Mania and hypomania are periods of high energy, activity, and feelings of euphoria. Hypomania is a less intense form of mania.
If you’re living with bipolar disorder, you may be familiar with the highs of mania and hypomania. It can be difficult to tell which one you’re experiencing, especially while it’s happening, but there are key differences to look out for.
According to the American Psychiatric Association, mania lasts for at least a week and is usually a sign of bipolar I disorder. Hypomania lasts for a shorter time — 4 days in a row — and can occur in bipolar I or bipolar II disorder.
The main difference between mania and hypomania is that manic episodes are more intense and have a greater impact on your life, including your social, work, and personal life. Hypomanic episodes are challenging too, but by definition, they do not lead to major problems in your daily functioning.
Determining whether you’re experiencing mania or hypomania is one step toward finding the most effective treatment and ways to manage these states.
Both mania and hypomania are periods of extreme “highs” during which you feel filled with energy. You might talk faster than usual, organize lots of activities, and have less need for sleep. Your family and friends might notice these changes even if you’re not acutely aware of them.
Bipolar disorder affects around 2.8% of the United States population and is diagnosed in males and females equally. Most people receive a diagnosis between the ages of 18 to 29 years, but the symptoms can appear in your teenage years or, more rarely, during childhood.
The symptoms of mania and hypomania are the same. The only difference is that in mania, the symptoms are more intense and more disruptive than in hypomania.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), three of the following behavioral changes define a manic or hypomanic episode:
- having feelings of grandiosity or heightened self-esteem
- feeling rested after little sleep, such as needing only 3 hours of sleep
- speaking rapidly or loudly, or feeling pressure to keep talking
- having racing thoughts and a flight of ideas
- feeling easily distracted
- doing lots of activities at once, such as organizing social events, doing work tasks, or making seemingly purposeless movements
- doing potentially harmful activities, such as using alcohol or drugs, overspending, having risky sex, or driving dangerously
The triggers for mania and hypomania are likely to be the same and might include:
- periods of stress
- a lack of sleep or changes in your sleep patterns
- using drugs or alcohol
- seasonal changes
- significant life changes
- trauma or abuse
While these states tend to feel good, and you might associate them with productivity, many people deal with the consequences of their overactivity afterward, like if they’d made risky investments or taken on too many projects. This is especially hard to deal with if a period of depression follows shortly thereafter, which is common with bipolar disorder.
A doctor may diagnose manic and hypomanic episodes after ruling out another medical cause, such as hyperthyroidism or the side effects of drugs or new medication.
The treatments and ways to manage mania and hypomania are similar. They usually involve medication and therapy as treatment for bipolar disorder. Mania may require a higher level of treatment, such as a hospital visit if there is a risk of harming yourself or others.
The main difference is how intense they are and how significantly they interrupt important parts of your life:
- Manic episodes can lead to severe dysfunction in your social, work, or personal life. Hypomanic episodes, by definition, do not lead to major problems in your daily functioning.
- Mania, but not hypomania, may involve hallucinations or delusions.
- Mania, but not hypomania, commonly results in hospital visits.
- Manic episodes last for at least a week, while hypomanic episodes are shorter, lasting about 4 days in a row.
While mania occurs in bipolar I disorder, hypomania can occur in both bipolar I disorder, bipolar II disorder, or cyclothymic disorder. It’s possible for a doctor to diagnose bipolar I disorder after you experience just one episode of mania.
Even though hypomanic episodes are less severe, they can still cause significant distress, and they can be more difficult to spot.
The good news is that there are effective ways to manage manic and hypomanic episodes through treatment and coping strategies.
Episodes of mania and hypomania will be different for each person, so your treatment plan and management strategy will be unique to you.
When you feel the early symptoms starting, there are ways to prevent them from getting worse. The International Bipolar Foundation recommends the following:
- Remember that having bipolar is not your fault. You are not broken in any way.
- Pay attention to the warning signs that a mood episode is coming on. Noticing the symptoms early can help you prevent an episode from escalating.
- Avoid using drugs and alcohol.
- Make use of support networks, including healthcare professionals, family, and friends.
- Try to get enough sleep and keep up consistent sleeping patterns.
- Use stress management techniques, like therapy or exercise.
- Continue to take your medication, even if you feel well during a manic episode.
For long-term management, research shows that medication paired with psychotherapy (aka talk therapy) results in more successful treatment than just having one form of treatment.
Some therapy options to help with difficult emotions or thoughts are:
If you’re having periods of mania and hypomania, there are other things you can do to feel empowered and in control of your mental health.
Research has shown that without active and honest acceptance of help, long-term treatment is less effective. Learning more about bipolar disorders and mood episodes through podcasts and books can arm you with greater knowledge and an understanding of what help is available.
Looking for patterns and spotting triggers for your episodes can help you notice and act on them. Triggers might include certain social interactions or not getting a good night’s sleep. Identifying these can help you to develop a lifestyle and wellness plan that works for you. The Depression and Bipolar Support Alliance (DBSA) has a free downloadable tracker to help with this.
When it comes to developing a treatment plan, the DBSA recommends being actively involved and collaborating with your doctors and therapists. Here are some questions to take with you to your next appointment.
After the plan has been set, it’s super important to practice patience with the treatment and with yourself. Often, finding the right treatment is a case of trial and error, and the path to staying well can be difficult, but you can do it.
Other things that can help:
- Join a support group, where you can share your challenges and experiences with others who have similar episodes.
- Create an emergency action plan. This may involve letting loved ones know when symptoms are starting, and creating a resource list and a list of coping strategies.
With treatment and potentially some lifestyle changes, it can become easier to live with mania or hypomania and live the life you choose.