What is Dysphoric Mania?

Eric Stolze

Dysphoric mania, or a mixed bipolar state, is a condition that some bipolar disorder patients experience when they have symptoms of mania and depression at the same time. Bipolar disorder affects a patient’s brain and typically causes mood episodes that may shift between manic episodes and depressive episodes and may include episodes of dysphoric mania. Patients with bipolar disorder can be diagnosed and treated by medical doctors in many cases. Many bipolar disorder patients can lead productive and full lives with ongoing and effective treatment of this condition.

The depression aspect of dysphoric mania can bring extended periods of worrying.
The depression aspect of dysphoric mania can bring extended periods of worrying.

People with dysphoric mania may have symptoms such as changes in appetite, sleeping problems or agitation. Feelings of deep sadness or hopelessness can combine with an extreme level of energy during some episodes of dysphoric mania. Impulsiveness and irritability may develop in some cases of dysphoric mania as can thoughts of suicide. Dysphoric mania episodes can be very dangerous for patients, because the risk of substance abuse and suicide attempts tends to increase during this mixed bipolar state.

Individuals suffering with dysphoric mania may experience irritability.
Individuals suffering with dysphoric mania may experience irritability.

Patients with bipolar disorder may also experience separate manic episodes or depressive episodes. Manic episodes can include mania symptoms such as extended periods of agitation, jumpiness or an unusually outgoing and happy mood. Racing thoughts, fast talking and being easily distracted are common mania symptoms. People may also notice a reduced need for sleep and an increase in high-risk or impulsive behaviors related to sex and money during a manic episode.

Depressive episodes often develop in bipolar disorder patients and usually include symptoms of depression such as a loss of interest in activities that a patient used to enjoy, feelings of tiredness and extended periods of emptiness and worrying. Problems with decision-making, memory and concentration may also occur during depressive episodes. Thoughts of suicide and suicide attempts can also increase during depressive episodes. Combinations of manic, depressive and dysphoric mania episodes as well as their specific symptoms tend to vary from patient to patient.

Doctors typically conduct physical examinations, mental health evaluations and medical tests to help diagnose patients with bipolar disorder. In many cases, patients with bipolar disorder receive drugs such as lithium or other mood-stabilizing medications to control symptoms. Some patients may take antipsychotic medications or antidepressants to help control the episodes of this disease. In some cases, doctors may recommend psychotherapy for patients with bipolar disorder to help them with their day-to-day functioning and social interactions.

Episodes of dysphoric mania can be dangerous phases for people with bipolar disorder.
Episodes of dysphoric mania can be dangerous phases for people with bipolar disorder.

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Discussion Comments


@cloudel – Even though hypomania is scary, it isn't quite as extreme as mania. Someone with hypomania does go to the extreme, but a person with mania can go even further.

I know a lady with dysphoric hypomania, and though she is hyper and motivated, she also gets really irritable easily and feels very empty inside. However, her actions are never harmful. The main difference between hypomania and mania is the intensity.

Her sister has dysphoric mania, and she exhibits odd behavior. She will behave really flamboyantly in a room full of strangers, and she even has hallucinations sometimes. The hallucinations usually have some sort of depressing element, and they can make her break down in tears.


I can't imagine having a lot of hyper energy and feeling very depressed at the same time. I can really see how this could be a dangerous combination.

Since your mind would be in overactive mode, you might just sit around and think about all the different ways you could end your pain. I have a feeling that none of them would be very constructive, though.


Being around someone with dysphoric hypomania is scary! My friend once had a manic episode that lasted five days.

She felt like a superhero. She reorganized her entire house, and I watched helplessly as she scrubbed all the floors with a brush and soap. I offered to help, but all she wanted was someone to be there to listen to her ramble on about all her plans.

When you see someone going through this, your instinct is to try to calm them down. However, this is futile and may actually anger them, so the best thing to do is just be there for them.


I think the best treatment for bipolar disorder, especially when it involves dysphoric mania, is medicine. Therapy can help you look at things differently, but if there is an actual chemical imbalance in your brain, you can only get relief from that with drugs.

Having a new outlook on life can't help you much if you still have those physical feelings of emptiness and restlessness. It's enough to drive a person over the edge!


How does this differ from borderline personality disorder?

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