Hypomania

I just wanted to know about the average length of hypomania, and what are the signs to look for in term sof it coming to am end/how long recover from it is in terms of someone being able to think straight/have times of clarity.

I feel that my ex partner may have bipolar type 2, and that she is a slow cycler. She developed depressive symptoms in Feb/March of this year – however about a month ago her mood seemed to change over night – it was initially elevated but mixed with one period of hostility (towards me) and more recently irritability and her asking me to leave her alone/no contact this past week.

I am not a GP but I have undertaken a vast amount of research in the aim of making sense what was happening. It seems that she has endured 5/6 months of depression followed by onset of hypomania (elevated mood/need for less sleep/increased socialisation/hypersexuality/

irritability etc)She refuses to believe anything is wrong with her (therefore untreated) and asserts that I am the one that is ill. I guess I am waiting until she levels out/swings back to depression before I try (again) to convince her to seek medical help.

Most of us with bipolar disorder are familiar with the term “hypomania”.  I have become very familiar with this term and what it involves.  I know it fairly well as it is one of the symptoms that I often experience with my bipolar II disorder.   According to Wikipedia hypomania literally means, “below mania”.  It seems like a rather simple definition but what exactly does it mean to be “below mania”?  Well in order to make some sort of sense of what this entails it may be helpful to think about what “mania” actually is.  According to the Diagnostic and Statistical Manual of Mental Disorders, aka the DSM-IV-TR a “manic episode” includes the presence of the following symptoms:

  • A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week
  • Along with at least 3 of the following symptoms being present: inflated self-esteem or grandiosity, a decreased need for sleep, more talkative than usual and/or pressure to keep talking, flight of ideas and/or racing thoughts, distractibility, an increase in goal-directed activity (taking on a bunch of projects all at once), psychomotor agitation, excessive involvement in pleasurable activities that are likely to lead to unpleasant consequences,  (unrestrained shopping/spending sprees are an example)
  • The mood disturbance is sufficiently severe enough to cause a marked impairment in occupational functioning or social activities and/or with relationships with others
  • Or psychotic features are present and/or hospitalization is necessary to prevent harm to self or others

A “hypomanic episode” then according to the definition mentioned earlier would be “an episode where the symptoms are below that of a manic episode”.  In other words hypomania is less severe and its symptoms are less intense when compared with symptoms of mania.  This however does not mean that having a hypomanic episode is any easier to cope with; it just means that its symptoms are not as severe as they are during a “manic episode”.  Sound confusing?  Well it sort of is in some ways.  To lessen the confusion between “mania vs. hypomania” it helps to look at what symptoms are “shared” between the two and what is different.

Hypomania and mania share all of the same symptoms I have listed earlier except that with hypomania the episode is not severe enough to cause a marked impairment in social and/or occupational functioning, there are no psychotic features present, and hospitalization is usually not necessary.  I suspect that in some ways hypomania would be harder to detect or recognize in oneself because even though the symptoms are present they are just not as “obvious” as the more severe/intense symptoms that are part of full blown mania.  This was certainly the case for me as I was misdiagnosed for years.  Although my hypomanic symptoms were present at times the doctors only recognized my “depressive symptoms” and totally missed all of my other symptoms.  As a result I was only being treated for depression and I continued to struggle until a correct diagnosis of bipolar II was given to me in January 2011.  In reality I not only needed an antidepressant, but a mood stabilizer as well.  To complicate matters even more I have Generalized Anxiety Disorder and ADHD mixed in there as well.  So in hindsight I can see why it was difficult for the doctors to diagnose me correctly and get me on the right medication.

It turns out that my Bipolar II Disorder is my “primary diagnosis”.  My ADHD and Generalized Anxiety Disorder are considered to be “secondary diagnoses”.  I refer to my three diagnoses as a “Triple Whammy” because I have to deal with three disorders on a daily basis, not always easy.  So how does one cope with a manic or hypomanic episode?  Well there are various things that people can try but it is somewhat individual in what may work for you may not work for the next person.  For me a hypomanic episode can be both a blessing and a curse.  It is positive in the sense that I can be very productive and super creative.  My senses increase but so does the intensity of my emotions, so it can be tricky to balance and manage.  Some of the things I do to help with my hypomania states are to just take on one project at a time.  If I do not do this I have a tendency to take on multiple things and typically nothing gets completed.  Exercise is also helpful, I go for walks and in the winter I ice skate.  Exercise helps take the edge of for me and decreases my restlessness and hyperactivity.  The other activity I engage in is drawing/painting/creating.  I can often lose myself in that and churn out some interesting art at the same time.

So for me I need a few outlets to engage in to help keep my hypomanic episodes under fairly good control.  That along with the appropriate medication/s can really help one manage their symptoms quite well.  The other thing that can be helpful is for people to utilize mood disorder/bipolar disorder support groups.  That way you can associate with others who are experiencing the same sort of things.  Often times others have new ideas and tips that they can offer which can provide you with additional coping tools.  Furthermore if you find that you are struggling and not coping well with mania, hypomania or any other aspect of your bipolar disorder do not be afraid to call your doctor or pdoc.  If things become overwhelming and you cannot cope access a local community mental health clinic or go to the hospital.  If that is too difficult for you then at the very least reach out to a friend or a family member as sometimes that is all that is needed to get through a rough period.  For additional tips on how to cope please see Chelle’s post on, “How I Deal with Hypomania” from August 30/11 in the blog section at www.askabipolar.com .  Thank you for submitting your question and please send us any additional questions or comments that you may have.

*Note:  A word of caution – There are certain medications that can trigger hypomania and/or mania in a person.  Drug abuse can sometimes be a trigger also.  There can be emotional/environmental triggers that can lead to hypomania/mania as well.  Generally speaking, hypomania is a part of bipolar II disorder whereas mania is a part of a bipolar I disorder.      

6 thoughts on “Hypomania

  1. *I would just like to add that there is really no specific length of time that a manic or hypomanic episode may last. Some people rapidly cycle between mania, hypomania and depression where each episode may only last a short time but return frequently. Others can experience episodes that last for weeks or even months, it really just depends on the person.

  2. Thats great Vicky!,very enlightening for a bipolar type 1.(me)
    When my mania is on the up and up I deal with it by walking,or talking,or asof lately,even trying to sit and slow down a bit by reading or playing Words With Friends helps. I learned something new!,I never knew about hypomanic!,what it meant.

    jules

  3. Having someone seek treatment is one of the hardest things when it comes to having a bipolar loved one. Sometimes, I’m happy that I’m the one with bipolar disorder, since I know that I have control over whether or not I seek treatment.

    In this particular case, it might be difficult to take a suggestion from an ex-partner to seek treatment. It might instead be a good idea to talk to a common friend about the situation, and see if you can plan some sort of strategy together. You are also right that it is especially hard to get people to seek treatment when they are hypomanic. They aren’t generally thinking straight.

    I hope no one minds if I make a small clarification on the italicized part at the end. People with Bipolar I can have hypomanic episodes. In fact, many bipolar I people have more hypomanic episodes than manic episodes (I know that I do). Being bipolar I requires only ever having had one manic episode for the diagnosis.

  4. Yes Daniel you are right that hypomania can be a part of bipolar I. If I am not mistaken it can occur before mania and lead to a manic episode. Likewise with bipolar II hypomania can turn into a manic episode, it can be confusing and is not all that easy to explain. I think it really just depends on the person and that it can vary greatly.

  5. Great article, Vicky. I am working on an article on definitions of bipolar cycles. I think that there are misconceptions on the actual meanings of each of the phases of cycling. It is comforting for me to know how to better direct my stabilization and not to be so hung up or afraid of my diagnosis. Thanks again, Jan

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