Bipolar disorder (BPD) is a mental health condition that causes dramatic and noticeable changes in energy and mood swings. Mood swings that are “up” are called mania. People with BPD also have less extreme up moods called hypomania.1
Mania can be so serious it requires a hospital stay to protect the person from harm. Hypomania, on the other hand, is not as severe. It may still disrupt daily life, but not as badly. But it is noticeably different from a person’s typical behavior.1
What mania looks like
Mania causes major changes in mood, emotions, and energy and activity levels. It may feel like a positive thing to the person in the midst of a manic episode. But it can become frightening, confusing, and frustrating if psychosis develops. Psychosis involves paranoia, delusions, and/or hallucinations.1
Examples of extreme behaviors that may occur during an episode of mania include:1,2
- Going for days without sleep
- Working on unrealistic projects, such as trying to invent a new snack with no expertise in nutrition or cooking
- Emptying bank accounts to make rash financial moves, like gambling, going on shopping sprees, or giving it away to strangers
- Risky behavior like having unprotected sex with strangers or swimming in dangerous waters
- Binge drinking or drug use, often in an effort to calm down
- Becoming very irritated and overreacting to a trigger that does not warrant it, like a social media post
- Becoming convinced a famous person is a good friend
- Being unable to sit still, pacing, or fidgeting for hours
Symptoms of mania
Doctors have an official list of behaviors they look for when diagnosing mania. This list appears in a book known as the DSM-5. According to this manual, an official manic episode must last at least 7 days, most of each day. Or it can last any amount of time if a hospital stay is needed. Mania symptoms include:1,2
- Much more energy, activity, or irritability than what is typical for that person
- Rapid, nonstop conversation or a feeling of pressure to keep talking
- Racing, overwhelming thoughts
- Extreme self-esteem or grandiose belief in self
- Little to no sleep yet still energetic
- Obsession with goal-oriented projects
- Spending money recklessly
- Easily distracted by minor things
- Risky, uncontrolled behaviors
- Psychosis
Almost everyone who has 1 manic episode goes on to have more. Six out of 10 manic episodes are preceded or followed by depression. But early treatment of mania can stop it from becoming worse.3
What hypomania looks like
Hypomania is mania’s less extreme cousin. It shares many of the same features of mania, but generally it is less destructive to the person’s life. Also, hypomania never includes psychosis. If someone has hallucinations but their other symptoms are not as extreme, it is still considered full mania.3
People in a state of hypomania may be noticeably more energetic, require less sleep, or be more talkative. But they can typically function well enough to work, go to school, and take care of themselves.1,3
However, hypomania still needs treatment because it can be distressing and may lead to risky behavior. Like mania, an episode of hypomania may come before or after an episode of depression.1,3
What triggers mania or hypomania?
Doctors often recommend that people with BPD keep a mood diary. This is because each person has unique triggers, or things that happen in their life that come before a manic episode. Common mania triggers include:1-3
- Environmental stimulation, such as loud noise, large crowds, or a busy schedule
- Lack of sleep
- Major life changes, such as divorce, death of a loved one, marriage, or loss of a job
- Alcohol or recreational drug use
- An episode of depression or hypomania
After a manic episode
Dealing with the aftermath of mania or hypomania can feel embarrassing and overwhelming. The person may remember only some or none of what they did. It may take weeks, months, or years to repair personal relationships.1-3
They may need to look for work if they lost their job due to reckless or extreme behavior. If they spent all of their money, the financial hardships can be immense. This type of fall-out is part of why early intervention is so important.1-3
To help avoid periods of mania, follow your treatment plan closely and check in with your doctor regularly.