What You Should Know About Mania vs. Hypomania

Medically reviewed by Timothy J. Legg, PMHNP-BC, GNP-BC, CARN-AP, MCHES on May 3, 2016Written by Ann Pietrangelo

What are mania and hypomania?

What is mania?

Mania is more than just having extra energy to burn. It’s a mood disturbance that makes you abnormally energized, both physically and mentally.

A manic episode can last a week or more. During that time, you may experience grandiose thoughts and take more chances than usual, regardless of the consequences. Mania can be severe enough to require hospitalization.

People with bipolar 1 disorder have had at least one episode of mania. Usually, manic episodes alternate with periods of major depression. Mania is the high and depression is the low of bipolar 1 disorder.

What is hypomania?

Hypomania is a milder form of mania. If you’re experiencing hypomania, you have a higher-than-normal energy level that’s not as extreme as mania. Other people notice hypomania and it causes problems but not to the extent that mania can. If you have hypomania, you won’t need hospitalization for it.

People with bipolar 2 disorder experience hypomania alternating with depression. Hypomania can also occur for other reasons, such as a drug interaction.

What are the symptoms of mania and hypomania?

• involves having a manic episode that lasts for one week or more
• may lead to hospitalization
• involves extreme risk-taking
• involves grandiose ideas
• can be a symptom of bipolar 1 disorder
• involves having higher-than-normal energy levels
• generally doesn’t lead to hospitalization
• can be a symptom of bipolar 2 disorder

Most of the symptoms of mania and hypomania are the same and include:

  • having a higher-than-normal energy level
  • being restless, or unable to sit still
  • pacing
  • having a decreased need for sleep
  • having a heightened sense of smell and touch
  • having increased self-esteem or confidence, or grandiosity
  • having a racing mind, or having lots of new ideas and plans
  • taking on too many projects
  • being extremely talkative
  • being easily distracted
  • being more sociable and outgoing
  • having decreased inhibitions
  • having increased sexual desire
  • being irritable, or quick to anger
  • being impulsive, or making rash decisions without concern for the consequences

During a manic or hypomanic phase, you may not be able to recognize these changes. If others mention that you’re not acting like yourself, you’re likely to not think that anything is wrong.

The main difference between mania and hypomania is the intensity and duration of the symptoms.

What are the causes and risk factors?

Mania and hypomania can be side effects of:

  • sleep deprivation
  • medication
  • alcohol use
  • drug use

They can also be symptoms of bipolar disorder. There are two main types of bipolar disorder. Bipolar 1 occurs when you experience both depression and mania. In bipolar 2, you have depression and hypomania.

The exact cause of bipolar disorder is unclear. Heredity may play a role. You’re more likely to develop bipolar disorder if you have a family history of the illness. It may also involve a chemical imbalance in the brain.

You’re at increased risk of mania or hypomania if you’ve already experienced an episode. You may also increase your risk if you don’t take medications for bipolar disorder as your doctor prescribed.

During a manic episode, you may do things without regard for the consequences. This can lead to substance abuse, sexual indiscretions, and extremely risky behavior.

Manic episodes can lead to serious consequences. When the mania subsides, you may be left with remorse or depression for things you’ve done during the manic episode.

How are they diagnosed?

Diagnosing mania

If you’ve never had an episode before, your doctor will take your medical history and perform a physical exam. It’s important that you tell them about all of the prescription and over-the-counter medications and supplements you take, as well as any illicit drugs you may have taken.

The symptoms must last at least a week for your doctor to diagnose them as mania. A manic episode interferes with your ability to function, and it can lead to a hospitalization.

You may also have a break with reality. Psychotic symptoms can include:

  • visual hallucinations
  • auditory hallucinations
  • delusional thoughts
  • paranoid thoughts

Mania is a symptom of bipolar 1 disorder.

Diagnosing hypomania

You must have at least three major symptoms that last at least four days for your doctor to diagnose hypomania. Hypomania causes enough of a change in your personality that other people notice, but you continue to function and there’s generally no need for hospitalization. In hypomania, there may be psychotic symptoms.

Hypomania is associated with bipolar 2 disorder, but it can occur for other reasons.

Diagnosing mania and hypomania can be complicated. For instance, you may not be aware of some symptoms or how long you’ve been having them. If you have depression but your doctor is unaware of manic or hypomanic behavior, they may diagnose you with depression instead of bipolar disorder. This can also make it more difficult to determine if you have bipolar 1 or bipolar 2 disorder.

An overactive thyroid gland can also lead to symptoms that mimic hypomania or mania.

How are hypomania and mania treated?

You can take mood stabilizers to treat mania and hypomania. However, it’s often possible to cope with hypomania without using medication.

Healthy lifestyle habits can help. Maintain a healthy diet, get a little exercise every day, and go to bed on schedule every night. Not getting enough sleep can trigger hypomania. You might also want to avoid too much caffeine.

Bipolar disorder isn’t currently curable, but it’s possible to control it. The treatment may involve antipsychotic drugs.

Mood stabilizers and antipsychotics can have serious side effects. People often need to try several different medications before their doctor discovers the right combination to treat their symptoms effectively. It’s important that you take medication as your doctor prescribes. Even if you have unpleasant side effects, it can be dangerous to stop taking them without your doctor’s supervision.

Doctors usually recommend psychotherapy as well.

Coping with mania and hypomania

Follow these tips to cope with mania and hypomania:

  • Make it a point to learn all you can about your condition. Mania and hypomania can be managed. Learn to recognize triggers so you can avoid them.
  • You might find it helpful to keep a mood diary. By charting your moods, you might be able to spot early warning signs. With your doctor’s help, you may be able to prevent the episode from worsening.
  • If you have bipolar disorder, it’s important that you stay in treatment. It might even be a good idea to get your family involved in therapy.
  • If you have suicidal thoughts, call the National Suicide Prevention Lifeline at 800-273-TALK (1-800-273-8255) or call 800-799-4TTY (4889) if you use a TTY. Trained counselors are available 24/7.
  • Reach out to others for help. You can also join a support group for people with bipolar disorder.

If you get proper treatment, you can effectively manage bipolar disorder.

Can mania or hypomania be prevented?

Mania and hypomania aren’t preventable. However, coping strategies and medications can lessen the effects of an episode.

Bipolar also isn’t preventable. If you learn to spot the early warning signs of a manic episode, you can work with your doctor to keep it under control.

You’re best defenses are to stick with your treatment plan. This includes taking your medications as your doctor prescribes.

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