hypo vs. full blown mania

I wonder whether or not I really have ever been full blown manic before. I have been hospitalized twice for "mania," but I think I might have just been hypomanic those times. I was still sleeping 5-6 hours per night at least and had some insight into my condition.

What really tipped the diagnosis over to mania was the presence of hallucinations and delusions. But I have since been re-diagnosed with schizoaffective disorder and have experienced psychosis totally outside the presence of a mood episode.

For those of you who have experienced both mania and hypomania, what is the difference, not including psychosis?

Hi franz kafka. Do you have a psychiatrist that you can talk about this topic with that would be aware of your situation during your two hospitalizations? They may have insight into this that is not obvious to you.

When my mania is very severe, I do tend to have psychosis, but I've sure been full blown without the psychosis a number of times. The edge between "very hypomanic" and "full blown manic" is probably a curious one for some people. From my reading of others' experiences, how one person experiences full blown mania is not always the same as an other's. A person's "norm of conduct" can also make one person's full blown mania seem different, milder, or more severe than another's. One person's multiple piercings, tattoos, and mohawk could be stable behavior, while it wouldn't be for another.

In my case, I believe it is clear that I'm full blown manic when my behavior becomes scary to people, or attracts so much of an attention that people are shocked by my behavior. I think it's one thing for a person to observe an elated hypomanic and "laugh with them", "shake their heads", or think "Wow, she's REALLY in a good mood, exceptionally productive, loud/fast talking, or acting a little strange today!" It's another for them to see a full blown manic and say/think "What on earth is wrong with that person! OMG! Whoa, Nellie!"

Or if a hypomanic person is irritable, a person may say "Damn that person is an a**ho*e!" or "Cut the road rage!", "Shut the heck up!" or "Stop the tirade!" It's another to see a person with full blown mania that's in a fury basically looking like a psychopath killer, inspiring people to call the police, run away in fear, or have hospital security guys drag you in an isolation room for a nurse to give you an injection. In some of the latter cases, people get strapped to beds. I've also had a hospital guard assigned to sit outside my room and then follow me around the ward.

Definitely adding psychosis to either of the above full blown manic scenarios can be extra disconcerting or frightening. I know that psychosis even without bipolar is surely scary and can look similar.

I know that strangers saw me manic in the past, but maybe weren't immediately clued in that I was totally unwell. That's where knowing baseline can come in. Riding the border of the very hypomanic/manic is likely quite common. Or, there are just times when people don't see/hear everything, and definitely don't know what's all going on in your mind. I believe I was not really aware of the reality of my situation on many occasions. Insight is difficult. Mine has improved since I learned about my disorder, but isn't always perfect.

What is the Difference Between Mania and Hypomania? | HealthyPlace

I know that the difference between mania and hypomania is a matter of severity, but I guess I'm wondering how that gets measured. I never totally went without sleep when manic, for example. But I did drive very recklessly, to the point of scaring my wife when she was in the car with me. I also experienced extreme euphoria and felt like God was communicating with me. I only had that delusion when I was manic, not when just everyday psychotic.

I'm going to bring this up with my tdoc this week. Is it possible to have bipolar II and schizoaffective?

I'm sure it's possible to have bpII and schizoaffective (why not?), but I don't know if it would be considered schizoaffective depressive type or schizoaffective bipolar type.
I wish I knew the difference between hypo and mania too. I know when I'm to tally out of control (fights, breaking windows, dancing naked in public, etc) that's full blown mania and when I'm just a little speedy that's hypo, but I'm not sure where the exact line is. Sorry I couldn't help, but I'm confused too.

My T explained to me that you can have psychosis and still be hypomanic. It is really hard to find the line between hypomania and full blown mania. For me it is a total lack of judgment, little insight into my condition at that point, almost zero sleep but still full of energy, super rapid speech and unable to see that I am controlling conversations, and being unable to see the impact of my behaviour on others. I also push into psychosis and become very grandiose. Mania often requires hospitalisation as you cannot function in society. With hypomania some insight is still there and you can still function to a decent degree. No hospitalisation is required. Well, that is my take but we are all different. Please see your pdoc ASAP and they can assess correct where you sit on the scale.

I guess a complicating factor is that I have been hospitalized (twice) while having an elevated mood. I wonder if they locked me up because of my mood or the psychosis or both? I guess I'll never really know.

I'm kind of in a similar boat. I know there's subjectivity about it, and it can vary from provider to provider. Sure, some cases are clear cut, but others are foggier. My dx was changed from 2 to 1, but I'm not sure when it was changed or why exactly. I suspect it was hallucinations etc. experiences, but I don't consider that to be problematic as it's infrequent and I'm aware what I see isn't real (well, not immediately, but soon after). Or maybe they judged some of my earlier elisodes to be more severe than a previous provider(?) I did have a major extended mixed episode. Positively hell. Definitely should have been hospitalized. That might have been it too. Who knows.

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Mr. Robot

Makes me sick to the heart, Oh I feel so tired. And the way the rain comes down hard, that's how I feel inside.

--The Cure

I've had some pretty gnarly manic episodes, although I never ran around naked or flew off to China on a whim. No, what I do is get crazy angry and scare the hell out of people, I drive (literally) like a maniac, and I can't get the 280 TV channels in my head to shut up. I also get religious delusions and see/hear things that aren't there. I've always questioned my bipolar 1 diagnosis even though four different providers have agreed on it, but in the general scheme of things I guess my mania does rise to the level of BP 1. I go back and forth with it a lot though. I don't suppose it matters as long as I'm getting the proper treatment, which I am. I just came through a mild depressive episode and am now back on track with just an uptick in my mood stabilizer, and so far I haven't had a hint of the insanity which usually accompanies the onset of Spring.

My doctor says it's possible to have psychosis with hypomania. Makes it hard to figure out what kind of episodes I've had in the past. BPNurse: I also have had the crazy driving symptom. That's why I was hospitalized the first time with "mania," because I was a danger to myself and others behind the wheel.

My diagnosis is BP 1 but I really wonder the same. I guess my diagnosis is BP 1 because I had religious delusions, delusions of reference, delusions of grandeur and some persecutory delusions too.

Sometimes I completely believed in my delusions, other times they were milder. But I have never totally lost my touch with the reality. I also had delusions where I was getting signs from God that I should do bad things to myself and that the world was ending.

Well these times when I really become delusional are rare. I am more likely to become "just" hypomanic. That's when I barely sleep, am very active, laugh at everything, even at my own thoughts, I have wasted money, cut my hair, partied many days a week with people I didn't know (I'm shy and insecure normally). I sometimes become "a creative artist" during my hypomanias, can't sit still and talk so fast others need to tell me to talk slower. The racing thoughts keep me from sleeping. Basic symptoms of a bipolar high I guess.
One time I felt creative and thought I was a reincarnation of Vincent van Gogh. I guess that was mania then.

But really I don't know where the line is, I wish I knew. Usually when the hypomania ends I start to feel crappy and either crash into depression or become delusional. Idk if that is like mixed episode or if that is the line between hypomania and mania. I've heard people say that mania doesn't (always)feel pleasant like euphoric hypomania does, but rather very unpleasant.

Once I told my nurse about my previous hypomanic episode and she asked about my sleep and when I said I slept 0-3h every night she asked: "so you were full manic?".

I guess I've only had hypomania and moderate mania perhaps but yes I'd like to know where the line between hypomania and mania goes, what is severe enough to be considered mania (without psychotic symptoms).
Sorry I didn't really answer your question.