Bipolar Disorder Symptoms Mania and Hypomania What Is Hypomania? 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 October 14, 2022 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 Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Laurence Dutton / Getty Images Table of Contents View All Table of Contents Definition Symptoms Diagnosis Causes Impact Treatment Coping What Is Hypomania? Hypomania is characterized by overactive energy, mood, behavior, and activity levels significantly different from your normal state of mind. These mood episodes are usually shorter in duration and less severe than mania. Hypomania is a potential symptom of bipolar disorder, particularly bipolar II disorder. A hypomanic episode commonly manifests with unusual gaiety, excitement, flamboyance, or irritation, along with other characteristics such as inflated self-esteem, extreme talkativeness, increased distractibility, reduced need for sleep, and racing thoughts. Symptoms of Hypomania The specific symptoms experienced during hypomania can vary from one person to another, and they can also change over time. Examples of hypomanic behaviors and characteristics include: Behaving inappropriately, such as making crude remarks at a dinner party Dressing and/or behaving flamboyantly Hypersexuality, which may involve making unusual demands on your partner, inappropriate sexual advances, engaging in an affair, or spending a lot of money on phone sex, pornography, or sex workers Jumping from one subject to another unrelated topic when speaking Reduced need for sleep Spending recklessly, like buying a car you cannot afford Taking chances you normally wouldn't take because you "feel lucky" Talking so fast that it's difficult for others to follow what's being said Unusual irritability, excitement, hostility, or aggression Diagnosis of Hypomania Diagnosing hypomania depends on the presence of a combination of key symptoms and features. There must be a persistent and abnormally elevated, irritable, or expansive mood accompanied by unusually increased activity and energy for most of the day over at least four days. The mood, activity, and behaviors that are present with hypomania are clearly different from a person's normal, everyday state and readily noticeable to those around them. A lack of mood fluctuation and persistence of the mood state helps distinguish a hypomanic episode from normal mood variation. It's also important to rule out medications or recreational substance use as a possible source of the symptoms before making a diagnosis of hypomania. Hypomania vs. Mania By definition, certain characteristics and features rule out a diagnosis of hypomania and often point toward a manic episode instead. For example, symptoms of psychosis—such as hallucinations or delusions—exclude the possibility of a hypomanic episode. Additionally, symptoms so severe that they significantly interfere with daily functioning or necessitate hospitalization are manic versus hypomanic. Hypomanic Episode vs. Manic Episode While manic episodes typically last a week or longer and can have severe impacts on other areas of a person's life, hypomanic episodes are a bit shorter in duration (four or more days) and often not severe enough to impact work, school, or social functioning. Bipolar Hypomania To be diagnosed with bipolar I or bipolar II disorder, a person must generally experience both depressive and manic and/or hypomanic episodes. Experiencing symptoms associated with hypomania and depression without mania suggests bipolar II disorder. Other factors may determine if another diagnosis is more appropriate, such as cyclothymia. Bipolar hypomania is considered present when a person experiences at least three of the following symptoms accompanied by a persistently elevated mood or four of these symptoms in association with a sustained irritable mood: Easily distracted Excessive involvement in activities with a high potential for negative consequences (such as spending sprees, gambling, sexual indiscretions, or risky financial investments) Feeling intensely driven to accomplish specific goals Fidgetiness, pacing, or restlessness (also known as psychomotor agitation) Flight of ideas or feeling like your thoughts are racing Grandiose thinking, meaning unrealistic thoughts about your powers, talents, or abilities Reduced need for sleep without feeling tired Unusual talkativeness or feeling pressured to keep talking Hypomania and bipolar disorder are diagnosed separately, so receiving a diagnosis of hypomania does not necessarily mean also being diagnosed with bipolar disorder and vice versa. Overview of Bipolar I and Bipolar II Disorder Causes of Hypomania While hypomania can be a symptom of bipolar disorder, this state can occur for other reasons as well. Some of the potential causes of hypomania include the following. Alcohol or Drug Use Hypomania and/or depression occur in 11% of people with substance use disorder and 55% of people with substance-related impairment. Changes in Sleep Patterns Insomnia is associated with hypomanic experiences in some individuals, particularly if the circadian rhythm is consistently disrupted. Although, more research is needed to confirm whether sleep issues cause hypomania or if hypomania causes sleep issues. Depression Depression can be part of bipolar disorder, but it can also exist on its own and co-occur with hypomania. In some cases, it is the treatment of depression that leads to hypomania. This is called antidepressant-associated hypomania and occurs in 0.3% to 22.4% of people using depression medications. Genetics Research on twins suggests that hypomania may be inherited genetically, with this risk being greater for males (59%) than for females (29%). High Levels of Stress A study involving 99 students in an emergency medicine residency program found that not only did the students' levels of stress increase significantly over the course of the program, but the rate of hypomania increased significantly as well. These findings suggest that higher levels of stress may contribute to the development of hypomanic behaviors. Medication It's also possible that the medicines you're taking could lead to hypomania. Escitalopram is one, which is a medication often used to treat both depression and generalized anxiety disorder. It is better known by the brand name Lexapro. Herbal Supplements Like medication, herbal supplements are not without their risks, and some have been linked with psychiatric symptoms. There are reports of large combinations of herbal supplements causing symptoms of hypomania when taken together over a prolonged period of time. Impact of Hypomania Even in the absence of the psychosis and wildly exaggerated moods associated with mania, hypomania can have serious long-term consequences. Hypersexuality can lead to ruined relationships and sexually transmitted infections (STIs), for instance. Reckless spending can result in severe financial hardship and engaging in inappropriate behaviors can cause you to lose your job or alienate your loved ones. To be transparent, not all impacts are negative. For instance, one case study found that hypomania appears to increase aerobic capacity and cardiopulmonary functioning, potentially through increased mobility and hypomania-related goal-directed behavior. Increases in energy can also help you get more done; confidence increases help you feel good mentally; and you may even notice more creativity. The one thing to remember, though, is that these benefits are often associated with pure euphoric hypomania, which is uncommon as hypomania typically morphs into something more negative than positive. Hypomania Treatment The use of medications called mood stabilizers is the most common and effective way to treat hypomania, a healthcare provider may prescribe one or more of the following: Antipsychotics, which can reduce hypomania symptoms until other medicines (such as lithium or valproic acid) take full effect Benzodiazepines, or anti-anxiety drugs Lithium, a mood stabilizer with antidepressant effects Valproic acid, an anticonvulsant There are also holistic approaches and lifestyle changes that can help in the treatment of hypomania, including: Avoiding stimulants that could act as triggers such as caffeine, sugar, and loud, crowded social scenes all fall into this category Eating meals regularly Exercising daily Getting seven to eight hours of sleep each night Treatment Options for Bipolar Disorder Coping With Hypomania If you've been experiencing hypomania-like symptoms, make an appointment with a mental healthcare provider such as a psychiatrist. A mental health professional with experience in diagnosing mood disorders can determine if a diagnosis of hypomania is accurate and whether it's a symptom of underlying bipolar disorder. In the meantime, here are a few tips to help you cope with symptoms of hypomania: Educate yourself. The more you learn about hypomania and your individual symptoms and triggers, the easier it becomes to manage your condition. Keep a mood diary. Writing in a journal or using an app can help you chart your moods so you and a healthcare provider can work together to keep your hypomanic episodes under control. Stay the treatment course. If you do have bipolar disorder, seeking treatment and complying with your treatment is important to managing hypomania. Ask for support. Whether you reach out to trusted friends and family members or join a support group for people with similar symptoms, it can be beneficial to ask for help. If you or a loved one are struggling with hypomania, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. The Best Online Bipolar Disorder Support Groups 17 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. National Collaborating Centre for Mental Health Commissioned by the National Institute for Health and Care Excellence. Bipolar disorder: The assessment and management of bipolar disorder in adults, children and young people in primary and secondary care. Substance Abuse and Mental Health Services Administration. 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Neurosci Biobehav Rev. 2018;89:119-131. doi:10.1016/j.neubiorev.2018.02.008 Stanton K, Khoo S, Watson D, Gruber J, Zimmerman M, Weinstock L. Unique and transdiagnostic symptoms of hypomania/mania and unipolar depression. Clin Psychol Sci. 2018;7(3):471-487. doi:10.1177/2167702618812725 Swift Yasgur B. Antidepressant-associated hypomania: Navigating clinical challenges. Psychiatry Advisor. Hosang G, Martin J, Karlsson R, et al. Association of etiological factors for hypomanic symptoms, bipolar disorder, and other severe mental illnesses. JAMA Psychiat. 2022;79(2):143-150. doi:10.1001/jamapsychiatry.2021.3654 Rahmati F, Safari S, Hashemi B, Baratloo A, Khosravi Rad R. Prevalence of depression and personality disorders in the beginning and end of emergency medicine residency program; a prospective cross sectional study. Arch Acad Emerg Med. 2019;7(1):e5. PMID:30847440 Yamaguchi Y, Kimoto S, Nagahama T, Kishimoto T. Dosage-related nature of escitalopram treatment-emergent mania/hypomania: a case series. Neuropsychiatr Dis Treat. 2018;14:2099-2104. doi:10.2147/NDT.S168078 Kazi S, Karia R, Leontieva L. Herbal supplements: Can they cause hypomania?. Cureus. 2021;13(2):e13476. doi:10.7759/cureus.13476 Shoval A, Armstrong H, Vakhrusheva J, Ballon J, Bartels M, Kimhy D. The impact of hypomania on aerobic capacity and cardiopulmonary functioning—A case report. Front Psychiatr. 2018;9:729. doi:10.3389/fpsyt.2018.00729 Takeshima M. Treating mixed mania/hypomania: A review and synthesis of the evidence. CNS Spectr. 2017;22(2):177-185. doi:10.1017/S1092852916000845 Qureshi NA, Al-Bedah AM. Mood disorders and complementary and alternative medicine: A literature review. Neuropsychiatr Dis Treat. 2013;9:639-658. doi:10.2147/NDT.S43419 Additional Reading Faedda GL, Baldessarini RJ, Marangoni C, et al. An International Society of Bipolar Disorders task force report: Precursors and prodromes of bipolar disorder. Bipolar Disord. 2019;21(8):720-740. doi:10.1111/bdi.12831 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? Other Helpful Report an Error Submit Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.