Mania involves extreme, elevated changes in mood, emotions, energy, and activity levels that occur in people with bipolar disorder. Hypomania is a form of mania that involves the same symptoms but is milder and usually shorter in duration.
At a Glance
Mania and hypomania involve similar symptoms, but they differ in terms of severity and duration. Mania is more severe and lasts a week or more, while hypomania is less severe and typically lasts a few days. Being able to recognize the symptoms of mania and hypomania is important and will help your doctor determine which type of bipolar disorder you have.
What Are Mania and Hypomania?
Mania is a mood state, not a medical condition. It is a period characterized by persistent elevated, expansive, or irritable mood lasting at least one week.1 In some cases, it can become severe enough to cause delusional thinking and significant problems with functioning in social situations or daily activities.
A manic episode may require hospitalization if the person becomes dangerous to themselves or others, develops psychosis, or experiences suicidal thinking.
On the other hand, hypomania can be defined as a milder form of mania. It is a period of persistently elevated, expansive, or irritable mood that lasts for at least four days and up to a week.
It has the same symptoms as mania; however, instead of being severe, it is mild enough that the person can usually function normally in daily activities.
Symptoms of Mania/Hypomania
Below is a list of symptoms that characterize mania or hypomania:2
- Feeling very happy and/or silly for most of the day, nearly every day (euphoria)
- Strong feelings of excitement and energy
- Increased activity level
- Racing thoughts, ideas, and talking (pressured speech; jumping rapidly from one idea to another)
- Distractibility (attention too easily drawn to unimportant or irrelevant external stimuli)
- Decreased need for sleep (feeling rested after only 3-4 hours of sleep; sleeping fewer than 5 hours per night, nearly every day)
- Feeling like you don’t need to eat (not feeling hungry)
- Impulsiveness, taking on too many activities at once
- Reckless decisions, such as the purchase of big-ticket items without considering cost or consequences; gambling; excessive sexual activity; engaging in risky behaviors like reckless driving
- Unusual confidence and optimism about your abilities
- Irritability or aggression
In addition, in the case of severe mania, people may experience psychosis, which is the loss of contact with reality. This can lead to delusions or hallucinations, such as hearing voices or seeing things that are not there.
Psychosis may also involve delusions of persecution, such as the belief that people are plotting against you or delusional jealousy, where a person comes to believe their partner is unfaithful. In the case of hypomania, you will most likely not experience psychosis.
After a Manic/Hypomanic Episode
After a manic or hypomanic episode, you may feel upset about your actions. You may have few memories of what happened during the manic/hypomanic episode. Now that your energy levels have decreased, you may feel tired and no longer have the energy to keep up with the plans you made during the mood episode.
Mania vs. Hypomania
Let’s take a look at the differences and similarities between mania and hypomania.
- A mood state
- Severe symptoms
- Symptoms last for at least one week
- Causes significant functional impairment
- A form of mania
- Symptoms are milder
- Symptoms last between four days and one week
- No functional impairment
What Are the Differences Between Mania and Hypomania?
Mania and hypomania differ with respect to duration, intensity, and functional impairment:
- Duration: In mania, an elevated or irritable mood lasts at least one week. In hypomania, symptoms last for at least four days.3
- Intensity: In mania, symptoms are severe, and in hypomania, they are mild to moderate.
- Functional Impairment: In mania, critical life activities such as work and social relationships are impaired. In hypomania, there is no functional impairment.
What Are the Similarities Between Mania and Hypomania?
Both mania and hypomania are associated with increased energy, activity levels, and restlessness. They are also similar in terms of other symptoms such as racing thoughts, distractibility, pressured speech, inflated self-esteem/grandiosity, decreased need for sleep, sexual arousal or pleasure, irritability, or aggression.
In other words, the symptoms of mania and hypomania are very much alike.
Diagnosis
Mania is typically diagnosed as part of bipolar I disorder. Hypomania, however, is part of bipolar II disorder.
A diagnosis of bipolar I disorder requires that the person has had at least one episode of mania. A diagnosis of bipolar II disorder requires that the person has never had an episode of full-blown mania but rather has gone into a hypomanic state.
People with bipolar I disorder tend to have more depressive episodes, more mixed episodes (episodes in which depression is combined with mania), more hospitalizations, and are at higher risk for suicide than those with bipolar II disorder.
A mental health professional can diagnose these conditions through a thorough psychiatric interview and evaluation.
Hypomania and Mania Triggers
Certain factors may trigger episodes of mania or hypomania, including lack of sleep, drug and alcohol use, medication changes (particularly those that increase norepinephrine), illness, and overwork.4
Below is a list of potential triggers:
- Alcohol and drugs
- Caffeine (excessive consumption)
- Drugs that affect norepinephrine (such as thyroid medications, antihistamines, stimulants, and antidepressants)
- Lack of sleep or insomnia
- Mental stress (such as losing a loved one or completing an important project at work)
- Overwork, overplay, and overexercise
- Sensory overload including excess light, noise, and/or crowds
Can You Prevent Mania or Hypomania?
There is no way to prevent mania or hypomania, and bipolar disorder cannot be cured. Instead, there are steps you can take to reduce the likelihood of having a mood episode and to minimize the negative effects of manic/hypomanic periods. Sticking to your treatment plan is the most important thing you can do to manage your condition.
Causes of Mania and Hypomania
The causes of mania and hypomania include a combination of genetics, neurobiology, and life experiences. Studies suggest that a strong family history of the disorder increases one’s risk for bipolar mania and hypomania.5
Research has also identified a specific gene that increases the risk of both bipolar disorder and schizophrenia.6
Evolutionary psychologists theorize that bipolar disorder evolved as an adaptation to help those in northern climates engage in alternating phases of hibernation and activity.7 This would allow them to store up food and other resources during the summer months when they could easily obtain them. Then in the winter, they would stay in their homes, conserving energy until spring came again.
Treatment of Mania and Hypomania
Treatment for bipolar disorder usually involves psychotherapy, medication, and lifestyle modifications.
Psychotherapy
Evidence-based therapies that are the most effective in the treatment of bipolar disorder include psychoeducation, cognitive-behavioral therapy (CBT), interpersonal and social rhythm therapy, family-focused therapy, and peer-support programs.8
Research has shown that patients with hypomania due to bipolar II disorder experience a reduction in their symptoms after receiving psychotherapy,9 such as cognitive-behavioral therapy (CBT).
This form of psychotherapy helps individuals to recognize and avoid behaviors or situations that trigger mood episodes. In addition, it can be helpful for individuals to recognize early warning signs of mood episodes so that they can take action before a full episode occurs.