Bipolar disorders and mood disorders with mania are diagnosed when episodes of elevated mood significantly affect someone's daily functioning. Out of different variations of mood disorders, bipolar disorder with its two distinct types: I and II are more commonly and easily recognized, diagnosed, and treated. Type I is typically considered more severe due to one or more manic episodes being present for this diagnosis versus hypomania for Type II even if there are more occurrences of hypomania than mania in someone's lifetime. Hypo - means less, hyper - means more. Hypomania may both be more manageable or less impactful than mania allowing someone with Bipolar II to sometimes go undiagnosed or tolerate the symptoms as to not require medical treatment, and focus on reducing the impact of symptoms through holistic coping mechanisms and lifestyle changes. Someone may be having a full manic episode which is the severe version of a hypomanic episode when they are not sleeping or sleeping for a few hours at night for days at a time while having unusually high levels of energy, significantly elevated mood, increased activity with little or no experience of fatigue. This lack of sleep can factor into another symptom of mania which is delusional thinking or thoughts that they are not aware of as not being grounded in reality. In believing their delusional thinking is real they may act according to their delusion. For example, someone who is experiencing grandiosity may spend more money than they typically spend and in a way that has a significant impact on their finances out of their thoughts of the amount as not as significant or in the false belief that they can recover this amount of money quickly. Other examples are starting large projects than what the person may have realistic resources for, taking big risks with their work and profession which may involve suddenly quitting, switching, or adding onto their work, suddenly changing their living situation such as moving without adequate planning, and sudden changes in their stable and longterm relationships such as seeking divorce or engaging in affairs without concern for the consequences or changes that follow. This risk taking when during a manic episode is fueled by manic delusional thinking or an internal orientation of themselves and their lives affected by elevated mood and grandiosity rather than compulsion or through calculated risk. The manic episode may progress to have more severe psychotic symptoms such as more severe delusional thinking including belief they have god like powers, being invincible, or being actively targetted by entities. The severe delusional thoughts can progress to hallucinations or seeing, hearing, experiencing something that is not objectively there. The more severe the symptoms, the more the person can be at risk of acting in a way that puts themselves or others in danger or lead to severe decompensation where they cannot care for their daily needs where they may be involuntarily admitted for hospitalization. Therapy for bipolar I is typically about prevention and maintenance to prevent the reoccurrence of a manic episode such as through supporting a person to take medication that is perscribed by a medication perscriber for mood stability through processing effects and side effects, supporting a medication change when needed, and supporting them to lead a more balanaced lifestyle that promotes sleep hygiene and mood regulation. If symptoms start to reoccur, the therapist may act as the first responder for the client in obtaining a higher level of care as needed for stabilization or reduction of hypomanic and manic symptoms. Therapy can also support someone with either bipolar I or bipolar II to have a healthy separation or distance from their episodes and these states of elevated mood to further understand themselves and bring awareness of when symptoms reoccur. Without a mood stabilizer, someone with a diagnosis of bipolar I can experience a manic episode without a trigger, and it is possible for bipolar II or hypomania to progress into bipolar I mania without having a known cause. The first episode of mania may be more related or affected by severe stress and typically occurs during one's formative years which can be through someone's middle 20s which activates someone's genetic predisposition for the disorder. There are some cases where there is a late onset. It is possible for someone to have a single episode of mania, but often the risks with safety with reoccurrence is too significant that someone is typically advised to start taking medication even after one episode. It is common for someone with Bipolar I to not accept or treat their disorder to prevent episodes until after the second episode or a rehospitalization. Often people who have experienced a drastic change in themselves that cause a severe negative effect for themselves and others may experience reoccurring shame and complex trauma. The therapist can then provide trauma-informed therapy to support the person recovering from an episode of mania to regain a healthy and realistic sense of self, repair and improve their relationships, and regain stability in their finances and work. Often hypomania is not seen as the primary problem by a person with bipolar II but rather the drop in mood that can meet criteria for depression that typically follows a hypomanic episode. The more drastic swings in mood that is not shared by those without bipolar can also affect the person with bipolar II's mental health through difficulties with perception of themselves and in trusting themselves in maintaining mood and energy that is required to maintain their quality of life.