Hypomania — periods of intense energetic, happy, or irritated moods — is a part of life for many people with bipolar disorder.
Hypomanic episodes are a type of mood episode in bipolar disorder. Depending on the type of bipolar disorder you have, mood episodes might include highs (mania or hypomania) and/or lows (depression).
Hypomania is a milder form of mania. Although hypomania has a less severe impact than mania, it can still be disruptive and come with its own set of challenges.
While mood episodes can significantly impact your life, the right treatments and coping methods can reduce their impact and improve your overall well-being.
An episode of hypomania is a period of at least 4 days in a row when you have lots of extra energy, and you may feel very happy — or very irritable — for most of the day.
Sometimes, you might enjoy the feelings that come with hypomania. At other times, you might feel like they’re uncomfortable or distressing.
Either way, you’ll typically be able to carry on with your usual daily activities. But, you might also end up making decisions or doing things you wouldn’t normally, and that might have harmful consequences.
A diagnosis of bipolar II disorder requires that you have at least one hypomanic episode, before or after a major depressive episode.
During a hypomanic episode, you might feel happy, euphoric, excited, agitated, overly energized, or easily distracted.
These are significant changes to your typical mood and behavior, so people who know you may notice the difference in you.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), an episode of hypomania involves at least 3 of the following behavior changes:
- elevated self-esteem, high self-confidence, or feelings of grandiosity
- less need for sleep, such as feeling rested after only 3 hours of sleep
- feeling more talkative than usual or feeling a pressure to keep talking
- racing thoughts or quickly-changing ideas
- feeling easily distracted
- doing many activities at once, such as work tasks, organizing social events, or seemingly purposeless movements
- engaging in activities that may lead to harmful consequences, such as excessive spending, dangerous driving, or risky financial investments
By definition, the symptoms of hypomania aren’t severe enough to significantly affect your daily life or require hospitalization. If symptoms are severe, it’s more likely that it’s mania.
It is possible to have symptoms of hypomania from taking certain drugs, such as cocaine, or from psychiatric medications, like when starting a new course of antidepressants.
But your doctor likely won’t diagnose hypomania unless the symptoms continue beyond the effects of the drug being in your system.
To diagnose mania or hypomania, your doctor will also rule out other medical conditions that could cause similar symptoms — like hyperthyroidism or diabetes.
And finally, if you have repeated periods of hypomania and depression symptoms — but not enough to reach the criteria for a full episode, your doctor may diagnose cyclothymic disorder.
The symptoms of hypomania and mania are the same. The differences lie in how severe they are and the duration.
In hypomania, your symptoms aren’t severe enough to significantly disrupt your social or work life. They’re also not severe enough that you need hospital care.
There are also no features of psychosis in a hypomanic episode. For instance, you wouldn’t experience hallucinations or delusions, which can be present in a manic episode.
For diagnosing the two episodes, hypomania must last for at least 4 days in a row, while mania must occur for at least 1 week or any duration if hospitalization is required.
Just one episode of mania is enough for diagnosing bipolar I — even if you haven’t experienced an episode of depression.
And while the impacts of hypomania are less severe than those of mania, the DSM-5 states that bipolar II isn’t considered a “milder version” of bipolar I.
This is because the intense mood changes that come with untreated bipolar II usually lead to serious issues in social and work life, and episodes of depression may be longer and more severe.
Treatments for bipolar disorder aim to help you maintain stable moods and keep your symptoms managed. This usually involves a combo of medication and therapy.
- interpersonal and social rhythm therapy (IPSRT)
- cognitive behavioral therapy (CBT)
- family focused therapy
- dialectical behavioral therapy (DBT)
Medications for bipolar disorder often include:
- mood stabilizers
- atypical antipsychotics
- antidepressants to help with symptoms of depression
- medications to help with sleep or anxiety
According to the
Need more info? Here’s a list of treatments for bipolar disorder.
Every person’s experience will be different, so of course your coping methods will be different, too.
But with some trial and error, you can find the best ways to cope with episodes of hypomania (and any other symptoms you have).
An important first step is to work out your personal triggers that you’re having or about to have a hypomanic episode. Knowing your triggers can help you feel empowered and more in control.
Tracking your moods — such as through apps or journals — can help you keep track of and notice changes to your moods. You can also check out the Depression and Bipolar Support Alliance (DBSA)’s free wellness tracker that you can print out and stick on your wall or keep in a folder.
You may also find it helpful to ask a loved one or two to let you know when they notice some signs, because you might not always be aware that it’s happening.
Here are some tips for preventing episodes of mania and hypomania:
- When you notice your triggers, reach out. Accepting help from others takes practice, but if you think you’re about to experience a mood episode, it can really help to reach out to your treatment team, along with family and friends. Noticing your symptoms early and getting help can prevent an episode from worsening.
- Avoid substance use. Alcohol and drug use can interfere with medications and your moods.
- Be patient — with yourself and your treatment. Learning the best ways to cope and finding the right meds for you can take time. Be patient and gentle with yourself.
- Take it one step at a time. Small steps can help things feel more manageable. Think: Setting up a sleep routine, talking with a friend for support, or reaching out to a doctor or therapist.
- Join a support group. Not everyone you know will understand your symptoms or condition, and while you can try to explain it, joining a support group of like-minded people can be a breath of healing air.
- Relieve your stress. Try using stress management techniques to relieve stress, which can exacerbate mood symptoms. Try a new exercise or a daily walk, meditation, or deep breathing.
- Set up a crisis plan. By putting together an emergency action plan, you can get the help you need — fast. Put together a list of resources and people you can call in a moment of crisis.
- Aim for better sleep. Sleep is often found lacking in people with bipolar disorder, and less sleep can mean more stress. So aim for good sleep hygiene. Sleep at the same time every night and maintain good sleep habits like avoiding screens an hour before bed.
Even if you feel good during a hypomanic episode, it’s important to stick with your treatment plan. In the long term, treatments help stabilize your mood and ultimately reduce the impact of depressive episodes, too.