Mental health conditions
Hypomania: Signs, symptoms and treatment
Learn about hypomania, including symptoms, causes, diagnosis, and treatment options to better understand mood and energy changes over time.
By Ryan DeCook, LCSW • Clinically reviewed by Caitlin Pugh, LCSW
Spikes in mood, high levels of energy, and impulsive behaviors are all symptoms that can feel confusing. It may be hard to judge what’s considered normal and when you might need to get help for a condition called hypomania.
This guide walks through what hypomania is, including its symptoms, causes, diagnosis, and treatment, so you can better understand what you're experiencing and what kind of support might help.
Key insights
1
Hypomania is a mental health experience associated with a change in mood and behavior, with heightened energy and more intense feelings of happiness, confidence, agitation, or other emotions.
2
Hypomanic episodes are usually less intense than fully manic episodes, which are often associated with Bipolar I disorder.
3
Episodes often last for several days, and are often (but not always) associated with mental health experiences like Bipolar II disorder.
4
Hypomania is treatable, usually with the help of a licensed mental health provider, medication, and/or lifestyle changes.
What is hypomania?
Hypomania happens when your mood, energy, and activity levels rise well above your normal baseline. You may feel elevated, irritable, unusually confident, or like you can't slow down.
It is a significant shift and usually lasts for several days straight. It can sometimes be hard to find awareness or want to change initially because it feels good or productive when it’s happening.
It does not include psychosis (delusions, or hearing or seeing things that aren’t really there). It is less intense than a full manic episode, which is often associated with Bipolar I disorder.
Hypomania is often part of Bipolar II disorder or cyclothymia, though people with Bipolar I can experience hypomanic episodes, too. While it's less intense than mania and usually doesn't require hospitalization, it can still meaningfully affect your daily life.
What is a hypomanic episode?
According to the key book that defines mental health disorders (the DSM-5-TR), a hypomanic episode lasts for at least 4 consecutive days. The increase in energy, activity levels, and mood are present for almost all of the time during those days. You may also notice that you need much less sleep than usual but still feel fully rested.
Everyone has changes in energy and mood, but hypomania is different. It's a noticeable, sustained shift that often gets pointed out by people around you.
If you’re only experiencing mood changes for a few hours in a day, or the levels of intensity don’t seem very high, what you are experiencing may not be a hypomanic episode. But if you’re questioning whether you’re experiencing hypomanic episodes, it’s always best to be assessed by a mental health professional.
Risk factors and triggers of hypomanic episodes
The underlying causes of hypomania aren't fully understood, but genetics and environment both likely play a role. Hypomania and bipolar spectrum conditions tend to run in families — having a parent or sibling with bipolar disorder raises your likelihood of experiencing it yourself.
Other risk factors include emotional trauma, family conflict, or brain injury, which has been linked to a higher risk of manic and hypomanic episodes. All of these contribute to vulnerability rather than determining whether you'll experience hypomania.
If you have hypomania, triggers are experiences that can push you closer to an episode, though they won't cause hypomania in someone who doesn't already have it.
Triggers can include:
Medication reactions (e.g., antidepressants or steroids): Sometimes experiencing hypomanic episodes along with depression can be misdiagnosed as depression alone, followed by a prescription for an antidepressant (usually an SSRI). Research shows antidepressants and the supplement St. John's wort can sometimes trigger hypomanic episodes in people prone to them.
If you’re wondering if either interaction may impact you, consult with the professional who oversees your psychiatric medications. It is never recommended to make abrupt changes in your medication without speaking to your doctor or licensed prescriber first.
Ongoing stress or trauma exposure: Repeated stress or trauma, including around major life events like getting married, changing jobs, or moving can increase your likelihood of a hypomanic episode.
Disruptions in sleep patterns or circadian rhythm: Getting less sleep or having major shifts in your sleep schedule can come before an episode. Hypomania has also been linked to occurring in spring and summer, possibly because increased daylight disrupts circadian rhythms.
Menstruation and hormone events: Hormonal shifts during the menstrual cycle, particularly around the premenstrual or mid-cycle phases, may trigger mood episodes in some menstruating people.
Substance use or substance use disorder: Recreational stimulant use and cannabis use are the most commonly named substances that can trigger hypomania. High amounts of caffeine have also been associated with triggering episodes, though the evidence is not fully conclusive.
Hypomania signs and symptoms
There are some key changes during a hypomanic episode. These can be related to your thoughts, emotions, or behaviors. The most common symptoms include:
- Increased energy or activity levels: You feel much higher levels of energy and activity levels than normal. You may find yourself starting a lot of projects or staying constantly busy, and it feels hard to slow down.
- Reduced need for sleep: Even while doing many different activities, you may not be nearly as tired or feel the need to sleep. You may only sleep for a few hours at night and don’t feel tired the next day.
- Racing thoughts or rapid idea generation: Your mind moves faster than normal, jumping quickly from one idea to the next.
- Increased talkativeness or pressured speech: You talk more than usual, often driven by your overflow of ideas and people around you tend to notice.
- Elevated confidence or unusual assertiveness: Sometimes called grandiosity, this means you think of yourself and your abilities more highly than usual — a level of confidence that's noticeably different from your normal baseline.
- Impulsivity or engagement in risky behaviors: Your high activity levels can sometimes be impulsive or done without much thought. This might include overspending or engaging in riskier sexual behaviors than what you typically choose to do.
- Distractibility or irritability: New ideas or tasks can easily pull your focus. You may also notice higher levels of irritability or frustration.
- Increased goal-directed actions or social activity: You feel driven, like there's a motor pushing you that's hard to stop. This may look like spending lots of time with others, juggling projects, or starting new goal-oriented tasks.
How is hypomania diagnosed?
A formal diagnosis comes from a clinical evaluation with a trained healthcare professional. It’s a collaborative process where they'll ask about your experiences, assess you fully, and apply their clinical judgment, with honest input from you. The diagnosis process usually includes:
Clinical evaluation and history
When you speak with a mental health professional, they'll likely ask about your history, your family's mental health history, and details from your day-to-day experiences. They may use screening tools such as the Mood Disorder Questionnaire (MDQ), although diagnosis is based on a comprehensive clinical evaluation.
Diagnostic criteria for hypomania (DSM-5-TR)
As you're assessed, they'll be looking at whether your experience matches the criteria for hypomania and related diagnoses like bipolar disorder, as laid out in the DSM-5-TR.
Ruling out other potentials
A professional will often ask about your medical and substance use history. If necessary, they may refer you to a medical professional to rule out any other conditions that could appear like hypomania (e.g. hyperthyroidism or Cushing’s disease).
How to treat hypomania
There are different approaches that can help treat hypomania. These approaches often focus on stabilizing mood, reducing triggers, and preventing more episodes from happening. Some of the most helpful treatments include:
- Medications prescribed by a licensed psychiatric care provider: The right medications can be helpful for hypomania. They’re usually prescribed when hypomania is associated with another diagnosis such as bipolar disorder. In these cases the most commonly used classes of medications are mood stabilizers, antipsychotics, or a combination of the two.
- Psychotherapy: Several types of therapy can help, including cognitive behavioral therapy (CBT) for changing thought and behavior patterns, and family therapy so loved ones can better understand and support you. Psychoeducation and interpersonal and social rhythm therapy (IPSRT) to improve daily routines and relationships can also be helpful.
- Peer support: Getting support from others who struggle with hypomania can be helpful. Support groups can boost emotional wellbeing, normalize your experience, and give you ideas for managing your symptoms.
- Lifestyle changes: Because sleep disruption can be a strong trigger, developing healthy, consistent sleep routines is extremely important. A healthy diet and good levels of physical activity can help to maintain mood balance. Reducing or eliminating intoxicating substances can also be an important part of lifestyle management.
- Stress management strategies: Keeping stress levels low through structured routines and stress-reduction tools is a top priority.
If symptoms intensify, begin to significantly impair your functioning, or lead to increasingly risky or unsafe behavior, it may be time to seek urgent support. Hypomania can sometimes escalate into a full manic episode, which is considered a psychiatric emergency. If you start experiencing suicidal thoughts, thoughts of hurting others, or feeling concerned about your safety, you can reach out to an emergency line such as 988.
If you or someone you know is in crisis, support is available. Call or text 988 (Suicide & Crisis Lifeline), text HOME to 741741 (Crisis Text Line), or call 911 for a mental health emergency.
Understanding hypomania and finding support
Identifying and managing hypomania can feel challenging at first, and you may question whether what you're experiencing fits. An outside perspective from a therapist can help. They can assess your experience, offer feedback, and build a treatment plan suited to you.
Headway offers a directory of psychiatrists and therapists who offer this support. Search filters help you narrow down the list to find the right fit who accepts your insurance. You can get your insurance coverage verified, see transparent pricing estimates, and book instantly through the site. Start your search today.
This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.
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