There are two key differences between mania and hypomania: One of the criteria for a hypomanic episode is: For a manic episode: http://www.behavenet.com/capsules/disorder...cation.htm#Mood But there are similar features of both: [these are noticeable changes] feelings of optimism, confidence, creativity, sometimes feeling 'high' Sometimes feeling easily agitated inappropriate behavior or risk taking heightened senses, noted clarity of thought noting events, coincedences, or events as being more signifigant than they are -Black Dog Institute http://www.blackdoginstitute.org.au/bipola...a.cfm#Psychotic Examples of psychotic features are hallucinations are delusions and hallucinations. A hallucination is an unreal experience. A delusion is an untrue thought. Hallucinations can manifest itself in all five senses: sound, taste, touch, smell, sight. Delusions can be either grandiose or persecutory. Someone can think they are capable of fantastic things, or are a fantastic being [a king, a millionare, a healer] or think that they are being followed, something bad might happen, someone might want to hurt them. http://www.blackdoginstitute.org.au/bipola...a.cfm#Psychotic Other psychotic symptoms can include disorganized speech and thought. An observer of this will likely not be able to understand or make any connection between one topic and the next. http://www.camh.net/about_addiction_mental...order_mhfs.html These symptoms are not terribly common, but they do happen. They are the symptoms which can lead to mis-diagnosis.