Hypomania vs. Mania: What's the Difference?

Mania and hypomania refer to mental health episodes in which an individual experiences abnormal and extreme mood changes, such as mood episodes that vary from elevated or irritable mood, racing thoughts, changing energy levels, and changing sleep patterns.

Both mania and hypomania symptoms commonly occur in people with bipolar disorder. However, symptoms can also occur in those without bipolar disorder.

Continue reading to learn the main differences between mania and hypomania, how they’re both diagnosed, what treatments are available, and what symptoms to look for.

What is mania?

Mania, or a manic episode, refers to a period of one week or more where an individual experiences a drastic change in their mood and behavior that disrupts how they function in their day-to-day life. They typically feel more physically and mentally energized. In some instances, severe mania can require hospitalization.

Mania can often occur in people with bipolar I disorder, which means they may or may not experience a depressive episode at some point.

What is hypomania?

Hypomania, or a hypomanic episode, is a milder form of mania. With hypomania, your energy levels are higher than usual. However, people will not usually require hospitalization, and symptoms only last a few days.

Hypomania commonly occurs in those with bipolar II disorder, which is where the hypomania alternates with depressive episodes.

Symptoms of mania and hypomania

The following are common symptoms of mania or hypomania:

Feeling extremely happy or excited (euphoria)
Increased talkativeness and talking quickly
Higher than usual energy levels
Reduced need for sleep
Racing thoughts with new ideas and plans
Increased self-esteem and confidence
Getting easily distracted
Increased irritability or aggression
Impulsivity and making reckless decisions, such as making rash financial decisions, gambling, shopping sprees, or engaging in risky sexual behaviors.

Symptoms can vary from person to person. The individual's friends and family might notice a change in their mood and behavior. At the same time, the one experiencing the symptoms of mania or hypomania might not be aware of these changes themselves.

What are the main differences between mania and hypomania?

Despite the mania and hypomania mainly having the same symptoms, they can be distinguished in the following ways:

Intensity of symptoms: Hypomania is considered the less severe form of mania. Symptoms tend to be less serious than mania. Manic episodes can be intense enough to warrant a trip to the emergency room due to excessive changes in behavior.
Impact of symptoms on daily life: Manic symptoms are often severe enough to disrupt how a person functions in social settings, at work, school, or home. In contrast, hypomanic symptoms usually do not cause any major disruptions to a person's functioning in daily life.
Duration of symptoms: In a manic episode, symptoms must last for at least one week or more. Hypomania symptoms last for about four days.
Presence of hallucinations: A manic episode can lead to psychotic features like auditory or visual hallucinations or delusions. For instance, a person with mania may believe they are a spy or a secret agent. Some may feel paranoid and like they're being stalked or targeted. Hypomania, however, does not lead to any delusions or hallucinations.

Although mania can lead to more severe symptoms, hypomanic episodes may still require proper treatment, as it can bring about risky behaviors.

Causes of hypomanic and manic episodes

Mania and hypomania are often symptoms of bipolar illness, a mental health condition that requires a diagnosis from a mental health professional. In general, an individual must experience depressive episodes and manic or hypomanic episodes to be diagnosed with bipolar I or bipolar II disorder. Those who have experienced at least one manic episode in their lifetime are typically diagnosed with bipolar I disorder, while those who have not are diagnosed with bipolar II disorder.

Apart from bipolar disorders, there are other possible causes of a hypomanic or manic episode. They are as follows:

Substance abuse (i.e., misuse of alcohol and recreational drugs)
Certain medications, like an antidepressant called escitalopram
A lack of sleep
Family history or genetics
High levels of stress
A major change in life, such as a death or divorce
Other mood disorders, such as cyclothymic disorder
A history of trauma or abuse

Often, the development of hypomania and mania cannot be attributed to one single cause. In many cases, a combination of short or long-term factors can trigger mania or hypomania.

Mania and hypomania diagnosis

If you are experiencing any manic or hypomanic episode symptoms, it's best to seek professional advice. Your doctor will conduct a thorough examination and ask about your symptoms, medical history, and family history.

If your doctor suspects that you have hypomania, mania, or bipolar disorder, they may refer you to a mental health professional who will be able to make a proper disorder diagnosis and recommend a treatment plan.

Diagnostic criteria for hypomania and mania

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), hypomania will only be diagnosed if symptoms occur for at least four consecutive days and are present throughout most of the day. These symptoms should not be severe enough to cause functional impairment and cannot be attributed to a medication or substance abuse.

Based on the DSM-5, a diagnosis of mania will only be made if symptoms last for at least a week and are present for most of the day. If hospitalization occurs, the symptoms do not need to be present for more than one week before your doctor can make a diagnosis of mania.

Treating mania and hypomania

Psychotherapy and medications are often included in the treatment plan for mania and hypomania. These medications may include antipsychotics and mood stabilizers, such as benzodiazepines and lithium.

Psychotherapy typically helps individuals recognize and identify triggers for hypomanic or manic episodes. It can also help the person learn coping strategies and detect the early warning signs of an episode so they can take any necessary action before their symptoms worsen.

Hypomania with milder symptoms can sometimes be managed without any medications. Exercising daily, getting enough sleep, and maintaining a healthy diet can help keep mild symptoms under control. It's also best to avoid known triggers, such as coffee, bright lights, or loud environments, and build a stress management routine.

If you've been diagnosed with hypomania or mania, you can also consider keeping a mood diary to keep track of your mood, emotions, and possible triggers. This can also be a helpful tool for your healthcare professional to keep tabs on your symptoms and your treatment response.

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