The book definitions of hypomania and mania seem to make the difference between the two pretty unclear. They generally either list hypomania as “mild mania”, or — the other way round — mania as “stronger hypomania”. Then list the same symptoms next to both.
Here in the Netherlands the definition is a bit clearer: mania requires hospitalisation (or arrest, but hopefully the former). Hypomania is what you can cope with by yourself; mania requires help. While this still isn’t a 100% clear division — how are you expected to know, especially when manic, that you have now crossed the threshold and you need hospitalisation? — it’s helpful, because it gives a clear and understandable difference.
You wake up after 6-7 hours of sleep, feeling energetic and happy. You’re skipping stairs, dancing your way to work. At the office you dazzle everyone with displays of creativity and sheer speed at which you (perfectly) perform your work. After work you have a date, to which you go in your work clothes, but it doesn’t matter, because you’re a fascinating person, you’re fabulous, great to talk to and your smile — never fading from your face — attracts everyone, from the waiter to your date, who is thanking their lucky stars they met someone like you. You don’t drink but you don’t have to, because your inner extrovert is out, and having a field day. When you get home, you write two chapters of your novel before finally going to sleep. It’s a bit hard to fall asleep without a sleeping pill, but you don’t mind, running through the details of your amazing day in your mind over and over.
The perfect storm: the mild hypomania. +1 on your mood chart. You don’t have hallucinations, you don’t do anything scary, you dazzle and amaze. Work is a pleasure. Sunshine feels like it’s caressing your skin. Rain feels that way too, actually, come to think of it. Gods smile at you, and you perform, and create, and attract, and…
Does this scenario sound familiar?
You are walking around a shopping centre, or browsing Etsy, or passing by an Apple Store. Place doesn’t matter. You look around, somewhat bored, when suddenly your eyes focus on something: THIS. IS. IT. Suddenly you can not imagine your life without Item X. How could you have survived until 30 seconds ago without owning Item X? Suddenly it feels like your entire brain has turned into one enormous WANT. You NEED Item X. For… reasons. It doesn’t really matter, why would anything matter when you WANT it so much you could suddenly turn into a 3-year-old and throw a crying strop complete with kicking the floor and hitting it with fists?
You leave the store with Item X in your bag. You already start feeling a little less excited about it, and you haven’t unpacked it yet, but you convince yourself that now your life is complete, after all you wanted it so badly, how could it be anything but the most important key thing that will unlock potential amazingness hiding right inside the box? You get home, not quickly enough, and unwrap the box, and take Item X out, and hold it and kiss it and call it George, and you fully intend to spend the rest of your life enjoying it non-stop.
One of the reasons why it is problematic to talk about depression, mania and hypomania is that those words may mean many different things.
For instance, bipolar and unipolar depression are called the same, but they are not the same. In most cases, unipolar depression is caused by past events, and dealt with using anti-depressants and therapy. In fact, therapy is the better solution of dealing with unipolar depression, as it offers a possibility of removing the trigger that’s been hidden deep inside for years, sometimes decades. Anti-depressants deal with the symptoms, and are sometimes absolutely necessary because a person in deep depression is unlikely to respond to therapy (or to anything at all).
What a crazy time it was. The book, even though it’s short, took me eight months to write. I started by writing down a list of sections that I thought need to be covered; then I followed up by writing them one by one. I showed the book to people with bipolar, asking their feedback, which was overwhelmingly positive, which made me feel much better about my idea: a non-professional writing a book about mental illness? Surely that can only end badly! But it didn’t, so far at least.
The way I describe the illness is the way I needed someone to describe it to me when I got diagnosed. I am trying to avoid medical jargon as much as possible – you’ll get enough of that from your doctor. What my goal is: to explain things that are difficult to explain – in a way understandable to someone who hasn’t studied medicine and doesn’t necessarily understand the difference between an anti-psychotic and mood stabiliser. I wanted to write a book that I would like to be handed to me on the day of my diagnosis. It is short on purpose; there are enough thick tomes about bipolar, written by actual doctors, describing in great detail hormonal interactions inside our head and how each particular medication affects them. You’ll notice that often within the book I send you to your doctor – there are questions nobody else can answer. There is no magical pill that will work for everyone. You and your medical team need to work together on achieving what’s best for you.