Understanding hypomania and mania

When we experience hypomania or mania, this is called a hypomanic or manic episode. Experiences can differ from person to person. And from episode to episode.

We're here to help you understand what you're going through. 

What are hypomania and mania?

Hypomania and mania are both types of high mood.

During hypomanic or manic episodes, you might be much more active than usual. You might feel as if you have much more energy. You may feel extremely happy and excited or intensely restless and irritable, or both.

You can be manic but not be really happy. You can feel really agitated and kind of frustrated.

What do hypomania and mania feel like?

During a manic or hypomanic episode, you might feel:

• Happy, joyful or a sense of wellbeing

• Excited

• That you can't get your words out fast enough

• Irritable or agitated

• An increased sexual energy or desire

• Easily distracted - as if your thoughts are racing or you can't concentrate

• That you're making connections or having insights that feel obvious to you, but that other people may not see

• Confident or adventurous

• That you're untouchable or can't be harmed (more likely in mania)

• That you can perform physical and mental tasks better than normal

• That you need less sleep than usual

• Very focused or determined to complete certain tasks or projects

• Frustrated that other people can't seem to keep up with your ideas, plans or conversation

• That you don't need to eat or drink, or doing so will slow you down or waste time

What happens during a hypomanic or manic episode?

During a hypomanic or manic episode, you might:

• Be more active than usual

• Talk a lot, speak quickly or not make sense to other people

• Be over friendly to others

• Say or do things that are inappropriate or out of character

• Sleep very little or not at all, even when you have the chance

•  Act rudely or aggressively

• Misuse drugs or alcohol

• Spend a lot of money or spend in a way that's unusual for you

• Lose social inhibitions (stop caring about what other people think)

• Take risks with your safety

• Take other risks, such as gambling a lot

• Forget or choose not to eat or drink properly

• Forget to take medication or decide you don't need it

• Forget to look after yourself in other ways

I believed that I was always right and everyone else was always wrong. I was bubbly and my confidence was really high. At work I felt that the work was way beneath me. I also started spending a lot and would spend almost all my wage.

Hypomania or mania - what's the difference?

Both hypomania and mania can be tough to experience and manage. It's always OK to seek support. Even if you're not sure if that's what you're experiencing.

These are the main differences.

Severity of symptoms

Mania usually has more severe symptoms, such as more extreme risk-taking behaviours. It usually requires hospital treatment. Hypomania can noticeably change your mood or behaviour, but it's less severe.

Impact on your life

Manic episodes will often disrupt or stop your normal activities. Hypomanic episodes can disrupt your life, but you may still feel able to work or socialise.

Length of episode

Doctors may diagnose mania if a mood episode lasts for a week or more. For hypomania, it needs to last for 4 days or more. But both manic and hypomanic episodes can last much longer than this. And even if they don't last this long, you might still need support.

Psychosis

Manic episodes can sometimes include symptoms of psychosis, like hallucinations or delusions. They are sometimes called ‘psychotic episodes’. You don't get psychosis during hypomania.

Feelings after hypomania or mania

After a manic or hypomanic episode, you might:

• Feel very unhappy or ashamed about how you behaved

• Feel overwhelmed by commitments or responsibilities you've taken on

• Feel anxious about money you've spent or lost gambling

• Not remember what happened during your episode

• Feel very tired and need a lot of sleep and rest

• Feel pleased or proud of things you have created or done

Some of us may have a period of depression after mania or hypomania. This is common if you experience some types of bipolar disorder or schizoaffective disorder.

Causes of hypomania and mania

The causes of hypomania and mania seem to be complicated.

Some things might cause hypomania or mania directly. Like medication withdrawal or a neurological (brain) condition.

Some things might make you more likely to have hypomania or mania. These are called ‘risk factors’. But you might have a risk factor and still never actually experience hypomania or mania.

Some things might start an episode right now. These are sometimes called ‘triggers’. If you have risk factors for mania and hypomania then a trigger might be more likely to start an episode for you.

We don't know how these things interact. They may sometimes overlap. It seems to be different for different people.

Things that might make you more likely to experience hypomania or mania include:

• Trauma and abuse

• Difficult life experiences, like problems with money, housing or loneliness

• Using recreational drugs and alcohol

• Family history - if someone in your family has bipolar mood episodes, you are more likely to experience hypomania or mania

Things that might trigger an episode of mania or hypomania include:

• High levels of stress

• Changes in sleep patterns or lack of sleep

• Drinking a lot of caffeine, which might affect your sleep

• Seasonal changes - you may be more likely to experience hypomania and mania in spring

• Stressful changes, like moving house or going through a divorce

• Large hormonal changes like childbirth and menopause - see our pages on postpartum psychosis and menopause

• Loss or bereavement

You may also have mania or hypomania:

• As a side effect of medication

• As a symptom of a physical illness or neurological (brain) condition

A side effect of medication

Some medications can cause hypomania or mania as a side effect. Or as a withdrawal symptom (when you reduce or stop your dose).

This includes medications for physical conditions and for mental health, including some antidepressants.

Always discuss your medications and any side effects with your doctor. Don't stop taking any medication without support. See our page on planning for withdrawal.

A symptom of a physical illness or neurological condition

Some physical illnesses and neurological conditions can cause hypomania and mania. This includes lupus, encephalitis, dementia, brain injury, brain tumours and stroke.

Your doctor should always check for a physical cause for your hypomania or mania.

A typical hypomanic episode for me will begin by a night of hardly any sleep. Then the next night I probably won't sleep at all.

Support for hypomania and mania

Hypomania and mania can be difficult to live with and manage.

But the right treatment and support can make a big difference. Getting to know your triggers and looking after yourself can help too.

We have a page on tips for living with hypomania and mania. And a page with information on treatment.