How to deal with hypomanic entrepreneurs

Sooner or later, if you deal with enough entrepreneurs, you will realize that the person you are talking to at a thousand miles a minute is hypomanic. Things could be even more challenging, though, since there are many entrepreneurial syndromes.

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Hypomania is a condition similar to?mania?but less severe. The symptoms are similar with elevated mood, increased activity, decreased need for?sleep, grandiosity, racing thoughts, and the like. However,?hypomanic?episodes differ in that they do not cause significant distress or impair one's work, family, or social life in an obvious way while?manic?episodes do.

Hypomanic people tend to be unusually cheerful, have more than ample energy, and need little?sleep. Hypomania is a pleasurable state. It may confer a heightened sense of creativity and power. However, hypomania can subtly impair a person's judgment. Too much confidence can conceal the consequences of decisions.

Hypomania can be difficult to diagnose because it may masquerade as mere?happiness. It is important to diagnose hypomania because, as an expression of?bipolar disorder, it can cycle into?depression?and carry an increased risk of?suicide.

Paul Graham was once asked if he chooses stable or crazy applicants for Y Combinator. His reply: “There’s some people who are crazy, who are basically manic depressives and somehow manage to keep the depressive part to a minimum. Those are good. But hearing voices kind of crazy? Not good.”

Graham isn’t talking about full-blown manic depression, which can include hallucinations and psychotic delusions. He is describing what UCSF’s Michael A. Freeman M.D., a psychiatrist and former VC startup executive, calls “soft bipolar.” Soft bipolar is a distant cousin to manic depression that often includes mild depressive dips and a light form of enthusiastic, energized, creative mania, called?hypomania.

If you are hypomanic, here are some coping tips.

If you are working with someone who is hypomanic, here are some tips:

1. Decide whether this is someone you want to work with given your own beliefs and mindset.
2. Practice active listening. Most hypomanics won't let you talk, let alone listen to what you have to say, particularly when you already know what you want to say before the other person is finished.
3. Pick your spot that works
4. Besides the fact that bipolar people want it, there are major benefits to getting hypomania under control for all involved. Greatest among them are increased stability and lower risk of crisis, but removing the behavioral issues is most appreciated by those who have had to tolerate them for too long.

5. Recognize the positive. Here are some of the elements of bipolar disorder that are considered advantages, for a brief period:

• Productivity.?People with bipolar disorder sleep less as they become manic and have more energy. As a result, they are often more productive than their peers, at least for a while. The lack of sleep and high-energy work can eventually lead to burnout and may contribute to symptoms of psychosis, such as paranoia and hallucinations.
• Confidence.?Feeling more self-confident is one of the benefits described by people with bipolar disorder. Unfortunately, as mania increases, this self-confidence can become unrealistic fantasies about power and success, leading to poor life choices and impulsiveness.
• Charm.?Along with greater energy and self-confidence, people with bipolar disorder may be more outgoing and charming as their mood improves. This can draw people to them, making them the life of the party (for a while). However, as mania progresses, increasing irritability, impulsiveness, irrational behavior or speech, and risk-taking also can drive people away.
• Euphoria.?Intense joy and pleasure in life, including a heightened awareness of details, may also be experienced by bipolar patients as they approach mania. This perception of the world in bright and beloved detail is often what patients cite as the most missed element of bipolar disorder.
• Insight.?Many people with bipolar disorder experience a feeling of greater intellectual ability and insight as they approach mania.

6. Rather than showing vulnerability, business leaders have practiced what social psychiatrists call impression management--also known as "fake it till you make it." Toby Thomas, CEO of EnSite Solutions (No. 188 on the Inc. 500), explains the phenomenon with his favorite analogy: a man riding a lion. "People look at him and think, This guy's really got it together! He's brave!" says Thomas. "And the man riding the lion is thinking, How the hell did I get on a lion, and how do I keep from getting eaten?" Imposter syndrome is right around the corner.

7. Be patient. Wait for the downtime to offer your ideas.

8. In the midst of the noise, there are often important signals coming from the lips of your hypomanic guest. Find them.

9. Don't be judgemental

10. Sometimes it is hard to tell one syndrome from the next. Amidst predominant focus on positive traits for entrepreneurship, this paper explores how disorders such as ADHD influence the decision to engage in entrepreneurial action and the success of entrepreneurial action. Based on a multiple case study of fourteen entrepreneurs previously diagnosed with ADHD, our inductive model highlights impulsivity as a major driver of entrepreneurial action and hyperfocus as a major catalyst for its consequences, both positive and negative. By drawing attention to the positive implications of symptoms commonly seen as negative, the paper opens several major avenues for future theoretical development and empirical research.

Here is an entrepreneur mental health accelerator. Maybe it can help you deal with the loneliness of the long-distance entrepreneur too.

Bottom line: If you are asked to work with an entrepreneur who exhibits some of these symptoms, decide whether you are a good fit and willing to go along for the ride. Sometimes, it's the only way to change the world. If you do, be sure to fasten your seat belt.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs