The symptoms of hypomania are similar to those of mania -- elevated mood, inflated self-esteem, decreased need for sleep, etc. -- except that they don't significantly impact a person's daily function and never include any psychotic symptoms.
A hypomanic episode is not a psychiatric disorder or diagnosis in itself, but rather is a description of a part of a condition called bipolar II disorder.
Hypomanic episodes have the same symptoms as manic episodes with two important differences: the mood usually isn’t severe enough to cause problems with the person working or socializing with others (e.g., they don’t have to take time off work during the episode), or to require hospitalization; and there are never any psychotic features present during the episode.
While once thought to be a less severe form of bipolar disorder, bipolar II disorder (with hypomanic episodes) is now recognized that it can be just as debilitating and difficult to live with as bipolar I disorder (with manic episodes).
What is a Hypomanic Episode?
A hypomanic episode is an emotional state characterized by a distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least four (4) consecutive days, according to the American Psychiatric Association (2013). The mood must be present for most of the day, nearly every day. This hypomanic mood is clearly different from the person’s usual mood and level of functioning.
During the time a person experiences a hypomanic mood episode, three (3) or more of the following symptoms need to be present (4 if the mood is only irritable), and have been present to a significant degree:
- Inflated self-esteem or grandiosity
- Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
- More talkative than usual or pressure to keep talking
- Flight of ideas or subjective experience that thoughts are racing
- Distractibility (e.g., attention too easily drawn to unimportant or irrelevant external stimuli)
- Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
- Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
It’s important to keep in mind that a hypomanic episode is associated with a significant change in functioning that is uncharacteristic of the person. For example, the individual may be far more productive or outgoing and sociable than they usually are. This change in functioning and in mood is not subtle — the change is directly noticeable by others (usually friends or family members) during a hypomanic episode.
A hypomanic episode is also not severe enough to cause serious impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features during the episode (for instance, the person does not experience hallucinations or delusions).
The observable symptoms of a hypomanic episode must not be due to substance use or abuse (e.g., alcohol, drugs, medications) or caused by a general medical condition (e.g., hyperthyroidism or diabetes).
People who experience a hypomanic episode are often diagnosed with a type of bipolar disorder called bipolar II. Bipolar II disorder is a serious mental illness that could result in possibly significant problems in a person’s life if left untreated or unaddressed.
A hypomanic episode brought about by the effects of a drug or psychiatric treatment (such as starting a course of antidepressants) is generally not diagnosed, unless it continues to persist beyond the physiological effects of the treatment. For instance, a person who experiences a hypomanic episode for four or more consecutive days due to ingestion of cocaine or meth would generally not be diagnosed with bipolar II disorder.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: Fifth edition. Arlington, VA.