Mania is a term used to refer to a set of mood symptoms that are characterized by irritability or euphoria lasting for at least a week. Episodes of mania is a requirement to qualify for the diagnosis of bipolar disorder. Hypomania, on the other hand, is also similar to mania, but it is a less severe version of mania. The symptoms of mania are more intense. If you experience mania or hypomania frequently or from time to time, you might be having bipolar disorder, which is a mental health condition marked by extreme mood shifts. Read on to find out about hypomania vs. mania.
Hypomania vs. Mania: Differences Based on Their Definition?
Hypomania and mania are both common symptoms of bipolar disorder, but they can also occur in people who do not have bipolar disorder.(1)
Both hypomania and mania are periods during which a person feels exceptionally elated, full of energy, and very active. They may also feel irritated. While mania is marked by intense feelings, hypomania is a less severe form of mania.(2,3) Some other types of mental health disorders may also make a person experience mania or hypomania.(4,5) Let’s take a closer look at both these conditions.
What is Hypomania?
Hypomania can be termed as being a milder form of mania. If a person is experiencing hypomania, their energy level is going to be higher than average, but not as extreme as it is in mania. If you have hypomania, people are bound to notice it as it causes several types of disruptions in your life, but nothing to the extent of what mania can cause. People with hypomania rarely need to be hospitalized.
People who have bipolar II disorder are more likely to experience hypomania that alternates with episodes of depression.(6,7)
What is Mania?
Mania is a term used to describe an episode of mood disturbance that makes a person have abnormal levels of energy, both physically and mentally. As a symptom of various mental health conditions, especially bipolar disorder, mania can be severe enough to require hospitalization.(8)
Mania is commonly observed in people with bipolar I disorder, with many people with this condition experiencing manic episodes alternating with episodes of depression. However, many people with bipolar I disorder don’t always experience the depressive episodes.(9)
Hypomania vs. Mania: Differences Based on Their Symptoms
The primary difference between hypomania and mania is the severity or intensity of the symptoms. A person who has mania is going to experience much more severe or intense symptoms as compared to someone having hypomania.(10)
While the symptoms of the two conditions vary in severity, most of the symptoms of hypomania and mania are the same. Some of the key symptoms of these two include:(11)
- Having higher than normal levels of energy
- Unable to sit still or being restless
- Having a reduced need for sleep
- Being excessively talkative
- Having increased confidence or self-esteem
- Feeling grandiose and making impulsive decisions
- Feeling like your mind is racing, full of new ideas and plans
- Being easily distracted
- Having lesser inhibitions
- Taking on several projects at one time, even when there is no possible way you can finish all of them
- Having an increased sexual drive
Engaging in impulsive or risky behavior, such as gambling with your life savings, going on a spending spree, having spontaneous sex, etc.
During an episode of mania or hypomania, you are unlikely to recognize these changes in yourself. Furthermore, if another person points out that you are acting differently, then you are likely to doubt that person and not think that anything could potentially be wrong with you.(12)
While hypomanic episodes do not pose any significant risk, episodes of mania can lead to severe consequences as when the mania eventually subsides, a person is left with depression or remorse for the things they have done during that manic period.(13)
A person with mania is also more susceptible to having a break with reality and suffer from psychosis. Some of the psychotic symptoms of mania may include:(14)
- Delusional or paranoid thoughts
- Auditory or visual hallucinations
Hypomania vs. Mania: Differences Based on Their Causes and Risk Factors
Hypomania and mania are the most common signs of bipolar disorder. However, this does not mean that they are only caused by mental health disorders. They can also be caused by:
- Excess alcohol and drug use
- Sleep deprivation
- Certain medications or medication abuse
The exact cause of bipolar disorder still remains unclear, but it is believed that family history or genetics may play a role.(15) It has been found that you have a higher chance of developing bipolar disorder if there is a family history of the disease.(16) In some cases, bipolar disorder is also known to be caused by a chemical imbalance in the brain or due to structural changes in the brain.(17)
You are likely to be at a higher risk of hypomania or mania if you have already experienced an episode in the past. You are also at a higher risk of having bipolar disorder if you leave mania or hypomania untreated, or don’t take your medications as prescribed by your doctor.
Hypomania vs. Mania: Differences Based on Their Diagnosis Procedure
If you have a doubt that you might be experiencing any of these conditions, it is better to consult a doctor at the earliest. Your doctor will take down your entire medical and family history, and also do a complete physical exam. It is essential to let your doctor know about any over-the-counter or prescription medications you are taking and provide honest information about any illegal drugs you are taking or may have taken.
Diagnosing hypomania and mania is a challenging process. This is because a person might simply not be aware of some symptoms they are experiencing, or have no idea about how long they have had these symptoms for. Additionally, if you also have depression, but your doctor is unaware of any hypomanic or manic behavior you have experienced, then you are likely to be diagnosed with depression, rather than bipolar disorder. This is a cause of concern because the treatment for depression and bipolar is different, and it will not benefit you if you are put on a wrong treatment protocol.(18)
At the same time, there are several other health conditions also that can cause hypomania and mania, such as having an overactive thyroid gland, which causes symptoms that often mimic mania or hypomania.
How to Diagnose Hypomania?
You must have experience at least three of the typical symptoms of mania for a minimum of four days for your doctor to diagnose you with hypomania.
How to Diagnose Mania?
Doctors will diagnose a person with mania if they have had symptoms that lasted at least a week. If the symptoms were severe enough to require hospitalization, then a diagnosis can be made even if you do not experience the symptoms for a week.
Hypomania vs. Mania: Treatment
Your doctor is likely to start the treatment for mania or hypomania with a combination of psychotherapy and medication. Medication for treating hypomania and mania include antipsychotics and mood stabilizers.
You will probably need to go through several different medicines before you, and your doctor finds one that is the right combination and helps treat your symptoms effectively.(19)
It is essential that you take these medications as prescribed. Otherwise, your symptoms may continue to become more severe. Even if you are experiencing certain side effects from the medicines, it is still dangerous to stop taking them without your doctor’s consent. Discuss the side effects with your doctor to find a solution, such as lowering the dosage or changing the medication.(20)
People with hypomania might not need to take any medication. For them, following a healthy lifestyle and maintaining a healthy diet, regular exercise, and a strict sleeping schedule can help. They should also avoid taking too much caffeine.
Hypomania and mania cannot be prevented. Neither is there a cure for these conditions. However, it is possible to lessen the impact of an episode by living a healthy life and following your treatment plan. Taking your medications in the right dosage and at the right time, and keeping your doctor updated about your condition can help manage your symptoms and also improve your overall quality of life.
- Bauer, M.S., Whybrow, P.C., Gyulai, L., Gonnel, J. and Yeh, H.S., 1994. Testing definitions of dysphoric mania and hypomania: prevalence, clinical characteristics and inter-episode stability. Journal of affective disorders, 32(3), pp.201-211.
- Coryell, W., Andreasen, N.C., Endicott, J. and Keller, M., 1987. The significance of past mania or hypomania in the course and outcome of major depression. The American journal of psychiatry.
- Henderson, T.A. and Hartman, K., 2004. Aggression, mania, and hypomania induction associated with atomoxetine. Pediatrics, 114(3), pp.895-896.
- Goodwin, F.K. and Jamison, K.R., 2007. Manic-depressive illness: bipolar disorders and recurrent depression (Vol. 2). Oxford University Press. Brown, L.K., Hadley, W., Stewart, A., Lescano, C., Whiteley, L., Donenberg, G. and DiClemente, R., 2010. Psychiatric disorders and sexual risk among adolescents in mental health treatment. Journal of consulting and clinical psychology, 78(4), p.590.
- Angst, J., 1998. The emerging epidemiology of hypomania and bipolar II disorder. Journal of affective disorders, 50(2-3), pp.143-151.
- Benazzi, F., 2001. Is 4 days the minimum duration of hypomania in bipolar II disorder?. European Archives of Psychiatry and Clinical Neuroscience, 251(1), pp.32-34.
- Strakowski, S.M., Tohen, M., Stoll, A.L., Faedda, G.L. and Goodwin, D.C., 1992. Comorbidity in mania at first hospitalization. Am J Psychiatry, 149(4), pp.554-556.
- Kupka, R.W., Altshuler, L.L., Nolen, W.A., Suppes, T., Luckenbaugh, D.A., Leverich, G.S., Frye, M.A., Keck Jr, P.E., McElroy, S.L., Grunze, H. and Post, R.M., 2007. Three times more days depressed than manic or hypomanic in both bipolar I and bipolar II disorder 1. Bipolar disorders, 9(5), pp.531-535.
- Van Meter, A.R., Burke, C., Kowatch, R.A., Findling, R.L. and Youngstrom, E.A., 2016. Ten‐year updated meta‐analysis of the clinical characteristics of pediatric mania and hypomania. Bipolar disorders, 18(1), pp.19-32.
- Fiedorowicz, J.G., Endicott, J., Leon, A.C., Solomon, D.A., Keller, M.B. and Coryell, W.H., 2011. Subthreshold hypomanic symptoms in progression from unipolar major depression to bipolar disorder. American Journal of Psychiatry, 168(1), pp.40-48.
- Serretti, A. and Olgiati, P., 2005. Profiles of “manic” symptoms in bipolar I, bipolar II and major depressive disorders. Journal of affective disorders, 84(2-3), pp.159-166.
- Garety, P.A., Kuipers, E., Fowler, D., Freeman, D. and Bebbington, P.E., 2001. A cognitive model of the positive symptoms of psychosis. Psychol Med, 31(2), pp.189-195.
- Taylor, P.J., 1998. When symptoms of psychosis drive serious violence. Social Psychiatry and Psychiatric Epidemiology, 33(1), pp.S47-S54.
- Müller-Oerlinghausen, B., Berghöfer, A. and Bauer, M., 2002. Bipolar disorder. The Lancet, 359(9302), pp.241-247.
- Craddock, N. and Jones, I., 1999. Genetics of bipolar disorder. Journal of medical genetics, 36(8), pp.585-594.
- Speerforck, S., Schomerus, G., Pruess, S. and Angermeyer, M.C., 2014. Different biogenetic causal explanations and attitudes towards persons with major depression, schizophrenia and alcohol dependence: Is the concept of a chemical imbalance beneficial?. Journal of affective disorders, 168, pp.224-228.
- Winokur, G., Coryell, W., Endicott, J. and Akiskal, H., 1993. Further distinctions between manic-depressive illness (bipolar disorder) and primary depressive disorder (unipolar depression). American Journal of Psychiatry, 150, pp.1176-1176.
- Truman, C.J., Goldberg, J.F., Ghaemi, S.N., Baldassano, C.F., Wisniewski, S.R., Dennehy, E.B., Thase, M.E. and Sachs, G.S., 2007.
- Self-reported history of manic/hypomanic switch associated with antidepressant use: data from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). The Journal of clinical psychiatry, 68(10), p.1472.
- Knoll, J., Stegman, K. and Suppes, T., 1998. Clinical experience using gabapentin adjunctively in patients with a history of mania or hypomania. Journal of affective disorders, 49(3), pp.229-233.