I’ve covered depressive episodes pretty thoroughly, thanks to the book I’m reading, but with Bipolar II Disorder there are literally two sides to the same coin, by definition:
Hypomania
A defining characteristic of Bipolar II Disorder, hypomania is a necessary part of a diagnosis, and differs from the mania experienced with Bipolar I Disorder. While the symptoms of hypomania are the same as mania, they are more extreme when experienced in a manic episode. They also tend to last longer, interfere with daily lifestyles such as school or work, and can end in hospitalization.
Hypomania is defined by experiencing a distinct period of abnormally and persistently elevated or irritable mood. In addition to this you must experience at least three of the following conditions for at least four days:
Inflated self-esteem or grandiose thoughts: It is a belief that you are smarter, more attractive, more creative, etc. than others despite a lack of evidence. However, these are not delusions, they are rational thoughts.
Decreased need for sleep: Instead of your usual eight hours of sleep, you may only require four or five. You may also find you have trouble getting or staying asleep.
Pressured speech or feeling more talkative than usual: You might find you have more to say and/or are talking faster than normal, or that you feel like you need to talk more or cannot stop talking. It may also mean you are interrupting others or feeling like they are talking too slow.
Racing thoughts or more ideas: You may feel like you have more thoughts and ideas running through your head than usual, feeling especially intelligent or creative so you feel the need to express yourself (which leads to the other symptoms of talking more).
Distractibility: Hard to concentrate for too long on any one task. This may lead to starting another task before finishing another.
An increase in goal-directed activity or excessive restlessness: Being noticeably more productive or busier than usual. Can also manifest as nervous energy - a hard time sitting still that can include fidgeting and pacing.
Overindulgence in enjoyable behaviors with a high risk of negative outcome: The urge to engage in behaviors that are unusual for you and potentially risky (ie: speeding, spending, or drinking).
Tracking your symptoms before, during, and after hypomania is just as important as with depressive episodes and a Hyperpositive Automatic Thought Record is very similar to the Cognitive Distortions checklist: writing down the situation, your related emotion and automatic thoughts, checked which cognitive errors apply, and then restructuring your thinking. It is also beneficial to track your impulsive behaviors (what behaviors do you exhibit, are there any downsides, do others notice, etc).
To reduce impulsivity, there are several methods to utilize:
Two-Person Feedback Rule: checking with two trusted sources before acting.
Forty-Eight Hours Before Acting Rule: waiting at least two days complete with full night’s rest before making any decisions.
Limit Your Access to Funds: Have a trusted person hold on to your physical credit cards and delete saved card information from vendors or apps that make it too easy to pay.
Avoid Confrontation: Not interacting with people who annoy or trigger you.
Think Before “Speaking:” You may be more inclined to blurt out something you regret, so try waiting five seconds before saying what you need to to give you time to properly think about what you need to say. It is also a good idea to censor jokes, or think carefully before you share them.
Avoid Alcohol/Drugs: Which can enhance your likelihood to engage in risky behavior.
*Sleep is just as important with hypomania as it is with depressive episodes, even though it may be tempting to enjoy needing less sleep so you can be more productive.
Hypomania is not really something I struggle with anymore, and if I do, it’s a short burst. Sometimes I can’t tell if I’m just in a good mood (or irritable) - because frankly those are few and far between. Then I find myself crying because I’m happy. It’s a whole mess. 👻
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