Bipolar disease is awful. Let’s just get that out of the way right out of the gate. It’s a mood disorder characterized by large swings in thoughts and behavior, from peaks of mania to valleys of depression. To have bipolar disease is to know what it must feel like to be zooming through life on a roller coaster blindfolded.
Most of us know what it is like to feel depressed, or have seen a close friend or loved one go through it. It is characterized by:
-Sleeping too much during the day / not enough at night
-Lack of interest in activities that used to be meaningful
-Feelings of guilt and worthlessness
-Fatigue, lack of energy
-Loss of appetite
-Anxiety and lethargy
If anyone feels these symptoms for a significant amount of time, they should seek psychiatric help immediately – this is treatable!
Perhaps less well understood generally is mania. It is a period of incredible intensity which can sometimes lead to overt psychosis. Here are the classic mania symptoms:
-Distractibility, easily frustrated
-Irresponsibility, erratic and uninhibited behavior
-Flight of ideas / racing thoughts
-Increased goal-directed, often high-risk activity (gambling, sex, improbable business ideas)
-Decreased need for sleep
These are generally thought of as the two ends of the mood spectrum: doldrums on the one hand, and rock and roll on the other. However, to what degree is mania a part of, and even integral for, modern success? Does anyone know an ICU doctor who gets enough sleep? What about a CEO who didn’t have a grandiose vision of the company? Wasn’t Steve Jobs famously easily frustrated? Aren’t most worthwhile investments high-risk?
Enter hypomania. As with most things in medicine, it started with Hippocrates. Its definition has changed a bit since the Greeks were running things, but at varying times it has meant “partial insanity,” “craziness,” and “monomania.” It now generally means “less than mania,” in that it shares similar features, but does not result in psychosis and doesn’t affect people’s functioning as much as mania or depression. Here are the descriptors of hypomania:
Now, look at the above list. Pretty impressive. What exactly is this thing? Is it a disease? Or the profile of your dream spouse/senator/graphic designer? Should you be treated for this, or be happy that your brain’s neurochemistry allows for you to be a motivated, competitive member of society? Here are some more ridiculously advantageous benefits of hypomania, from Christopher Doran’s 2007 book called The Hypomania Handbook: The Challenge of Elevated Mood.
-“Overflowing with new ideas”
-“Significant correlation between hypomania and creativity”
-“immune to fear and doubt”
-“negligible social and sexual inhibition”
-“life of the party”
-“offer solutions to problems”
-“finds pleasure in small activities”
Again, what is this thing? It’s made it’s way into the DSM-IV, so it’s currently listed as a disease, with treatment options. But what does it mean to have hypomania? Don’t we all get this, to some extent, at varying points in our lives? Think to a time in your life when you’ve been your most productive. That night that you stayed up until 3 AM, made a pot of coffee, and wrote the essay. That day off where you made a list of 10 things, and then gleefully ticked them off as you got groceries, went to the gym, paid your rent, hung up that picture you’ve been meaning to hang, and called grandma. That party where you had a bit too much to drink too quickly…and liked the resulting confidence, disinhibition, and euphoria of finally feeling like you just don’t care what other people think.
I think most of us experience hypomania. If I’m being totally honest, I wish I experienced it more. It’s enjoyable. It’s no wonder that people generally do not want to be treated when they are diagnosed with it. We treat and medicate and diagnose and define deviations from normal. But it’s usually the people who aren’t normal that propel our humble race forward. Building a civilization is hard, and it wasn’t that long ago that we lived in trees. If the key to creativity and success lies in psychological deviation from the norm, is it a disease? Or our salvation?