What Is Hypomania ?

Hypomania is a condition where you experience periods of abnormally high, extreme changes in mood or emotions, energy levels, or activity levels. Hypomania is considered to be a less serious form of mania, which can still cause problems in your life, but not as much as mania. Although symptoms of hypomania can be apparent to others, they can be less concerning than more extreme episodes of mania.

People who are experiencing mania, but not hypomania, also may experience delusions, hallucinations, or a manic delusion. Family or friends might notice changes in mood or activities, whereas a hypomaniac may not. Family and friends may notice a person with hypomania acting differently, even though the person does not realize this is happening.

Some behaviors and moods experienced during hypomania can look like regular manic episodes, but they are just shorter in duration or less dramatic. By definition, some characteristics preclude the diagnosis of hypomania, and usually indicate instead that there is a manic episode. In addition, hypomania frequently progresses into a full-blown manic episode, or is followed by a severe depressive episode. Key to the diagnosis of hypomania is that your increased mood, behavior, or activity levels should continue for at least four days (all day or much of the day) and should increase to levels beyond normal, noticeable by others.

In hypomania, your symptoms are not so extreme as to substantially disrupt your social or occupational life. Someone with bipolar disorder or another mood disorder can have periods of both hypomania and mania at different times, depending on their individual symptoms. When individuals experience symptoms of bipolar disorder, as well as experiencing periods of psychosis separate from the mood episodes, a schizoaffective disorder may be an appropriate diagnosis. Depending on which type of bipolar disorder you have, mood episodes can be higher (mania or hypomania) and/or lower (depression).

Some people are more likely to experience mania or depression, and others cycle between both types of episodes evenly. Consideration is given to how intense changes in mood associated with untreated bipolar II often cause significant problems with social and occupational lives, and episodes of depression can be longer and more intense. For instance, bipolar depression is more likely to include irritability, guilt, unpredictable mood changes, and feelings of anxiety.

It is very common for individuals with bipolar disorder to enter into a period of depression immediately after a manic episode, and these tend to be far longer in duration than the hypomania episode. When a person with bipolar disorder has an episode of hypomania, he or she can feel happy, and energetic for several days before an inevitable crash. While hypomania may be a symptom of bipolar disorder, these episodes may happen due to other reasons, including alcohol or drug use, changes in sleeping patterns, depression, high levels of stress, and medication side effects.

There are several types of mania that may occur with bipolar disorder, and some individuals may experience a less severe form of mania known as hypomania. If left untreated, and in those who are susceptible to it, hypomania can progress to mania, which may be psychotic, in which case bipolar I disorder is the correct diagnosis. If an individual does not get effective treatment for their hypomania, then it is possible that it will progress to mania, though it is not always possible.

The key difference is that whereas mania often gets out of control and causes a great deal of problems for people, hypomania is much more manageable. Mania is more serious than hypomania, causing more obvious problems with work, school, and social activities, and difficulties with relationships.

Mania and hypomania both involve periods in which an individual feels agitated or experiences a mood of energy. When ones mood switches into mania or hypomania (less extreme than mania), one can feel euphoric, energetic, or exceptionally irritable. Experiencing symptoms associated with hypomania and depression without mania suggests bipolar II disorder.

Hypomania and/or depression occurs in 11% of individuals with substance use disorders and 55% of individuals with substance-related disorders. Often, those experiencing their first hypomania episode–generally one that does not involve psychotic features–may have had a long history of or recent history of depression, or of hypomania combined with depression (known as mixed states) before onset of the manic symptoms. A mental health professional experienced in diagnosing mood disorders can determine if the hypomania diagnosis is accurate, and if it is a symptom of the underlying bipolar disorder. If you have been excluded from the list of illnesses and conditions, your primary care physician can refer you to a mental health specialist for a diagnosis of hypomania, your mental health professional can use criteria from the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders, the DSM-5.

If the hypomanic episode is lasting more than one week, is significantly interfering with functioning, or requires hospitalization, it is more likely a manic episode than a hypomanic episode. To diagnose hypomania, your healthcare provider also needs to rule out other health conditions or other mental health conditions that might explain symptoms better. Finally, if you experience repeated periods of hypomania and depressive symptoms — but not enough to meet criteria for an actual episode — the doctor can diagnose cyclothymic disorder. People are usually more likely to seek treatment when in a depressive episode than when experiencing a hypomanic episode. The consequences of misdiagnosis include inappropriate treatment and deterioration of bipolar disorder because of improper use of antidepressants, which may make hypomanic symptoms worse.

An individual with this condition can have an irritation that is not necessarily less serious than a complete manic episode; indeed, having pronounced irritation is a documented characteristic of both hypomanic and mixed episodes of Bipolar type II. Patients most often go through a phase which is initially pleasurable; but, later, possibly driven by decreased sleep accompanying the initial hypomania, the experience can shift to something far more dysphoric. Hypomania is an abnormally aroused mental state that impacts mood, thoughts, and behaviors, and is a potential symptom of bipolar disorder — especially type II.

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