What are mania and hypomania?

Mania and hypomania are periods where a person feels elated, very active, and full of energy. Hypomania is a milder form of mania.

Mania and hypomania both involve periods when the individual feels excited or experiences an energized mood. They differ in how severe these mood changes are:

  • Mania is a severe episode that may last for a week or more. A person may feel uncontrollably elated and very high in energy. These symptoms interfere with daily life, and in severe cases, a person may need to go to the hospital.
  • Hypomania is an episode that lasts for a few days. People may feel very good and function well. Family or friends may notice mood or activity changes, while the person with the hypomania may not.

Mania and hypomania are most often related to bipolar disorder. They can also occur as part of other mood disorders, such as schizoaffective disorder.

Bipolar disorder is a mental health disorder where a person experiences changes in their mood, energy, activity levels, and thought patterns.

People who have bipolar I disorder experience mania, while people with bipolar II disorder will experience hypomania.

In this article, we look at the differences between mania and hypomania, including their symptoms, treatments, and prevention.

Symptoms of mania

Woman out at night with possible mania or hypomania

Symptoms of mania can include uncontrollable excitement, high energy levels, feeling overconfident, and a lack of social inhibitions.

Mania goes beyond normal mood and energy changes. The symptoms of mania are so intense that they can affect a person’s relationships, job, or well-being.

Having mania does not always mean that the person feels happy. While mania can cause a feeling of euphoria, it can also cause extreme irritability.

Symptoms of mania can include:

  • uncontrollable excitement
  • feeling very happy or elated
  • feeling irritable or very agitated
  • high energy levels that the person finds hard to control
  • high activity levels, such as excessive running, fidgeting, or moving around
  • difficulty paying attention or focusing
  • unrealistic and very high self-esteem, feeling overconfident
  • a lack of social inhibitions
  • racing thoughts
  • less need for sleep or not sleeping at all
  • taking risks or reckless activities
  • thoughts of suicide or self-harm

People can experience psychotic symptoms during an episode of mania. These may include:

  • hallucinations, or seeing or hearing things that are not there
  • grandiose delusions, or believing that they are invincible, very powerful, or famous

The National Institutes of Mental Health (NIMH) say that manic episodes in bipolar disorder last for at least 7 days, or for any duration if the symptoms are so severe that the person needs hospital care. Between episodes, the individual may feel normal or have mild, lingering symptoms.

Symptoms of hypomania

Hypomania is a milder form of mania. People who have bipolar 2 disorder have hypomania. If a full manic episode occurs, a diagnosis of bipolar 1 is usually more appropriate.

Symptoms of hypomania can include:

  • having a higher, happier mood than usual
  • higher irritability or rude behavior
  • feeling overconfident
  • higher activity or energy levels than usual without a clear cause
  • a powerful feeling of physical and mental wellbeing
  • being much more social and talkative than usual
  • having a stronger desire for sex than usual
  • feeling the need to sleep less than usual

Differences

Hypomania and mania share many symptoms. The distinguishing factor is the severity of these symptoms.

Both mania and hypomania involve mood and behavior changes beyond normal, everyday changes.

Mania is so severe that a person cannot carry on with their usual activities. In more extreme cases, they may need immediate hospital care.

A person with hypomania may be able to carry on as usual. Family and friends may notice that the individual is acting differently even if the person does not realize it is happening. However, they should still seek medical help for their condition to prevent the symptoms worsening.

Although hypomania is not as severe as mania, it can also be dangerous and have negative effects on a person’s overall well-being.

One study found that people were more likely to engage in risky behavior during hypomanic episodes. This included spending large amounts of money, using alcohol or drugs excessively, dangerous driving, or engaging in risky, sexual behavior.

People experiencing mania but not hypomania may also have delusions, hallucinations, or manic stupor.

If a person does not receive effective treatment for hypomania, they may be at risk of it developing into mania, although this is not always the case.

Similarities

Staying out late and partying can be a trigger for mania and hypomania.

The symptoms of both mania and hypomania involve feeling very happy, on an emotional high, and feeling more energetic and creative.

In some cases, an episode of mania or hypomania can be mixed with one of depression. Specialists call this a mixed features episode.

When this mix happens, a person may feel energized while also feeling depressed, hopeless, or empty.

Certain life events or activities can cause an episode of mania or hypomania. These episodes are called triggers.

A small-scale study on a group of young people who had bipolar disorder found that triggers for mania and hypomania included:

  • falling in love
  • using recreational drugs, especially stimulant drugs
  • starting a new creative project
  • staying out late or partying
  • going on vacation
  • listening to loud music

Another study found the following factors could also trigger mania:

  • stress
  • lack of sleep
  • use of antidepressant medicines

When to see a doctor

If a person notices mood changes that seem to be stronger than normal, they should see a healthcare professional. Bipolar disorder can be difficult to diagnose, but a comprehensive health history, physical exam, and discussion of moods and symptoms can help.

If a friend or family member appears to have symptoms of mania or hypomania, those closest to them may want to talk to them about seeing a doctor and getting treatment.

Treatment and prevention

There is no cure for mania or hypomania, but people can manage their symptoms with medication and talking therapies. These treatments can help prevent episodes of mania and hypomania, as well as episodes of depression.

A person must take their medications as prescribed by a doctor, which is continuous, typically, to prevent episodes of mania or depression.

Medications that can help people manage bipolar disorder include:

  • mood stabilizers, such as lithium and antiseizure medicines
  • second generation or atypical antipsychotics, which treat mania and hypomania
  • antidepressants, which may help treat the depressive episodes of bipolar disorder in some cases
  • sleep medications may be useful for a limited duration for people who have trouble sleeping

Many people benefit from a combination of medication and talk therapy. Also known as psychotherapy, talk therapy can provide support, guidance, and education for people with bipolar disorder.

People who are on medication for mania or hypomania should not stop taking this medication without talking with their doctor. Suddenly stopping medication can lead to more severe symptoms if mania comes back. A person can also experience dangerous withdrawal symptoms.

Although lifestyle changes alone cannot treat mania and hypomania, people can try the following to help manage their symptoms and possibly avoid triggers:

  • Eat a healthful diet and avoid skipping meals.
  • Practice good sleep hygiene. Go to bed and wake up at the same time every day if possible. Avoid staying out late and keep a consistent sleep schedule each day.
  • Keep a journal of mood changes or use a mood chart. These can help a person spot mania or hypomania coming on, so they can work with their therapist to treat it.
  • Attend appointments and take medicines as a doctor has prescribed.
  • Get help right away for thoughts of self-harm or suicide.

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