What is hypomania?
Hypomania is a state of mind characterized by abnormally high spirits, and it is a potential symptom of bipolar disorder, specifically bipolar II disorder.
The primary symptoms of hypomania are heightened giddiness, excitement, flamboyance or irritability, as well as tension, restlessness, vigilance, distractibility and intense focus.
Read: Premenstrual Dysphoric Disorder
Causes
Hypomania is sometimes a symptom of bipolar disorder, but it may also result from other factors, such as:
- Alcohol or drug use
- Sleep changes
- Depression
- High levels of stress
- Medication side effect
Hypomania symptoms
Hypomanic symptoms and signs vary from person to person. Here are some examples of hypomanic behaviors:
- Taking advantage of a dinner party by making crude comments
- Behaving or dressing in a flamboyant manner
- Those who struggle with hypersexual tendencies may demand excessive amounts from their partners, initiate inappropriate demands
- Changing topics while speaking
- Sleeping less
- Purchasing a car you cannot afford recklessly
- “Feeling lucky” leads you to take risks you would normally avoid
- It is hard for others to follow you when you speak so fast
- Intense irritability, aggression or excitement
Read: Catatonic Schizophrenia
Diagnosis
Hypomania can be diagnosed based on common symptoms and signs. The patient should have a persistently elevated, expansive, or irritable mood for the majority of the day, accompanied by unusually increased energy and activity for at least four days.
Hypomania is marked by different moods, habits, and behaviors than one’s everyday state, and can be easily observed by those around them. It is important to distinguish hypomania from a variety of moods by noticing no mood fluctuations.
It is by definition impossible to diagnose hypomania with some features and instead need to look for a manic episode. A hypomanic episode cannot be explained by symptoms of psychosis, such as hallucinations or delusions.
Hypomania is also ruled out by symptoms so severe that they substantially interfere with your day-to-day functioning or necessitate hospitalization. Be sure to rule out the possibility of medications or recreational drug use as a cause before you make a diagnosis.
Read: Paranoid Schizophrenia
Bipolar hypomania
It is generally required that a person who suffers from both depressive episodes and manic or hypomanic episodes be diagnosed with bipolar disorder. Bipolar II disorder is associated with symptoms of depression, hypomania and mania. Other factors may lead to a different diagnosis, such as cyclothymia.
Bipolar hypomania is diagnosed when three or more of the following symptoms are present with a persistently elevated mood or a persistently irritable mood:
- Easily distracted
- Engaging in excessively risky activity, such as spending sprees, gambling or engaging in sexual indiscretions
- Intensely motivated toward achieving a specific goal
- Psychomotor agitation is characterized by fidgetiness, pacing or restlessness
- You feel that your thoughts are flitting around or that they are racing
- Imagine yourself as powerful, talented, or amazing in a way that is too grandiose
- Feeling tired less often without requiring more sleep
- Feeling compelled to talk constantly or unusual talkativeness
Read: Types of Schizophrenia
Manic vs. hypomanic episodes
There is no difference between hypomania and mania in terms of symptoms. It depends on how severe and how long they are. You are not likely to experience severe symptoms of hypomania that interfere with your social or professional life. It’s also not serious enough to require hospitalization.
Additionally, hypomanic episodes do not show symptoms of psychosis. An individual suffering from mania would not experience hallucinations or delusions. A hypomanic episode is diagnosed if it lasts for a minimum of 4 days, while a maniacal episode is diagnosed if it lasts for at least a week.
You can still be diagnosed with bipolar I if you experience only one episode of mania. Bipolar II is not considered a “milder version” of bipolar I, although its symptoms are less severe than those of mania.
Bipolar II usually results in dramatic mood changes that cause serious problems at work and in social situations, as well as longer and more severe episodes of depression.
It is not mandatory to also be diagnosed with bipolar disorder if you receive a diagnosis of hypomania.
Hypomania treatment
Hypomania can have serious long-term consequences even if no psychosis or exaggerated moods are present. Sexually transmitted infections (STIs) can ruin relationships as a result of hypersexuality. You may suffer severe financial hardship if you spend irresponsibly, and you may lose your job if you behave inappropriately.
Hypomania is most commonly treated with medications called mood stabilizers; your doctor may prescribe one or more of the following:
- Lithium and Valproic Acid (can relieve hypomania symptoms until antipsychotics fully take effect)
- Benzodiazepines (anti-anxiety drugs)
- Mood stabilizer lithium (with antidepressant properties)
- Valproic acid (an anticonvulsant)
Additionally, lifestyle changes and holistic approaches can help, including the following:
- Avoid stimulants like caffeine, sugar, and loud, crowded social situations that can trigger anxiety
- Exercise every day
- Sleeping seven to eight hours each night
- Meals on a regular basis
Read: Schizoaffective Disorder
How to manage a hypomanic episode
There is no one-size-fits-all when it comes to experience, so your coping methods will differ as well. If you don’t mind a little trial and error, you can learn how to cope with hypomania episodes.
Identifying your personal triggers is a crucial first step to preventing hypomanic episodes. It can be empowering to understand your triggers and feel more in control when you do.
It can be helpful to keep track of your moods by using apps or journals. If you’re not aware of what’s happening, you might be able to ask a loved one or two for help.
The following tips will help you prevent episodes of mania and hypomania:
- Don’t ignore your triggers. Reaching out to your treatment team, as well as your family and friends, can really help if you think you’re about to suffer a mood episode. Getting help early in the course of an episode can prevent it from worsening.
- Don’t use substances. It is possible for alcohol and drugs to interfere with medication and your mood.
- Don’t rush into treatment – be patient with yourself. It can take time to find the right medication for you and find the best ways to cope. Keep yourself in a gentle and patient frame of mind.
- Taking it slow is the key. It can be easier to manage things if you take small steps. Consider: Setting up a routine for sleep, reaching out to a friend for encouragement, or seeing a doctor.
- Find a support group to join. You can try to explain your symptoms to people, but joining a support group of people who share your concerns can be a breath of fresh air.
- Relieve your stress. You can relieve stress, which can aggravate mood symptoms, by using stress management techniques. Make a habit of exercising, walking, meditating, or breathing deeply.
- Prepare a crisis plan. Creating an emergency action plan will allow you to receive help quickly. When you are in a crisis, create a list of people and resources you can reach out to.
- Aim for better sleep. Bipolar disorder is often characterized by inadequate sleep, which will lead to more stress. Take good care of your sleep hygiene. A good sleep habit includes avoiding screens one hour before going to bed and sleeping at the same time every night.
The most important thing to remember during a hypomanic episode is to stick to your treatment plan regardless of how you feel. Ultimately, treatment reduces the impact of depressive episodes and stabilizes your mood over time.
