Managing Hypomanic and Manic Episodes
If you’ve never experienced a manic episode, you might think that it sounds funny or even useful to go through periods of extreme energy, talkativeness, wakefulness and concentration; just imagine what you could accomplish with all that extra focus and energy! But that’s only one side of a manic episode and in reality, hypomania and mania can be difficult, debilitating, and even dangerous for those who have been experienced it.
These episodes are also often preceded or followed by periods of severe depression which can send sufferers on a rollercoaster ride of highs and lows that can have a negative effect on their quality of life. If you or someone you love has experienced hypomania or mania, here’s everything you need to know about these complicated mood states and how you can manage them and how you can cope with them when they happen.
Hypomania and Mania Defined
Manic and hypomanic episodes are mood states that are characterized by elevated emotion and energy levels, an inability to sleep or decreased need for sleep, a heightened desire for social interaction, unusually high levels of self-esteem, and an increased ability to complete tasks or desire to achieve unattainable goals.  They can also be marked by racing thoughts, an intense focus on unimportant or menial tasks, irritability, agitation, and worst of all, an unusual lack of inhibition, which can cause the person to engage in risky or even dangerous behavior.
Hypomania and mania share many of the same characteristics but have a few key differences.  Hypomania is considered a less severe and higher functioning form of mania but can sometimes lead into a full-blown manic episode. Mania is more severe and can be characterized by a potentially dangerous feeling of invincibility and psychotic symptoms (i.e. visual or auditory hallucinations or delusional or paranoid thoughts) that can affect one’s ability to perceive what is real and what is not. While hypomania is generally more manageable, mania can sometimes be so severe that patients require hospitalization.
Who is Affected?
Hypomania and mania are perhaps most commonly associated with the three main types of bipolar disorder: bipolar I, II, and cyclothymia.  While hypomania can happen to anyone, full mania only occurs in bipolar patients.
If a person has experienced at least one severe manic episode lasting at least seven days or requiring immediate hospitalization, with or without depressive symptoms, they are classified as bipolar I. If someone has experienced a pattern of less severe hypomanic episodes they would be diagnosed with bipolar II. Finally if a patient has experienced numerous periods of less severe hypomanic and depressive symptoms for two years or more, they would typically be diagnosed with cyclothymic disorder.
Hypomania has also been known to occur in people suffering from schizoaffective disorder (a combination of schizophrenic and mood cycling symptoms) and narcissistic personality disorder but has also been known to happen to people without pre-existing issues. Hypomania can be caused by a lack of sleep, high levels of stress, significant changes in your life, or of the seasons, trauma, loss, drugs, alcohol, or even childbirth. 
The Dangers of Mania
Experiencing periods of hypomania and mania can obviously greatly affect someone’s life. While some people who experience hypomania actually do say that they’ve been able to successfully harness their extra energy into creative or professional pursuits, most would say that their mood swings take a toll on their ability to lead normal lives.  The irritability and unpredictability that comes with hypomania have a detrimental affect on personal and professional relationships and the lack of sleep and misplaced energy can have repercussions on physical health.
However, the most dangerous aspect of hypomania and mania is the fallout from the lack of inhibitions someone can experience during an episode. This risk-taking behavior can manifest itself in several damaging ways.
People suffering from hypomania are more likely to overestimate their own physical capabilities and potentially hurt themselves. They are also more likely to take financial risks by gambling, spending, or investing large amounts of money. It’s also not uncommon for people experiencing hypomania or mania to engage in risky sexual activity with people they don’t know without taking precautions, which can lead to sexually transmitted diseases, unwanted pregnancies, or traumatic situations.
How to Recognize a Hypomanic or Manic Episode
Hypomania and mania look different for everyone and it can be difficult to recognize the symptoms, especially in yourself. We can all go through periods of sleeplessness, elevated moods, or increased energy, but that doesn’t mean we are experiencing hypomania. However, if you or someone you know are experiencing at least three signs of hypomania and those problems are lasting for more than seven days, it may be time to consult a doctor.
If you or someone you know are uncharacteristically energetic, talkative, distracted, irritable, hypersexual, engaging in impulsive and reckless behavior, or are obsessing over unimportant activities or unrealistic goals, it could be a hypomanic episode. Should you or someone you know be experiencing these symptoms very strongly along with signs of psychosis, then the problem could be classified as a manic episode and you should seek help for them or yourself immediately.
How to Manage Hypomania and Mania
Experiencing hypomania or being diagnosed with bipolar disorder can be frightening and while there unfortunately is no cure, there are ways to manage symptoms and lessen the hold that your mood cycles have on your life. Here are some coping and treatment strategies that have been known to help people experiencing hypomania and mania.
For someone who has experienced moderate to severe mania or who has been diagnosed with bipolar disorder, a doctor will likely prescribe one or more medications to help manage symptoms.  Mood stabilizers like lithium, lamotrigine, divalproex sodium, or valproic acid could potentially help to control and prevent hypomanic and manic episodes. In bipolar I patients with more severe symptoms, anti-psychotic drugs like asenapine, lurasidone, olanzapine or ziprasidone could be prescribed alongside a mood stabilizer in order to control hallucinations, paranoid thoughts or delusions.
Sometimes it can take a few tries to find the right combination of medications, so try to be patient. If you are prescribed a medication to control your hypomania or mania, it’s very important that you follow your doctor’s instructions to the letter and take the right dose. Never go off, decrease, or increase a medication with consulting a physician as even the slightest alteration can throw off your brain chemistry and potentially hurt you or make your symptoms worse.
Therapy and Support
Psychotherapy is also an important aspect of treating hypomania or mania, particularly if it’s severe or if someone is diagnosed with bipolar disorder. Individual or group cognitive behavioral therapy, in particular, has been known to help to identify and reframe negative thoughts, patterns, and behaviors that can contribute to your mood states and replace them with healthier ways of thinking about and coping with your emotions and triggers. 
Support from a therapist is hugely important, but it’s just as important to have the support of friends and family. If you have experienced hypomania or mania, it’s a good idea to tell the people who know you best what to expect so that they can recognize changes in your behavior and get you help when you need it.
Taking Better Care
People who suffer from mild hypomania say that paying close attention to their body and its needs has helped decrease the severity of their issues. This means eating well, getting a good sleep of around eight hours a night, sticking to a daily schedule to maintain circadian rhythms, and exercising often to burn off that extra energy. It can also be helpful to take your “mood temperature” frequently and keep track of how you’re feeling each day on a mood chart, so that you can note any possible causes or fluctuations. 
Once you’ve start tracking your moods, you may start to identify patterns and realize that certain activities, circumstances, or substances can trigger your hypomania. Some common triggers are stress, drugs, alcohol, or caffeine. 
If you find that stress induces your symptoms, consider taking up meditation or yoga to help you feel more relaxed. If it’s caffeine, try switching to herbal teas to see if that helps stabilize your moods. If it’s drugs or alcohol (which you should avoid anyway if you’re bipolar or on medications), abstain. You may even find that you need to avoid certain people or places because they alter your stress levels or moods or inspire you to engage in other triggering behaviors. While this can be difficult, just remember that self-care is important and that you should never feel badly about putting your mental health and well being first.
If you or someone you know is showing multiple and prolonged signs of hypomania or mania, seek help and get a diagnosis. Hypomania doesn’t have to mean that you will be at the mercy of your wild moods for the rest of your life. A little treatment, support and self-care can go a long way to getting hypomania and mania sufferers back on track.
- Patterson, Eric, and Sharon Davis. “Bipolar Manic Episode: Helpful Tips for Getting Through Bipolar Mania.” NewLifeOutlook | Bipolar, NewLifeOutlook, 10 Oct. 2017, bipolar.newlifeoutlook.com/bipolar-manic-episode/.
- Pietrangelo, Ann. “Mania vs. Hypomania: What’s the Difference?” Edited by Timothy J. Legg, Healthline, Healthline Media, 15 Feb. 2018, healthline.com/health/mania-vs-hypomania.
- “Bipolar Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, Apr. 2016, nimh.nih.gov/health/topics/bipolar-disorder/index.shtml.
- Farrell, Helen M. “March Madness: 7 Signs of Hypomania.” Psychology Today, Sussex Publishers, 9 Mar. 2013, psychologytoday.com/us/blog/frontpage-forensics/201303/march-madness-7-signs-hypomania.
- Carey, Benedict. “Hypomanic? Absolutely. But Oh So Productive!” The New York Times, The New York Times Company, 22 Mar. 2005, nytimes.com/2005/03/22/health/psychology/hypomanic-absolutely-but-oh-so-productive.html.
- Hall-Flavin, M.D. Daniel K. “Bipolar Treatment: Are Bipolar I and Bipolar II Treated Differently?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 14 Feb. 2018, mayoclinic.org/diseases-conditions/bipolar-disorder/expert-answers/bipolar-treatment/faq-20058042.
- Wheeler, Regina Boyle. “6 Cognitive Behavioral Therapy Techniques for Bipolar Disorder.” Edited by Farrokh Sohrabi, Everyday Health, Ziff Davis, LLC, 27 Apr. 2015, everydayhealth.com/hs/living-well-bipolar-disorder/cognitive-behavioral-therapy-techniques/.
- “Bipolar Mood Chart.” Bipolar Lives: Living Better with Bipolar, Bipolar Lives, 20 Aug. 2014, bipolar-lives.com/bipolar-mood-chart.html.
- Dallas, Mary Elizabeth. “6 Triggers That Can Cause a Bipolar Episode.” Edited by Niya Jones, Everyday Health, Ziff Davis, LLC, 2 Sept. 2014, www.everydayhealth.com/hs/sanjay-gupta/bipolar-disorder/triggers/.