Hypomania

Hypomania happens when your mood, energy and activity level become higher than usual. It’s shorter and less severe than mania (manic episodes).

You may need little sleep, talk more or feel like you can take on many tasks at once. You may also feel unusually confident or even invincible. These changes are different from your normal self and noticeable to others. Hypomania usually doesn’t cause major problems in your daily life and doesn’t typically require hospital care.

Hypomania is a symptom of bipolar disorder, but it can also appear in other conditions. A healthcare provider can help you understand the cause and find the right treatment.

What is a hypomanic episode?

A hypomanic episode is the active period when your mood, behavior and energy level are much higher than usual. Symptoms last most of the day, almost every day, for at least four days in a row.

Even though the symptoms are less severe and may not disrupt your daily life as much as mania, they may still put you at risk of harm.

Hypomania signs and symptoms

Hypomania can build slowly, so you may not notice the changes at first. Loved ones often see the shift before you do. Common signs include:

• Acting on impulses and getting involved in risky activities, like overspending, unsafe sexual behavior or unwise business decisions
• Feeling unusually driven and taking on more social, work, school or sexual activities
• Moving in restless or agitated ways, like pacing or fidgeting
• Talking more than usual or finding it hard to stop talking

What does hypomania feel like?

The experience of hypomania can vary from person to person. Common symptoms include:

• Feeling overly confident or having inflated self-esteem (like believing you can’t fail, even without experience)
• Getting distracted easily by things that aren’t important (like switching tasks often or jumping from one idea to another)
• Having an elevated, excited or irritable mood (like feeling upbeat and driven for days in a row)
• Having racing thoughts or many ideas at once (like quickly jumping from topic to topic or talking very fast)
• Having very high energy or activity levels (like cleaning nonstop or working on projects for many hours)
• Sleeping much less than usual (like staying up until 3 a.m. or not sleeping at all and feeling fine the next morning)

What happens after a hypomanic episode?

After a hypomanic episode, you may feel:

• A drop in your mood
• Like you can’t remember all of what happened during the episode
• Proud of what you did or uneasy about how you acted
• Stressed by the tasks or plans you took on
• Worn out and need more sleep than usual

What causes hypomania?

Researchers don’t fully understand the exact cause of hypomania. They believe it develops from a mix of genetic factors, brain chemistry and life experiences. These can affect how your brain regulates mood, energy and judgment.

You may have a higher chance of having hypomania if you live with a mental health disorder (like bipolar II disorder or cyclothymia) or have relatives with bipolar disorder. You may also have a higher risk if you have a brain injury, brain tumor or stroke.

Hypomania triggers

Certain things may increase the chance of a hypomanic episode. These triggers can vary from person to person. Some common triggers include:

• A medication reaction (like some antidepressants and steroids)
• Dealing with ongoing stress or trauma
• Experiencing major shifts in your sleep routine
• Going through major life changes like a move or loss
• Substance use disorder

A healthcare provider can help you identify what may be triggering symptoms.

How doctors diagnose hypomania

Your healthcare provider will start by asking about your medical history and your biological family’s health background. They’ll also review all the medicines, supplements and herbal products you use. They may order blood tests, urine tests or imaging studies to rule out other medical issues that can look like hypomania.

If they don’t see a physical cause, your provider may connect you with a mental health provider to make a diagnosis.

Diagnostic criteria for hypomania

A mental health provider uses the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to decide if your symptoms meet the definition of hypomania.

To diagnose this symptom and its cause, your provider looks for:

• A clear period when your mood and energy are much higher than usual. This must last at least four days in a row and be noticeable most of the day.
• Several symptoms that are different from your normal behavior. These may include feeling unusually confident, sleeping less, talking more, having racing thoughts, being easily distracted, feeling driven to do many tasks or taking part in risky activities. Your provider will decide if enough symptoms are present based on what you’ve already described.
• A noticeable change in how you act or function. This change must be clear to the people around you.
• Symptoms that don’t cause major problems at work, school or home and don’t require hospital care. If psychosis is present (hallucinating or delusions), the episode is considered mania instead.
• Symptoms that don’t come from addictive substances, medications or another medical condition.

Your provider may also look at how your symptoms responded to past treatments. They’ll use all of this information to make the most accurate diagnosis.

Hypomania treatment

Treatment is personalized for hypomania. Your provider might recommend medications, therapy, self-care or a combination of these to manage symptoms.

Medication for hypomania

Your provider might offer different medications to manage hypomania. These may include:

• Antipsychotics
• Mood stabilizers
• Short-term sedatives

Talk with your provider about possible side effects before starting any medication. They’ll explain what to watch for and help you choose what’s safest for you. Some medicines may be unsafe if you’re pregnant or planning to become pregnant.

Therapy for hypomania

Your provider may suggest talk therapy to help you understand why this symptom happens and to build skills that make it easier to manage. Different kinds of therapy may be helpful:

• Cognitive behavioral therapy: This approach teaches you how to recognize unhelpful thinking patterns and replace them with more balanced thoughts.
• Family therapy: This gives your family or close supporters a chance to learn about hypomania (and its cause) and how they can help you during mood changes.
• Support groups: These groups connect you with people who have similar experiences. You can share tips, coping strategies and ways to take care of yourself.

Hypomania self-care

Your provider may encourage you to focus on self-care to help keep your mood as steady as possible. You may find these steps helpful:

• Avoid things that can overstimulate you, like coffee, tea, cola, sugar and loud, crowded places.
• Avoid addictive substances.
• Follow a healthy eating plan, like the Mediterranean diet or DASH diet.
• Get about 30 minutes of exercise on most days.
• Go to bed at the same time each night and aim for six to nine hours of sleep.
• Practice relaxation skills, like yoga, meditation or aromatherapy.

How long does a hypomanic episode last?

An episode lasts at least four days. It can continue for several weeks or longer. The length depends on the underlying cause. Treatment may reduce the length.

When should hypomania be treated by a healthcare provider?

You should call your provider if symptoms:

• Last more than a few days
• Start to get worse
• Lead to risky behavior (like overspending, driving unsafely or sleeping very little)

Getting help early may keep it from turning into a more serious manic episode or leading to harmful consequences.

Contact your provider right away if you have suicidal thoughts. You can always reach out to the Suicide and Crisis Lifeline at 988 (U.S., call or text). Someone is available 24/7.