Hypomania and mania

Explains hypomania and mania, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.

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What treatments can help?

How can I access treatment?

The first place to go is normally your GP. They should ask about your symptoms and discuss different treatment options. If you've been monitoring your moods, for example using a mood diary, it might help to show this information to your doctor. To make sure you get the right treatment, your doctor should check if your hypomania or mania has a physical cause or is a side effect of medication.

There are a range of treatments recommended for hypomania and mania. This page covers:

Talking therapies

You're unlikely to be offered a talking therapy if you are currently experiencing a manic or hypomanic episode, but you might be offered one if you experience hypomania or mania as part of broader mental health problems, for example if you have a diagnosis of bipolar disorder. See our pages on talking therapy and counselling for more information.

Medication

If you are experiencing mania or hypomania, you will normally be offered one of these antipsychotics:

haloperidol
olanzapine (Zyprexa)
quetiapine (Seroquel)
risperidone (Risperdal).

If you experience mania or hypomania, as part of a mood disorder, you may also be offered mood stabilisers. These include:

lithium (Camcolit, Liskonum, Priadel)
valproate (Depakote)
carbamazepine (Tegretol).

Warning to anyone who is pregnant, or could become pregnant, while using valproate

If you take valproate while you are pregnant it can increase the risk of your child being born with birth defects and learning disabilities.

The regulators of this medicine now say that valproate should not be taken by people who are able to become pregnant, unless there is a pregnancy prevention programme in place.

For more information see our page on valproate.

Your doctor or healthcare team should review any other medication you're taking when you develop hypomania or mania. If you're taking lithium, they should check your plasma levels.

"Lithium helps [me cope] and I just have to keep reminding myself that whichever feeling I'm going through won't last forever."

Medication really helps some people but isn't right for others. Before deciding to take any drug, it's important to make sure you have all the facts you need to make an informed choice.

See our pages on things to consider before taking medication and your right to refuse medication for more information. Our pages on coming off medication give guidance on how to come off medication safely.

Community-based support

If you experience hypomania or mania regularly, and it has a significant impact on your ability to carry out daily activities, you may be referred for community-based support.

This could include:

health services, such as support from a Community Mental Health Team (CMHT) or Community Mental Health Nurse (CMHN) (see our page on healthcare rights and choices for more information)
social support, such as support from a social worker or help with practical day-to-day tasks.

Some people experiencing difficulties with hypomania or mania may be entitled to a needs assessment by social services and to social care. See our pages on social care in our health and social care rights guide for further information.

"I now have a care co-ordinator and have been stable for a few months."

Crisis services

If you start to feel very unwell, or if an episode of mania is lasting for a long time and your regular treatment isn't working, you may need to access crisis services . This may include:

emergency support, such as going to A&E
getting support from a crisis resolution and home treatment (CRHT) team
hospital admission

See our pages on crisis services for more information on different types of crisis service, and planning ahead for a possible crisis.

Electroconvulsive therapy (ECT)

Very rarely, a treatment called electroconvulsive therapy (ECT) may be offered. According to NICE guidelines, this could be if:

you're experiencing a long period of mania, and
other treatments have not worked, or the situation is life-threatening

If you feel like you're in this situation, your doctor should discuss this option with you in a clear and accessible way before you make any decisions.