04 Oct Alcohol, Drug Binges During Hypomania Not Taken Seriously
Hypomania is a form of mania that produces less severe or exaggerated effects than full-blown mania. While full-blown mania appears in association with the classic bipolar condition called bipolar I disorder, hypomania usually appears in association with two lesser-known bipolar conditions called bipolar II disorder and cyclothymic disorder. People in hypomanic states often engage in various kinds of highly risky behavior that can produce unwanted or dangerous consequences. However, according to authors of a study published in August 2013 in the Journal of Affective Disorders, those affected by hypomania often disregard the seriousness of their behaviors and don’t recognize the importance of proper symptom treatment.
Hypomania vs. Mania
The definitions for mania and hypomania come from the American Psychiatric Association, which publishes a guide for mental health professionals called the Diagnostic and Statistical Manual of Mental Disorders. People affected by mania experience periods of unusual mood elevation, irritability or “expansiveness” that last for seven days or longer and involve symptoms such as insomnia, a reduced reliance on sleep, aimless body movement, racing thoughts, loss of focus, uncharacteristic talkativeness, an exaggerated sense of self-importance or an increase in pleasure-seeking behaviors. In addition, manic individuals sometimes develop symptoms of psychosis, or otherwise develop mania-related symptoms that are severe enough to merit hospital treatment. With the exception of psychosis, hypomanic individuals generally experience the same types of symptoms as people affected by mania. However, these symptoms don’t appear in equally severe forms and must only be present for four days or longer. Some people affected by hypomania don’t meet the full criteria for diagnosing bipolar II disorder or cyclothymic disorder.
Hypomania’s Potential Effects
Most of the individuals affected by bipolar II disorder or cyclothymic disorder spend much of their lives in a depressed frame of mind. For this reason, when hypomania appears, its relatively moderate symptoms often feel like a reprieve from depression and a positive force in a bipolar person’s life. This reaction to the onset of hypomania can be especially prominent in people newly diagnosed with a bipolar condition, who by definition have no long-term personal perspective on the shifts that the condition produces in their moods and mental states. When the presence of a hypomanic state isn’t viewed as a problem, affected individuals have a substantially lowered incentive to address their symptoms or follow the treatment plans established by their doctors.
In the study published in the Journal of Affective Disorders, an Australian research team examined the potential for hypomania-related participation in highly risky behaviors in a group of 93 people previously diagnosed with bipolar II disorder. Examples of the behaviors under scrutiny include excessive drug intake, excessive alcohol intake, participation in various forms of unsafe sex, participation in reckless driving and the spending of large sums of money. Some of these behaviors have the potential to harm the affected individual, while others have the potential to harm others. Specific harms associated with the behaviors include a significant increase in combative relationships with others, a significant increase in risks to physical well-being, a significant increase in potentially dysfunctional emotions such as regret or shame, and the acquisition of considerable amounts of financial debt.
After reviewing their findings, the authors of the study concluded that the participating bipolar II disorder patients were generally quite well informed about the risks and negative outcomes associated with uncontrolled hypomania. However, despite this fact, less than 20 percent of the participants viewed their hypomanic symptoms as problems that required some sort of treatment. Factors that influenced this outlook included frank enjoyment of the effects of hypomanic symptoms and a tendency to glamorize those symptoms.
Significance and Considerations
Since uncontrolled hypomania can trigger a number of dangerous or potentially fatal consequences (including substance abuse/addiction, exposure to sexually transmitted disease and involvement in car or motorcycle accidents), failure to take hypomanic symptoms seriously may frequently result in substantially increased overall health risks in affected individuals. Fortunately, as time passes, many people with bipolar II disorder or cyclothymic disorder eventually gain an improved perspective on their condition and start taking steps to control their hypomanic states, rather than giving them free reign.
The authors of the study in the Journal of Affective Disorders believe that their findings highlight an important conflict between the self-perceived beneficial effects of hypomania and the clearly negative effects observed by mental health professionals. They also believe that an increased understanding of this conflict can help doctors provide better management of their patients’ bipolar symptoms by improving their ability to create specific plans for dealing with hypomania in any given affected person.
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