Hypomania (A complete review)

Hypomania, is a period of persistently elevated, expansive, or irritable mood as well as increased energy.

It is a characteristic of Bipolar Disorder II, a type of bipolar disorder consisting of both hypomanic and depressive episodes.

Hypomania is not to be confused with mania, though the two are similar.

Hypomania is a milder version of mania, with symptoms that are much less intense.

Furthermore, mania is a characteristic of Bipolar Disorder I, not Bipolar Disorder II. 

In this blog piece, we will discuss what hypomania is, how it differs from mania, how it relates to bipolar disorder, symptoms, causes of hypomania, diagnosis, and treatment. 

What is Hypomania? 

Hypomanic behavior is when an individual has an abnormally elevated, expansive, or irritable mood.

It is also characterized by increased energy. The behavior typically lasts for at least four consecutive days, and is present nearly most of the day, and every day.

Such episodes of hypomanic behavior are a characteristic of Bipolar Disorder II. Bipolar disorder is a mood disorder.

It can be broken up into two categories, Bipolar Disorder I and Bipolar Disorder II.

Bipolar Disorder I consists of repeated episodes of manic behavior.

Bipolar Disorder II consists of alternating episodes of hypomanic behavior and depressive behavior. 

How is hypomanic behavior related to Bipolar Disorder II?

Bipolar Disorder II is a specific type of bipolar disorder, a mood disorder, characterized by alternating episodes of hypomania and depression.

Hypomania itself is not necessarily a diagnosis. Instead, it is a characteristic, or symptom so to speak, of bipolar disorder II.

Individuals with bipolar disorder II cycle between episodes of hypomania and depression, meaning they will go through time periods of significant elation followed by periods of significant withdrawal and sadness. 

What are the symptoms of Hypomania? 

Hypomania is characterized by moods which are abnormally elevated, irritable, and labile.

The symptoms of hypomania can also be physical, rather than just emotional.

Individuals with hypomania go through changes in mood, energy , activity, behavior, sleep, and cognition.

Again, though similar, the symptoms of hypomania are not as pronounced or excessive as they are in mania.

Common symptoms of manic behavior include:

·      Elevated, irritable, and labile mood

·      Increased energy/activity

·      Exaggerated self-confidence

·      Racing thoughts

·      Loud, rapid speech

·      Mild to moderate risk taking behavior

·      Mildly impaired psychosocial functioning 

·      Goal-directed activities

Many of these symptoms require clarification since individuals may confuse hypomanic tendencies with happiness and productivity, as well as with manic tendencies.  

Elevated and expansive mood, accompanied by increased energy and activity: these are core symptoms of hypomania.

Again, these are more severe emotions than simply emotions that occur during a “good mood,” but less severe than mania.

During this mood disturbance, due to the increased energy and activity, the individual may become extremely goal-oriented.

Their thoughts are often very quick and creative, allowing them to be this goal-oriented.

This is where hypomania differs greatly from mania. In mania the individual has racing and often disconnected thoughts, that lead them to be goal-oriented but very ineffective.

The thoughts in hypomania are definitely caused by mental over activity, but are more organized than in mania. 

Along with having elevated mood and increased energy, these individuals also experience a newly found self-confidence.

While their self-esteem may be inflated, it never reaches the point of grandiosity or delusion that it does in mania. 

Cognitively speaking, while the individual does experience mental over activity, the thoughts are more organized than they are in mania.

This allows them to be less disinhibited and so these individuals will not take part in risk-taking behavior as much as those with mania will.

This is why psychosocial functioning in hypomania is not as markedly impaired as it is in mania. 

Additionally, while those with hypomania will have loud and rapid speech. It is more comprehensible than the speech in mania.

Overall, psychotic symptoms do not occur in hypomania, as they can in mania.

Hypomania also never requires hospitalization.

How is Hypomania different from Mania? 

Hypomania can sometimes be confused with mania. Again, both behaviors are characteristics of Bipolar Disorder, a mood disorder.

What many don’t know however is that there are actually two types of bipolar disorder.

As mentioned above, there is bipolar disorder I and bipolar disorder II. Bipolar disorder I is characterized by mania.

Bipolar disorder II is characterized by both hypomania and depression. 

Both hypomania and mania episodes consist of elevation of mood and increased energy.

Hypomania, however, is a lot less intense than mania. Hypomania is still more severe than simply being in a “good mood,” but is not as severe as mania.

It is easiest to think about this on a spectrum with what what we typically think of as a “good mood” on the lowest end of the spectrum, hypomania in the middle, and mania on the extreme end of the spectrum, 

Probably the most important distinction between mania and hypomania is that hypomania is not severe enough to cause marked impairment in social or occupational functioning.

It is especially not severe enough to necessitate hospitalization.

If a mood disturbance causes significant impairment or requires hospitalization, it is by definition mania, not hypomania.

What causes Hypomania? 

Hypomania is a significant symptom of Bipolar Disorder II. A significant cause of bipolar disorder is genetics.

An individual is more likely to have bipolar disorder, and therefore hypomanic behavior, if one or more of their family members has bipolar disorder.

Because of one’s genetics, they may be predisposed to developing bipolar disorder.

If they encounter an event such as trauma or something stressful, this may tip them over the edge to develop bipolar, and therefore mania.

Traumatic and stressful events do not cause bipolar.

They certainly do allow for bipolar to surface in already predisposed individuals.

How do you diagnose Hypomania? 

A healthcare professional can give a formal assessment of hypomanic behavior, and can clarify how the diagnosis fits into a larger bipolar disorder diagnosis.

If you are experiencing any of the symptoms of hypomanic behavior, speak to your healthcare professional.

They will offer you all of the relevant information, or can refer you to someone who can.

Receiving a formal diagnosis can assist in seeking out the proper treatment and allowing you to control and monitor your symptoms. 

The diagnostic criteria for a hypomanic episode is:

A.   A period of abnormally elevated or irritable mood and abnormally increased energy

·      These symptoms last at least four consecutive days and present most of the day, nearly every day

B.   During the episode, along with the mood disturbance and increased activity, three or more of the following symptoms are present.

These symptoms represent a noticeable change from usual behavior:

·      Inflated self-esteem or grandiosity 

·      Decreased need for sleep

·      More talkative than usual

·      Flight of ideas

·      Distractibility

·      Increased in goal-directed activity

·      Excessive involvement in activities with high potential for painful consequences 

C.   Episode is associated with a significant change in functioning from when the person is not symptomatic

D.   Disturbance in mood is observable by others

E.   Episode is not severe enough to cause marked impairment in social or occupational functioning to necessitate hospitalization 

F.   Symptoms are not related to another condition or substance use (such as drug abuse, medication, or other treatment

Again, a healthcare professional can take proper symptoms and medical history and see if your symptoms match the diagnosis criteria for a manic episode. 

What is the treatment for Hypomania? 

Since hypomanic behavior is often a component of Bipolar Disorder, the treatment for hypomanic behavior is that for bipolar disorder.

The best way to seek out treatment is to speak with your healthcare professional.

They will be able to assess your symptoms and suggest a treatment plan that will be most beneficial to you. 

Bipolar disorder is not curable, meaning an individual will continue to have it for the rest of their lives. It is a chronic condition.

The symptoms of bipolar disorder, however, such as hypomanic behavior and episodes can certainly be managed with the proper medication or therapy

Treatment options for Bipolar Disorder, and therefore Hypomanic Behavior are:   

·      Medication

·      Psychotherapy

·      Electroconvulsive therapy (ECT) 

Certain medications are used specifically for mania in bipolar disorder.

Though there are clinical differences between mania and hypomania, the episodes are treated with the same medications.

This group of medication is referred to as antipsychotics.

There are a variety of antipsychotics and a healthcare professional can go over which might best for an individual with hypomania.

The medication is able to adjust the neurotransmitters in the brain to help control the fluctuations in mood.

For patients who do not respond to a variety of first-line antipsychotic medication, lithium (a common mood stabilizer) or a group of medications called anticonvulsants can be attempted.

Psychotherapy is often used in combination with medication.

It allows for the individual to identify their triggers for a hypomanic episode, know when their hypomanic episode is about to begin, and plan for what they should do if they feel they are entering one. 

Electroconvulsive therapy (ECT) is reserved for patients in whom medications and psychotherapy does not work.

ECT is an invasive procedure in which the brain is electrically stimulated while the patient is anesthesia.

Again, it is an invasive procedure that is reserved for people who are refractory to other treatment options. 

Frequently Asked Questions (FAQs) about Hypomania?

What is Hypomania?

Manic behavior is the behavior exhibited during a hypomanic episode.

A hypomanic episode is characterized by elated, irritable, and labile mood.

During these episodes, individuals have increased energy and activity.

These symptoms result in behavior that is very different from behavior the individual exhibits when they are asymptomatic.

These mood disturbances are also easily picked up on by other individuals.

The mood disturbances, however, do not cause a significant impairment in social and occupational functioning.

They also do not require hospitalization. 

2.    Is Hypomania the same as being in a good mood?

Hypomanic Behavior is not the same as being in a good mood.

Those exhibiting hypomanic behavior exhibit more than just the emotion of happiness.

They feel elated and irritable. They feel as though they are invincible.

Those that are simply in a good mood are still able to control their emotions, feelings, and behavior. 

3.    Is Hypomania a diagnosis all by itself?

Hypomanic behavior is not necessarily a diagnosis all by itself.

It is actually a common symptom of a broader disorder and diagnosis, Bipolar Disorder.

Hypomanic Behavior is specifically the core component of Bipolar Disorder II.

An individual can have Bipolar Disorder I, characterized by manic behavior or Bipolar Disorder II, characterized by alternating hypomanic and depressive behavior.

4.    Can Hypomania be cured?

Hypomanic Behavior is definitely treatable, but it is not curable.

As we know, hypomanic behavior and hypomanic episodes are components of Bipolar Disorder.

Bipolar Disorder is not necessarily curable. An individual will have it for their entire life since it is a chronic condition.

That being said, the symptoms of Bipolar Disorder, including hypomanic episodes and behavior are definitely manageable with proper medication and therapy. 

5.    When does Hypomania usually begin?

An individual will usually exhibit a hypomanic episode which will ultimately lead to the diagnosis of Bipolar Disorder.

Symptoms of bipolar, so hypomanic episodes, typically emerge in early adulthood.

That is not to say however that they cannot develop in childhood or teenage years. 

6.    Is Hypomania the same as mania?

Mania is not the same as hypomania.

Mania is a characteristic of Bipolar Disorder I. Hypomania, however, is a characteristic of Bipolar II.

Also, the characteristics of mania itself are different from hypomania.

Hypomania can be considered a milder form of mania. It lasts for a shorter period of time than does manic behavior, and also does not have as marked impairment in social or occupational functioning as does manic behavior.

It also does not require hospitalization.

Want to learn more about Hypomania? Check out these books! 

He Wanted the Moon: The Madness and Medical Genius of Dr. Perry Baird, and His Daughter’s Quest to Know Him

A beautiful story about a daughter trying to piece together her father’s life and journey with bipolar disorder.

Electroboy: A Memoir of Mania

A story about Andy Behrman, the author living with bipolar and his journey with misdiagnosis, multiple careers, and everyday life. 

Have more questions about hypomania? Post below!


Bipolar Disorder in Adults: Clinical Features UpToDate 2020

Bipolar Disorder WebMD 2020

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