Dysphoric Mania vs. Euphoric Mania: How To Tell The Difference

What is Mania?

Mania is a term used to differentiate bipolar disorder from depression. Referring to mania as the ‘high’ component and depression as the ‘low’ component is common. However, mania is much more than that.

A mood disorder, mania involves experiencing abnormal amounts of energy, both mentally and physically. However, it is much more extreme than an inability to sit still or a racing mind. In some individuals, the severity of mania can lead to hospitalization.

While mania is a symptom of bipolar disorder, it can also occur in people who do not have bipolar disorder. When mania occurs in individuals with bipolar I, depressive episodes often transpire as well, but not always.

Within the realm of mental health, there are several factors and significant details that separate conditions on the bipolar spectrum. In this article, we will break down these differences and hope to shed light on how an umbrella term such as ‘bipolar disorder’ actually has a lot of variation.

Hypomania vs. Mania

Hypomania is a milder form of mania. While energy levels are still higher than average, they are less extreme as in someone experiencing a manic episode. However, this is not to say hypomania doesn’t cause problems in the individuals who have it. It’s just that the effects aren’t as intense as someone with mania.

For the most part, hypomania, alternating with depression, often occurs in people with bipolar II disorder, but not always.

Symptoms of Mania and Hypomania

While the symptoms of mania and hypomania vary in intensity, they are often the same.

  • Higher than normal energy levels
  • Easily distracted
  • Extremely talkative
  • Racing mind
  • Decreased need or desire to sleep
  • Restlessness throughout the day and night
  • Inability to sit still or focus
  • Increased sexual desire
  • Impulsive decision making often involving sex, gambling, or spending money
  • Starting several tasks with no way of finishing them
  • Decreased inhibitions
  • Inflated self-esteem
  • Increased irritability
  • Aggression
  • Reckless behavior without considering consequences

In this case, the individual experiencing mania or hypomania may not be able to recognize these changes and think that they are acting normal.

Severe Symptoms of Mania

The individual may have a break from reality when experiencing a manic episode. Oftentimes the severity of a manic episode leads to hospitalization.

Psychotic Symptoms May Include:

  • Extreme paranoia
  • Hallucinations (visual or auditory)
  • Delusional thinking

Following a manic episode, a major depressive episode usually occurs and lasts around two weeks, sometimes longer.

Cycles

In addition to extreme changes in mood, individuals with bipolar disorder also experience changes in energy levels and behavior. These changes are called cycles.

Generally, an individual with bipolar disorder usually has two cycles per year. Furthermore, when individuals experience four or more manic, hypomanic, or depressive episodes in a year, it is called rapid cycling.

Mania and Hypomania – Not Always Bipolar Disorder

While mania and hypomania are common symptoms of bipolar disorder, they can also be brought on by:

  • Medication
  • Alcohol use
  • Drug use
  • Sleep deprivation

Treating Mania and Hypomania

For the most part, a mental health professional will prescribe medication along with psychotherapy to treat mania and hypomania. The medications may include mood stabilizers and antipsychotics.

It is absolutely crucial to take the medication as your doctor prescribes. Also important to note is that it may take trying several different medications before finding the appropriate combination and dose.

Conversely, for hypomania, mood stabilizers are not always necessary. For example, maintaining a healthy lifestyle may be enough to cope with the effects of hypomania. Individuals should make sure they are getting enough sleep and may want to avoid caffeine, as both can be triggers.

There is not a ‘one-size-fits-all’ pill for individuals dealing with mood disorders. Hence, finding what works best for you may take time but, will be paramount for your mental health.

Breaking Down the Types of Mania

Bipolar disorder is a mood disorder also known as manic-depressive disorder. There are two main types of bipolar disorder:

  • Bipolar I
  • Bipolar II

The difference between bipolar I and bipolar II comes from how severe the mania is. Individuals with bipolar I have full-blown mania while those with bipolar II have hypomania. However, people with hypomania can develop full-blown mania, often very quickly.

Furthermore, there are two types of mania:

  • Dysphoric Mania
  • Euphoric Mania

What is Dysphoric Mania?

Dysphoric Mania is another way to refer to bipolar disorder with mixed features. Mixed features involve symptoms of both mania and depression. If a person is experiencing an episode with mixed features it means that they are either having a depressive episode with at least three signs of mania or they are having a manic episode with at least three signs of depression.

Dysphoric Mania is a relatively dated term. However, some mental health professionals who use psychoanalysis as treatment may use it to describe the condition of the patient.

An estimated 50 percent of individuals diagnosed with bipolar disorder experience dysphoric mania or dysphoric hypomania.

During a dysphoric episode, patients experience the symptoms of bipolar disorder, depression, mania, and hypomania– just all at the same time. The mixed episode can make treatment more complicated and can also increase the risk of extreme behavior.

Additionally, individuals with dysphoric mania do not have feelings of euphoria. This difference causes many to view dysphoria mania as the opposite of euphoric mania, although they do have commonalities.

Symptoms of Dysphoric Mania

As previously mentioned, individuals with dysphoric mania, or mixed features, experience usually two to four symptoms of mania as well as at least one symptom of a depressive disorder.

It is crucial for individuals with bipolar disorder, as well as bipolar depression, to understand and acknowledge symptoms of dysphoric mania so that they can seek treatment immediately.

Below is a list of the most common manic symptoms of the dysphoric disorder. Additionally, we’ve listed common depressive symptoms.

Dysphoric Symptoms:

  • Severely depressed mood
  • Suicidal thoughts
  • Impulsive behavior
  • Increased anger and irritability
  • Agitated depression
  • Impulsive decision making
  • Excessive energy
  • Decreased need or desire for sleep

Depression Symptoms:

  • Feeling lethargic or having no energy
  • Feelings of worthlessness
  • Long episodes of crying
  • Changes in appetite and sleep
  • Feeling anxious, agitation, or anger
  • Feeling extreme amounts sadness
  • Social isolation
  • Aches and pains in the body
  • Thoughts of self-harm or suicide
  • Difficult or inability to make decisions

Usually, the satisfying mood elevation correlated with mania is lacking from a dysphoric episode. When individuals experiencing mixed mania do experience an elevated mood, it usually alternates rapidly with a severe depressive mood.

What is Euphoric Mania?

Generally, euphoric mania is precisely what it sounds it would be. Individuals with euphoric mania describe the feeling as beautiful, wonderful, exciting, and unbelievable. Everything becomes fascinating. The desire for new experiences dramatically increases with the exciting unknown possibilities.

At first, euphoric mania can be exhilarating. Individuals often have a newfound level of confidence and feel like they are on top of the world. Consequently, as these unstoppable feelings continue, judgment begins to fade. Individuals often make decisions without thought of what the outcome of their actions may be.

Symptoms of Euphoric Mania

The symptoms of euphoric mania can vary depending on the severity of the individual’s mania.

Individuals with bipolar II hypomania may actually enjoy the symptoms of euphoric mania. However, the carefree actions of a euphoric episode are not without consequence. These actions may resemble:

  • Recklessly spending money
  • Having sex with anyone who seems appealing at the time
  • Sleeping significantly less but not feeling tired
  • Poor decision making
  • Impaired insight

Full-blown euphoric mania in bipolar I disorder has more severe consequences and is often dangerous. Individuals experiencing this mania frequently experience a superhuman surge of invincibility. As a result, the grandiose sense of self can lead to the individual acting incredibly selfish and cruel to others. Symptoms of this euphoric mania are:

  • Thoughts of extreme arrogance
  • Not sleeping much or at all for weeks at a time
  • Feelings of hypersexuality
  • Inability to judge the safety of actions
  • Unable to consider the effects of actions
  • Picking up and leaving current living situations on a whim
  • Extreme drug and alcohol abuse due to the inability to realize what has already been consumed

Ultimately, the individual experiencing euphoric mania reaches the inevitable outcome – the end of the manic episode. Initially, euphoric manic episodes feel wonderful, but often end in destruction. Without proper help, euphoric mania can ruin an individual’s relationships, health, and finances. This is why major depression and mania are closely linked.

Coping with Mania

Both dysphoric mania (bipolar disorder with mixed features) and euphoric mania are treatable conditions. It is crucial to work with a mental health professional to manage your condition appropriately.

In addition to working with your doctor, individuals have also found several other coping methods to be effective.

Knowledge is Power

Make sure to know all you can about your condition, including triggers as well manic and depressive symptoms. Moreover, ask questions! Stay informed about all possible treatment and management.

Observation and Prevention

Keeping track of your mood and lifestyle may be able to help prevent an episode. Monitoring patterns and early warning signs can help keep you one step ahead.

Treatment

Stay in treatment! Consistency is key to managing your condition. Even when things feel in control, continuing treatment is necessary for bipolar patients.

Reach Out

You are not alone.

If you have experienced any of the symptoms mentioned, seeking guidance from a mental health professional is essential for finding the appropriate way to manage your condition. If you don’t currently have access to a mental health professional, ThriveTalk can help. Reach out. We are here to help.

Sources

https://www.healthyplace.com/bipolar-disorder/psychosis/types-of-mania-in-bipolar-disorder/

https://www.healthline.com/health/mania-vs-hypomania

https://www.medicalnewstoday.com/articles/315016.php

https://www.healthline.com/health/bipolar-disorder/dysphoric-mania#symptoms

https://www.bphope.com/bipolar-disorder-and-mania-surges-urges-and-loud-music/

https://www.bipolarlifeline.com/what-is-euphoric-mania/

author avatar
Angel Rivera
I am a Bilingual (Spanish) Psychiatrist with a mixture of strong clinical skills including Emergency Psychiatry, Consultation Liaison, Forensic Psychiatry, Telepsychiatry and Geriatric Psychiatry training in treatment of the elderly. I have training in EMR records thus very comfortable in working with computers. I served the difficult to treat patients in challenging environments in outpatient and inpatient settings
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