Hypomania: signs, how it relates to bipolar disorder and what helps

Hypomania is a state of elevated mood and raised energy that is noticeable to others but less extreme than mania. Bipolar UK describes it as the stage between a balanced, happy mood and mania, which doctors describe as a distinct period of abnormally and persistently elevated mood.

It is most often discussed in the context of bipolar disorder, where the NHS says people have extreme changes in mood, sometimes high (mania or hypomania) and sometimes low (depression). People with bipolar disorder usually have stable periods with no symptoms in between. A specialist decides which type of bipolar disorder someone has, and bipolar II is the form characterised by hypomanic rather than full manic episodes alongside depression.

The NHS lists high mood symptoms including feeling very happy and excited, feeling very irritable or aggressive, having a lot of energy and not needing much sleep, racing thoughts or poor concentration, talking fast or a lot, a high sex drive, feeling overly confident, being impulsive or extravagant, and saying or doing things that are out of character.

Bipolar UK describes how hypomania may feel: energetic, as though on an adrenaline rush, happy with a strong sense of wellbeing, confident, creative, irritable and easily distracted. What someone may do includes talking a lot and interrupting, being very friendly to strangers, having out-of-character sexual encounters, sleeping little, becoming very productive and drinking more tea, coffee or alcohol than usual.

People who have hypomania in bipolar disorder usually also have depression at other times. The NHS lists low mood symptoms including feeling sad or upset, loss of interest, low energy, disturbed sleep, changes in appetite, low confidence, feeling worthless or hopeless, difficulty concentrating, avoiding others and having suicidal thoughts or thoughts of harming yourself.

Because hypomania can feel good, people sometimes seek help only during depression. Bipolar UK notes that noticing and managing hypomania before it gets worse and turns into mania is one of the main challenges for people living with bipolar, so it helps to tell a GP or specialist about any past high periods, however pleasant they felt.

The NHS says to see a GP if you have extreme changes in mood that last a long time or affect everyday life. The GP may refer you to a psychiatrist, who will ask about moods, behaviour, health and family history. It can take time to diagnose because bipolar disorder affects everyone differently and symptoms resemble other conditions.

Treatment is planned with a mental health specialist and may include medicines to stabilise moods and talking therapy such as CBT. Some medicines are taken all the time and others only when symptoms worsen. The NHS says not to stop bipolar medicine unless told to by a doctor, even if you feel better, and that some medicines are not safe in pregnancy, so talk to a doctor if you are pregnant or planning a pregnancy.

The NHS suggests keeping a regular routine, getting plenty of sleep, eating healthily, exercising and managing stress, and avoiding recreational drugs, too much alcohol, lots of caffeine, shift work and flying across time zones where possible.

Bipolar UK describes mania as a psychiatric emergency in which treatment and support may be needed urgently to keep someone safe. The NHS says that if doctors are worried you are at risk of self-harm, suicide or harming someone else you may need to stay in hospital or have support from a crisis team at home. In an emergency call 999 or go to A&E, and NHS 111 can direct you to urgent mental health support.