Bipolar Disorder Symptoms Mania and Hypomania Understanding the Symptoms of Bipolar Mania Recognizing the 6 Signs of a Manic Episode By Marcia Purse Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial process Updated on April 06, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Amy Morin, LCSW, Editor-in-Chief Print Table of Contents View All Table of Contents Symptoms Diagnosis Mania and hypomania are phases of bipolar disorder characterized by elevated "highs" in mood and behavior that are in stark contrast to the depressive "lows" of the emotional cycle. Mania is a facet of type I bipolar disorder in which the mood state is abnormally heightened and accompanied by hyperactivity and a reduced need for sleep. By contrast, hypomania (often described as "mania-light") is a type II bipolar disorder which neither has the range nor severity of symptoms that classic mania has. If left untreated, bipolar mania can spin out the control and affect your ability to function on a daily basis. Recognizing the symptoms is the first step toward seeking the appropriate treatment and care. Verywell / Nusha Ashjaee Symptoms The appearance of one or two symptoms of mania doesn't necessarily mean that you have bipolar disorder. There may be other explanations for your sudden change in mood, including an emotional trauma, a brain injury, a drug reaction, or an undiagnosed anxiety disorder. Broadly speaking, bipolar mania can be characterized by some or all of the following features: Changes in thought patternsDevelopment of psychosisImpaired judgmentMood changesSpeech disruptionsSudden changes in energy and activity You wouldn't necessarily have all of these features to be diagnosed as manic or hypomanic. Instead, your doctor would review your symptoms and see if they meet the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) issued by the American Psychiatric Association. To better understand the nature of these symptoms, you would need to explore the root behaviors that characterize bipolar mania. Changes in Thought Patterns Changes in thought patterns are easily spotted by those with whom the person has regular interactions. They may manifest as a sudden burst of creative insight or appear fractured and nonsensical. Examples include: An increased focus on religion or religious activity Disorientation or disjointed thinking Enhanced creativity or inventiveness (often perceived as a "breakthrough" or an epiphany) Flight of ideas (a rapid succession of thoughts that shoot from one idea to the next) Racing thoughts (a rapid stream of thought, often repetitive) Development of Psychosis Psychosis is a severe manifestation of bipolar disorder which can affect people in a manic or depressive mood state. Psychosis is defined as a break from reality which typically requires medical treatment and hospitalization. It is not a feature one would expect to see in a hypomanic phase. Symptoms may include: Delusions (believing things that are not real) Hallucinations (hearing, seeing, smelling, touching, or feeling things that are not real) Paranoia (fearing things that are not real) The symptoms of psychosis tend to match the mood state. If it occurs during a manic phase, you may believe you have special powers and engage in reckless behaviors. If bipolar psychosis occurs during a depressive episode, you may believe that someone is out to harm you. Impaired Judgment Impaired judgment can often be missed by casual observers who may dismiss the behavior as either a momentary lapse or a sudden burst of generosity, passion, daring, or goodwill. At times, the behavior may be risky , hurtful, or even dangerous. Examples include: An apparent lack of insight into the consequences of an action Extreme impulsiveness (including gambling and risk-taking) Inappropriate humor and brash behavior Hypersexuality and sexually provocative behaviors Reckless and extravagant spending (including the lavishing of gifts on friends, casual acquaintances, and even strangers) Mood Changes Mood changes are characterized by a sudden burst of activity, often described as being as being outsized or larger than life. These changes would be long-lasting rather than transient and be uncharacteristic of your natural mood state. Symptoms may include: An expansive mood Extreme excitability Grandiosity and imperiousness Sudden shifts to extreme irritability, hostility, or even anger Speech Disruptions Speech disruptions are probably the easiest way to recognize a manic episode. A person may be described as having a "motor mouth" and be difficult or even impossible to interrupt. Speech disruptions may include: Clang associations (a serious condition in which words that sound similar are grouped together even if they don’t make any sense) Incoherent speech (often described as rambling and persistent) Rapid, pressured speech (as if you cannot get enough words in) Sudden Changes in Energy It is one thing to have a sudden rush of energy; it is an another when the energy is relentless, prolonged, and overwhelming. As with mood changes, the sudden upshot of energy would not be considered normal and can switch off as quickly as it was switched on. Symptoms may include: A decreased need for sleep with little apparent fatigueA sudden increase in goal-oriented activities (such as a project that needs to be done to the exclusion of other activities)Persistent and often purposeless movementRestlessness and an inability to remain still Diagnosis According to the DSM, bipolar mania can be diagnosed if you experience at least three of the following symptoms for no less than a week: An increased interest in goal-oriented activitiesAn increased pursuit of risky or dangerous activitiesBeing easily distractedFlight of ideasHigh self-esteemIncreased rate of speechReduced need for sleepPsychomotor agitation (such as pacing or hand-wringing) If you are experiencing manic symptoms that are impairing your ability to function, find a mental health professional in your area able to diagnose your symptoms and offer treatment, if needed. You can ask your family doctor for a referral or contact the National Alliance on Mental Illness (NAMI) hotline at 800-950-NAMI from Monday to Friday, 10:00 a.m. to 6:00 p.m. Eastern Time. 11 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Gold AK, Sylvia LG. The role of sleep in bipolar disorder. Nat Sci Sleep. 2016;8:207-14. doi:10.2147/NSS.S85754 Burton CZ, Ryan KA, Kamali M, et al. Psychosis in bipolar disorder: Does it represent a more "severe" illness?. Bipolar Disord. 2018;20(1):18-26. doi:10.1111/bdi.12527 Diagnosing Bipolar Disorder in Adults. NYU Langone Health. Abdel hamid AAL, Nasreldin M, Gohar SM, Saleh AA, Tarek MA. Sexual and Religious Obsessions in Relation to Suicidal Ideation in Bipolar Disorder. Suicide Life Threat Behav. 2019. doi:10.1111/sltb.12540 Lima IMM, Peckham AD, Johnson SL. Cognitive deficits in bipolar disorders: Implications for emotion. Clin Psychol Rev. 2018;59:126-136. doi:10.1016/j.cpr.2017.11.006 Culpepper L. The diagnosis and treatment of bipolar disorder: decision-making in primary care. Prim Care Companion CNS Disord. 2014;16(3). doi:10.4088/PCC.13r01609 Bipolar disorder. National Institute of Mental Health. 2018. Downey J, Friedman RC, Haase E, Goldenberg D, Bell R, Edsall S. Comparison of Sexual Experience and Behavior between Bipolar Outpatients and Outpatients without Mood Disorders. Psychiatry J. 2016;2016:5839181. doi:10.1155/2016/5839181 Fiedorowicz JG, Endicott J, Leon AC, Solomon DA, Keller MB, Coryell WH. Subthreshold hypomanic symptoms in progression from unipolar major depression to bipolar disorder. Am J Psychiatry. 2011;168(1):40-8. doi:10.1176/appi.ajp.2010.10030328 Brout JJ, Edelstein M, Erfanian M, et al. Investigating Misophonia: A Review of the Empirical Literature, Clinical Implications, and a Research Agenda. Front Neurosci. 2018;12:36. doi:10.3389/fnins.2018.00036 Carlino AR, Stinnett JL, Kim DR. New onset of bipolar disorder in late life. Psychosomatics. 2013;54(1):94-7. doi:10.1016/j.psym.2012.01.006 Additional Reading Canuso, C; Bossie, C.; Zhu, Y. et al. Psychotic symptoms in patients with bipolar mania. J Affective Dis. 2008;11(2-3):164-9. DOI: 10.1016/j.jad.2008.02.014. National Institute of Mental Health: U. S. Department of Health and Human Services. Bipolar Disorder. Bethesda, Maryland; updated April 2016 By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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