Hypomanic Episode (Hypomania)

What is a Hypomanic Episode?

Hypomania, or hypomanic episodes, are periods of time where a person feels elated or irritated for anywhere from a few days to several months. They affect the person for the entire time until the episode is over.

Hypomanic episodes are usually followed by depressive episodes that last longer and are more intense than depressive episodes experienced by someone with bipolar I disorder.

Hypomanic episodes are not a mood disorder on their own, but are actually a symptom of bipolar II disorder. Unlike mania, hypomania is less intense and usually does not require hospitalization or time away from work or school. However, the changes it causes in a person’s personality and sociability are easily noticed by peers and family, and while it might not require medical help, one might want to look into treatment for the mood disorder it is associated with.

Treatments for bipolar II disorder are available, and can treat hypomania in the process. It is important to seek professional medical help when diagnosing and treating these issues, to ensure the physical and mental health of the patient. Discovering the root of the disorder may also help professionals build a treatment plan, so it is important to take the first steps into researching the disorder. This can include anything from looking up symptoms to digging into family medical history.

Symptoms Hypomanic Episode

Obvious signs of a hypomanic episode vary from person to person, but there can be common symptoms.

Common symptoms include:

  • Lightning-chain thoughts, or high speed thinking that leads the person moving quickly from one thought or idea to the next.
  • Having trouble focusing, or being easily distracted by irrelevant or unimportant ideas, objects, or emotions.
  • Having severely elevated self-esteem. They may seem narcissistic or delusional, or believe that they are ‘on top of the world’.
  • Either an extreme pressure to keep talking, or an inability to stop themselves once they’ve begun talking.
  • Overcommitting to multiple projects at once, or heightened creativity that leads to rash decisions.
  • An extreme sense of elatedness, or a belief that nothing is wrong with them, their lives, or their surroundings.
  • Rushed speech, stuttering, or abrupt and absentminded topic changes.
  • A lowered appetite for sleep. A person suffering from a hypomanic episode may only need 3-4 hours of sleep to feel well-rested.
  • Increased energy, to the point of hyperactivity.
  • Heightened interest and action in pleasure-related activities such as:

Spending excessive amounts of money

Shopping sprees, business investments, charitable donations that they cannot afford, etc.).

Excessive sexual or provocative behavior

Sleeping with strangers, or people they would not normally have sex with).

Impulsiveness

They may act recklessly in a number of ways, from doing something as mundane as breaking up with partners, to partying nonstop or doing drugs.

While none of these symptoms require hospitalization, they can negatively affect their personal, social, and work-oriented lives. These symptoms might be hard to notice in oneself during a hypomanic episode, and it is common for someone having an episode to also lack the drive to stop themselves from acting recklessly. They might not realize the consequences of their actions, or they might be too manic to care.

Coworkers, friends, partners, or family are more likely to notice these changes in personality, and they may need to step in on the hypomanic person’s behalf. Someone who is experiencing a hypomanic episode might seem lively and friendly, but their actions and choices may negatively affect their lives forever. They can be harmed emotionally, physically, or even financially.

In the following depressive episode, a person who has suffered a hypomanic episode may regret what they’ve done, and may feel embarrassed, mortified, or depressed by what they did during their period of hyperactivity. They might “˜crash’ due to the depression, and enter a deep period of inactivity, lethargy, or despair.

Hypomanic Episode Causes

Since it is a symptom rather than a standalone disorder, hypomania does not have direct causes. To find the causes of a hypomanic episode, one needs to look at the causes for bipolar II disorder. Common roots of bipolar II disorder, and in turn hypomania, can include anything from genetics, a brain chemical imbalance, a hormonal imbalance, a violent change in one’s environment, or even a combination of the above causes.

Chemical imbalances in the brain may cause bipolar II disorder, which can then lead to periods of hypomania or manic behavior. Likewise, a sudden hormonal imbalance may also trigger a mood disorder to appear.

Genetic predisposition to bipolar II disorder may not manifest until later in life, or until after a high-stress, traumatic event. Environmental stressors or severe mood swings may kickstart the disorder into manifesting, and the person may need to seek help after the initial trigger.

Any sort of traumatic experience, abuse, period of extreme stress, or the loss of a loved one would be considered an environmental factor. These events can contribute to and possibly trigger a mood disorder if the person has issues coping properly with the stress. Bipolar disorder is sometimes accompanied by generalized anxiety disorder, post traumatic stress disorder, substance abuse, or even ADHD.

There is no real way to effectively avoid the troubles and trials of life, but if one begins to experience symptoms such as hypomania, then it is advisable that the person or their loved ones seek help. Looking into family medical records may glean some information on any histories of mental illness, and can help determine if the person suffering from hypomania may be genetically predisposed to bipolar II disorder.

In order to determine if someone has bipolar disorder, they must have a history of at least one depressive episode, one manic or hypomanic episode, and they must also be tested for other psychotic disorders such as schizophrenia in order to avoid misdiagnosis. It is common for bipolar people to seek out help during depressive episodes, and get misdiagnosed with depression instead of bipolar disorder. Having a record of any (hypo)manic episodes can prevent this.

Hypomanic Episode Treatments

Since hypomanic episodes are symptoms of a mood disorder, the treatments available for bipolar II disorder are also made to treat hypomania and prevent or control any future episodes. However, every person is different, and a treatment that helps one bipolar person may not affect, or even harm, another person with the same disorder. It is always advisable to speak to a medical professional before beginning a treatment plan, especially when it involves medication.

One of the drug subsets designed to help with hypomania are benzodiazepines, mild tranquilizers that may help with the decreased need for sleep, insomnia, and feelings of agitation. The second type of treatment is antipsychotics. Despite not being a psychosis, hypomanic episodes can be treated with an antipsychotic treatment plan.

Another type of treatment is mood stabilizers. One common drug is lithium, which has a long history of helping with bipolar disorder, more specifically the “highs” that occur with bipolar disorder. Lithium is more of a long-term stabilizer, as it does take up to two weeks for it to take full effect, so it would not be very helpful during acute or sudden hypomanic episodes. A person taking lithium would also have to have their blood levels, kidneys, and thyroid functions tested and monitored occasionally to ensure their safety and continued health.

And lastly, most people that have bipolar disorder are often times put on antidepressants to help with the depressive episode that occurs afterwards. It is widely agreed that antidepressants do not affect hypomania and do not worsen any existing episodes once they’ve begun. Other antidepressants frequently prescribed to patients with bipolar disorder may also have a mood stabilizer in them as well.

Non-medication methods of treatment are also available, although they usually work best when paired with a prescribed medication. Having a regular sleeping schedule and a healthy diet is frequently prescribed to patients with bipolar disorders, since a disorganized sleeping schedule can negatively affect mood and cause swings. Therapy is also an option, whether it’s interpersonal therapy for depressive episodes or cognitive-behavioral therapy to prevent any future relapses.

It is important to discuss any “˜alternative’ supplements with a doctor before beginning treatment. Some chemicals found in “˜natural’ treatments can negatively affect medications, especially when digested. This can cause illness, reduce the effectiveness of the prescribed drugs, or even cause symptoms to reappear. It is also advisable to contact your doctor before going off your medication. Stopping treatment abruptly can cause problems with recovery, or even bring about physical side effects.

If you wish to quit your medication or try another method of treatment, discuss this with your doctor beforehand. Medical professionals are there to help, and they have your best interest in mind when discussing your mental health. Discussing treatment options with family members is also advised, since they may notice changes in behavior sooner than you realize them.

Because hypomania is part of a recurrent mood disorder, continuous, ongoing treatment is the recommended method to treat and prevent further hypomanic episodes. If you or a loved one is experiencing hypomanic episodes, the first step to solving the issue is to contact a medical professional and begin the road to a treatment plan and recovery. Mental health is just as pressing an issue as physical health, and can affect almost every facet of your life, from social to professional.

It is also important to remember that the first treatment may not work. Every patient is different, so if a medication does not have the desired effects, contact a doctor and begin the path to a new treatment plan. Quitting or continuing a treatment plan that is not working does not help anyone, especially not you. Have frequent check-ins with your doctor, and pay close attention to your condition after starting any new medications.

Hypomanic Episode Prevention

To this day, medical science is not entirely sure what exactly causes bipolar disorders, and by extension, hypomania. Bipolar disorder and its symptoms can seriously disrupt daily life, and cause unique issues that may need special attention.

While there is no surefire way to prevent mood disorders, there are many healthy ways to cope with them and treat them with therapy and medication. Regular sessions with a social worker, psychologist, or therapist can be a good first step to recognizing or treating a mood disorder, and medications can further help stabilize a person’s mood and life. A healthy balance of both of these treatments can prevent or control hypomanic episodes.

The speed and level of recovery can vary from patient to patient, but with the proper knowledge and assistance, anyone can learn to cope and live with their mood disorder. By reducing the risk of further relapses into hypomanic episodes, you can also build the foundation for better overall physical, mental, and emotional health.

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Last Reviewed:
September 18, 2017
Last Updated:
January 12, 2018
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