patients with bipolar disorder, their first-degree relatives, and independent controls on all personality dimensions apart from reward dependence and persistence.

Bipolar patients had significantly higher scores for novelty seeking, harm avoidance, and self-transcendence and lower scores for self-directedness and cooperativeness than participants with depression, first-degree relatives, and controls.
All personality dimensions except harm avoidance and reward dependence were found to be significantly heritable. Linkage analysis in the subset of 51 families for which genetic data was available produced several suggestive linkage peaks for novelty seeking, persistence, and self-directedness.

The authors identified several genes of potential neuronal significance beneath the suggestive peaks; for example, the glutamate receptor gene GRIK2 lies directly beneath the “persistence peak” on chromosome.

The authors conclude that self-directedness may be a particularly useful measure in studying bipolar disorder, as it was “the most heritable personality dimension in our study, gave the strongest linkage signal, and showed the expected trend of significantly more pathological scores for [bipolar disorder] subjects, followed by their relatives, with the least pathological scores observed for controls.”

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