Hypomania Vs. Mania: What Is the Difference?

What Is Hypomania Vs. Mania?

Mania and hypomania are mood states that occur in bipolar disorder. Mania is more severe and can cause major issues in one’s personal and professional life.¹ In some cases, an individual can experience delusions, hallucinations, and suicidal ideation.¹ To be diagnosed with mania, symptoms must last for at least one week.

Hypomania is also characterized by elevated mood, increased activity, and other manic symptoms, but individuals are not as impaired, and symptoms are often not as noticeable to acquaintances. Another difference is that hypomania lasts at least four days. However, if the individual requires hospitalization, this is considered mania even if symptoms have not lasted one week.¹ Additionally, hypomania does not include psychotic features.

Hypomania & Mania in Bipolar I Vs. Bipolar II

The key differences between hypomania and mania are crucial for distinguishing between bipolar I and bipolar II. Bipolar I involves full-blown manic episodes, while Bipolar II involves hypomanic episodes. While both conditions can involve periods of depression, Bipolar II is often marked by more frequent and prolonged depressive episodes. Understanding these distinctions helps in accurately diagnosing each type of bipolar disorder.²

What Are the Differences Between Mania & Hypomania?

Symptoms of Hypomania Vs. Mania

Hypomania versus mania symptoms have differences in the intensity and duration of features. Overall, hypomanic symptoms are less severe and last for a shorter period of time.

Common symptoms of mania and hypomania include:

• Decreased need for sleep
• Increased self-esteem and confidence
• Feeling more talkative than usual
• Feeling more social or sexual than usual
• Bursts of energy and feelings of restlessness
• Many different ideas and thoughts
• New interest in hobbies
• Spending more money than usual
• Self-destructive behaviors

Symptoms of mania that do not occur in hypomania include:

• Psychosis
• Delusions
• Hallucinations
• Major personal and professional impairments
• Little to no insight into episodes
• Hospitalization

Causes & Triggers for Hypomania Vs. Mania

Although the exact cause of mania and hypomania is not known, there is strong evidence for psychological, social, and genetic factors. Research strongly supports a genetic component of bipolar disorder.¹ Stressful life events also have links to triggering hypomanic and manic episodes.¹ Environmental triggers for hypomania and mania include antidepressants, brain stimulation, energy drinks, hormonal changes, seasonal changes, and viral infections.⁴

Diagnosis of Hypomania Vs. Mania

The diagnosis of hypomania versus mania primarily hinges on the severity, duration, and impact of symptoms on daily functioning. Healthcare professionals will conduct a clinical interview with a patient and, sometimes if allowed, a family member to determine whether the individual is experiencing hypomanic or manic symptoms.

Individuals who are experiencing mania are easily diagnosable due to the severity of their symptoms. In contrast to mania, hypomania is sometimes more difficult to diagnose because it is less severe and noticeable. Oftentimes, hypomania’s predominant symptoms are depressive, which can result in individuals with bipolar being misdiagnosed.⁵ Hypomania actually occurs in 12% of people who initially had a major depressive disorder diagnosis.⁵

Here are the criteria used in the DSM-5 to diagnose bipolar I mania:⁶

• At least one manic episode with or without a history of depressive episode(s)
• Symptoms either last one week or require hospitalization
• Three or more symptoms of either inflated self-esteem, decreased need for sleep, more talkative, flights of ideas, distractibility, increase in goal-directed activity, or excessive involvement in pleasurable activities with a high risk of painful consequences
• Mood disturbance is severe and not caused by substances

Here are the criteria used in the DSM-5 to diagnose bipolar II hypomania:⁶

• No previous episodes of mania
• History of at least one hypomanic and one depressive episode
• Occurrence of mood episodes is not better explained by schizophrenia or related disorders

Impact of Being Hypomanic Vs. Manic

Individuals with hypomania generally lead relatively productive and stable lives. Sometimes, hypomania is even misconstrued as being productive. Mania, however, tends to have such severe negative symptoms that friends, family, and colleagues confront the individual about their episodes.

Treatment of Hypomania Vs. Mania

Mood stabilization is the initial goal of treating mania and hypomania. Medications for mania include mood stabilizers and antipsychotics, while hypomania sometimes uses mood stabilizers, antidepressants, and anti-anxiety medications. Therapies that are commonly used include dialectical behavior therapy (DBT), interpersonal and social rhythm therapy, and cognitive behavioral therapy (CBT) for bipolar disorder. Psychoeducation, lifestyle changes, and social support are other interventions that follow mood stabilization.

Treatment Differences for Mania Vs. Hypomania

How to Cope With Hypomania & Mania

Having a routine with therapy, primary care, and psychiatry visits can help manage symptoms. Coping with hypomania and mania involves lifestyle changes, stress management, and strong support systems. Self-monitoring is an important piece of treatment to develop insight into warning signs of mood episodes. Additionally, developing a crisis plan can help stabilize symptoms before hypomania transitions into mania.

Here are eight tips for how to cope with mania and hypomania:

• Therapy and counseling: Seeking therapy or counseling can help someone receive psychoeducation on mania and hypomania symptoms. Through therapy, a person can learn the warning signs for episodes and use preventative measures to mitigate episodes.
• Medication adherence: Developing a medication routine can help prevent fluctuations of bipolar medications in the bloodstream and consequential triggering of episodes. 20-60% of patients become non-compliant with medications, which often leads to dropping out of treatment completely.⁷
• Self-monitoring techniques: Therapy can help you develop self-awareness toward recognizing the early signs of mood escalation. Mood diaries or apps, such as Daylio, can help track emotional states and triggers for mania and hypomania.
• Stress management: Heightened stress can trigger mood episodes and exacerbate symptoms. Stress reduction techniques such as mindfulness, meditation, deep breathing exercises, and progressive muscle relaxation can help foster an important mind-body connection and support emotion regulation patterns.
• Developing a support system: A strong support system is vital for bipolar disorder treatment. Supports can be used in therapy to increase adherence to treatment plans, sometimes helping with administering medications, taking family members to therapy, or encouraging positive coping skills.
• Regular sleep patterns: Sleep deprivation can trigger mania and hypomania episodes and increase the severity of symptoms. Sleep deprivation can also lead to disturbances in mood regulation the following day. Regulate sleep through medication, psychological interventions, and light therapies.⁸
• Avoiding stimulants and alcohol: Substances can exacerbate irritability, mess with sleep schedules, and interact with bipolar medications. Completely avoiding the use of drugs and alcohol is the best way to avoid negative treatment outcomes.
• Crisis planning: A therapist can help you develop a crisis plan if symptoms escalate. Safety plans often include a support person, emergency contact information for local mental health and medical services, and steps to take in case of severe episodes. Notifying your support person of the crisis plan can help everyone involved plan for exacerbations in symptoms.

How to Prevent Hypomania From Escalating

Catching hypomanic symptoms early can prevent escalation into mania. Medication adherence, stress management, and monitoring moods are strategies to stabilize mood and mitigate episodes. Having a diary or place where you track moods, medications, side effects, and lifestyle goals can help you develop a routine around the prevention of hypomania. You can also bring this diary or tracker with you to appointments with your treatment providers.

Can You Prevent Mania or Hypomania From Happening at All?

Mania and hypomania in the context of bipolar disorder are not curable. It is possible to identify your warning signs and triggers to help mitigate and prevent escalations into episodes. Although it is not possible to completely stop manic and hypomanic episodes, many times, it is possible to stop a hypomanic episode from developing into a manic episode if symptoms are caught early enough.

When to Seek Professional Support

If mania and hypomania symptoms such as increased agitation, self-destructive behaviors, or spending and gambling sprees cause personal, relationship, and professional issues, it is likely that you need professional support. An online therapist directory or online therapy platform can help you secure a therapist familiar with mania and hypomania symptoms. Online psychiatrist options can offer medication management.