Hypomania: Signs, Symptoms, & Treatment

What Is Hypomania?

Hypomania is a period of heightened energy levels and elevated mood commonly associated with disorders like bipolar and depression. A hypomanic episode must last a minimum of four days but can continue for months, depending on the person and the severity of symptoms. Regardless of duration, those experiencing an episode exhibit uncharacteristic behavior that deviates from the norm.

Hypomania in Bipolar Disorder II

People often associate hypomanic episode symptoms with bipolar disorder, specifically bipolar II. For those with this condition, individuals cycle between bipolar hypomania and depression.¹ In these cases, they experience bipolar without mania and longer, more frequent depressive episodes.

Hypomania Symptoms & Signs

Symptoms of hypomania vary based on various factors, including the underlying mental health condition, situation, and external stressors. However, people often appear abnormally moody, active, or energized.¹ Some may feel a decreased need for sleep or struggle with insomnia, while others may exhibit increased self-confidence, a heightened ego, or arrogance.

Here are some of the other behavioral and emotional signs of hypomania:

• Decreased need for sleep
• Agitation or irritability
• Talking more than normal
• Risky behavior
• Grandiosity
• Inflated self-esteem
• Feeling powerful
• Racing thoughts
• Difficulty concentrating or focusing
• Feeling overly excited or happy
• Appearing restless

Hypomania Vs. Mania

Experts generally consider hypomania a scaled-down version of mania. The main difference between the two is that symptoms of mania last longer than a week and are often more severe. Those experiencing hypomania can typically manage daily responsibilities at work, school, or home, while mania can significantly impair functioning.

Differences Between Mania & Hypomania

Hypomania Triggers & Causes

What triggers hypomania differs from person to person, and experts have not determined a single cause of symptoms. However, a common theme is irregular brain function and neurochemical imbalances. Additionally, certain medications can increase the risk of an episode. In other cases, stress, life transitions, poor sleep, and genetic factors can influence the onset of hypomania.

Below are possible causes and triggers of hypomania:

• Genetic predispositions: Some evidence suggests having a family history of bipolar or another mood disorder increases the risk of hypomania.
• Neurochemical imbalances: Neurotransmitter imbalances (i.e., noradrenaline, serotonin, and dopamine) can contribute to hypomania in some individuals.
• Stressful life events: Stress is a common precipitating factor for hypomanic episodes.
• Substance use: Substance misuse can impact chemicals in the brain responsible for mood, memory, and normal functioning. These impairments may increase the likelihood of experiencing hypomania.
• Poor sleep: Sleep is essential for healthy brain activity and functioning. Lacking adequate sleep can cause chemical imbalances, dysregulated mood, and stress.
• Significant changes: Specific life transitions, like moving, starting/ending a relationship, death, birth, and employment changes, increase the risk of hypomania.

How Is Hypomania Diagnosed?

Mental health professionals will use hypomania DSM–5 criteria to guide a diagnosis. A typical evaluation will include multiple assessments, personal and family history reviews, and screening tools. Because hypomania symptoms can present differently, providing detailed information about your experience is crucial to obtaining an accurate diagnosis.

The DSM-5 hypomania criteria include:

• Abnormal and elevated emotions
• Unusual energy and activity levels
• Symptoms last at least four days
• Episode does not significantly impact work, school, or social functioning
• Symptoms do not require hospitalization
• Episode does not stem from substance use or a medical condition

Hypomania Treatment Options

Treating hypomania means seeking education, therapy, and medications.² Treatment can help mitigate mood swings and help individuals manage their symptoms. Recognizing the early signs of hypomania is crucial so people can receive the support they need and work toward stabilization and health.

Medications

Medications for hypomania generally include antipsychotics and mood stabilizers. These options are well-studied and can provide symptom relief for those managing mood disorders.² Consult your healthcare team to find the right medication and dose for your concerns.

Antipsychotic medications used to manage hypomania include:³

• Aripiprazole (Abilify)
• Lurasidone (Latuda)
• Olanzapine (Zyprexa)
• Quetiapine (Seroquel)
• Risperidone (Risperdal)

Mood stabilizers used to manage hypomania include:

• Lithium
• Valproate (Depakote)
• Carbamazepine (Tegretol)

Psychotherapy

Therapy can help you learn to anticipate, understand, and manage hypomania symptoms. A therapist can assist you in self-exploration to determine what triggers episodes and what coping skills best suit your situation and needs. For those living with bipolar disorder, interpersonal and social rhythm therapy and dialectical behavior therapy are especially beneficial.²

How to Cope With Hypomania

Many people may wonder, “How long does hypomania last?” Because everyone experiences symptoms differently, the duration and frequency of episodes vary significantly. For this reason, developing ways to manage hypomania outside therapy is essential.

Simple lifestyle changes like eating nutritious food, sleeping enough, and exercising can improve overall mood and stability. However, what works for someone else may not meet your needs. Experiment with different approaches so you can learn to live well with bipolar or hypomania.

Here are six strategies for coping with hypomania:

1. Establish a Routine

Prioritizing regular sleep, work, rest, and play leaves less room for unexpected events and change because you know what to expect every day. Stress often precedes hypomanic symptoms, so having control over specific aspects of your life can reduce the likelihood of an episode.

2. Practice Mindfulness & Relaxation Techniques

Relaxation is invaluable when coping with hypomania. Mindfulness means tuning into your inner world, thoughts, and feelings to increase self-awareness and emotional regulation. Recognizing your emotions in the moment allows you to address them rather than let them fester or worsen.

Here are some mindfulness and relaxation techniques to try:

• Box breathing 
• 5-4-3-2-1 method for anxiety
• Yoga
• Walking through nature
• Coloring
• Journaling
• Listen to calming music
• Gardening

3. Build a Support System

Your support system can help provide valuable insight and guidance when coping with hypomania. You may not notice symptoms as they develop, but your loved ones can often catch subtle changes in your behavior, mood, or demeanor. Find trusted individuals with whom you feel comfortable sharing your emotions and experiences. Sometimes, talking with a friend or family member can offer clarity about managing hypomania.

4. Journal Your Thoughts

Journaling is a great way to develop insight and self-acceptance. Be completely honest and avoid filtering out any negative thoughts or feelings. Your writing doesn’t need to be perfect, so don’t stress about grammatical errors or misspellings. Journaling is also helpful for tracking moods or cause-and-effect patterns in your life.

Below are journal prompts when coping with hypomania:

• Daily mood logs: Rate your day on a mood scale of +10 to -10. +10 represents mania, 0 is neutral, and -10 represents depression. Regular practice can help you catch cycles and determine what events trigger hypomania.
• Trigger identification: Writing about what leaves you sad, mad, or confused can help you identify areas that need improvement.
• Reflective writing prompts: Many worksheets and writing prompts are available online. These tools are helpful for self-reflection.
• Free-flowing thoughts: Set a timer and write as much as possible within this time frame. Brain dump everything on the paper. Reflect on what you write afterward to gain insight into your internal dialogue and thought patterns.

5. Educate Yourself

Understanding hypomania empowers you as you learn to live with and manage symptoms. Psychoeducation also shows that your experience is not abnormal and you are not alone. Additionally, your loved ones can benefit from learning more about your condition. For example, recognizing the early signs of a hypomanic episode means they can alert you of concerning behavior beforehand.

Here are some ways to educate yourself and your loved ones about hypomania:

• Read reputable sources on bipolar disorder and hypomania
• Attend workshops and seminars
• Utilize online resources and mobile apps
• Ask your doctor questions

6. Build Time to Relax

Everyone needs rest so the body and mind have time to recharge. Relaxation comes in many forms, but focus on finding fun, meaningful, or pleasurable activities. Finding joy throughout the day can help you cope with challenges, build resiliency, and reserve mental, physical, and emotional energy.

When to Seek Professional Support

Sometimes, professional support is necessary when dealing with hypomania. Working with a therapist can be a life-changing experience, so consider reaching out if you struggle with managing symptoms on your own. You can find a provider specializing in bipolar on an online therapist directory or online therapy platform. Psychiatry is also available for receiving medication management and symptom relief.