If you struggle with bipolar disorder, then you may also experience a hypomanic episode. In short, these are periods of intense energetic moods that can either be happy or irritable.

While these mood episodes may feel good, they’re often met by depressive episodes soon after. For this reason, it’s important to keep hypomania in check to ease overall bipolar symptoms.

What is a Hypomanic Episode?

Lasting about four consecutive days, an episode of hypomania results in intense energy that can make you feel very happy or irritable. ¹ Due to these conflicting emotions, there may be some episodes of hypomania you enjoy and others you don’t.

Still, no matter the circumstances, hypomania does NOT conflict with daily activities as a traditional manic episode does. However, some patients may take risks they wouldn’t normally take (i.e. participate in harmful activities, such as substance abuse).

Hypomanic episodes are typically found in those who struggle with bipolar II disorder. However, people with bipolar I can still experience hypomania symptoms.

Symptoms of a Hypomanic Episode

As mentioned, hypomania usually involves large amounts of energy that can make you feel happy, euphoric, excited, and/or agitated. Since this condition causes significant changes in mood and behavior, others may also notice you when you experience an episode.

Still, to receive a proper bipolar diagnosis, the Diagnostics and Statistical Manual of Mental Disorders (DSM-5) claims an episode of hypomania must involve at least three of the following behaviors: ²

• Increased self-esteem, self-confidence, or feelings of grandiosity
• Decreased need for sleep (i.e. being well-rested after only three hours of sleep)
• Becoming more talkative than usual (or feeling as though you need to keep talking)
• Racing thoughts (ideas rapidly changing)
• Easily distracted
• Taking on multiple activities at once
• Engaging in risky activities (i.e. excessive spending, dangerous driving, etc.)

Under its definition, hypomanic symptoms won’t be severe enough to affect your daily life (or require hospitalization). If such symptoms interfere with your daily life, you likely struggle with mania.

It’s worth noting that some individuals may experience hypomania, but not actually struggle with bipolar disorder. Such circumstances are common in drug users, notably those who take stimulants (i.e. cocaine).

Furthermore, doctors may not diagnose you with bipolar disorder if you don’t struggle with enough symptoms. In turn, you may be diagnosed with cyclothymic disorder instead. ³

Hypomanic Episode vs Manic

While symptoms between hypomanic and manic episodes are the same, the key difference is duration. If your symptoms are not severe enough to interfere with daily life, you struggle with hypomania. If they do interfere, you struggle with mania.

Furthermore, people who struggle with manic episodes may also experience psychosis. In other words, you may experience hallucinations and delusions that greatly inhibit your ability to function.

In terms of diagnosis, a hypomanic episode will last for (at least) four days. Whereas a manic episode can go on for (at least) one week and may require hospitalization.

How to Treat Hypomania

To treat hypomanic episodes, you must treat bipolar disorder as a whole. This helps to keep both manic and depressive symptoms in check and involves two processes:

Psychotherapy

Also known as “talk therapy,” psychotherapies can help you identify negative thought patterns and work towards changing them. The most common for bipolar disorder are: ⁴

• Interpersonal and social rhythm therapy (IPSRT)
• Psychoeducation
• Cognitive behavioral therapy (CBT)
• Family focused therapy
• Dialectical behavioral therapy (DBT)

Medication

To ease symptoms while you work through negative thought patterns, you may be prescribed: ⁵

• Mood stabilizers
• Atypical antipsychotics
• Antidepressants
• Medications for sleep or anxiety

Final Word

While hypomania may not be as severe as mania, it’s still worth it to consult a doctor. If symptoms ever get out-of-hand, you may find hypomania turning into mania. Luckily, treatment options are available, depending on your diagnosis.

References

¹ Jain A, Mitra P. Bipolar Disorder. 2023 Feb 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32644424.

² Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 3.8, DSM-IV to DSM-5 Hypomania Criteria Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t9/

³ Perugi G, Hantouche E, Vannucchi G. Diagnosis and Treatment of Cyclothymia: The “Primacy” of Temperament. Curr Neuropharmacol. 2017 Apr;15(3):372-379. doi: 10.2174/1570159X14666160616120157. PMID: 28503108; PMCID: PMC5405616.

⁴ Swartz HA, Swanson J. Psychotherapy for Bipolar Disorder in Adults: A Review of the Evidence. Focus (Am Psychiatr Publ). 2014 Summer;12(3):251-266. doi: 10.1176/appi.focus.12.3.251. PMID: 26279641; PMCID: PMC4536930.

⁵ Geddes JR, Miklowitz DJ. Treatment of bipolar disorder. Lancet. 2013 May 11;381(9878):1672-82. doi: 10.1016/S0140-6736(13)60857-0. PMID: 23663953; PMCID: PMC3876031.