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Hypomania is a symptom of bipolar II disorder, characterized by an inflated sense of self, increased productivity, and an inability to relax. It can lead to dangerous behavior, including suicide and addiction to alcohol or drugs. Treatment includes medication and therapy. Antidepressants may be used, but their effectiveness is debated.
A hypomanic episode is symptomatic of bipolar II disorder. Hypomania is a reduced level of mania that generally gives people more control over their actions than they would have in a manic state. Describing these episodes is difficult because each person experiences this state differently. Some people feel positive and productive and are relieved that they don’t feel depressed, while others are tortured by seemingly endless mental activity. In the absence of a description of how all people experience these episodes, it is still possible to discuss the characteristics that accompany hypomania; they just need to be understood as they occur at different levels in each person with each episode.
Some symptoms identified with hypomania are:
Feeling that the mind is going into overdrive.
Restlessness and difficulty relaxing.
Severe panic or anxiety.
Flight of ideas (where people have a conversation or think about a series of unrelated topics, one after another).
Inflated sense of importance.
Inability to get to or stay asleep.
Increased productivity.
Abnormally elevated mood.
Increased interest in sexuality.
Rapid mood swings to anger and rage.
When a hypomanic episode occurs, the longer it lasts, the more it tends to turn negative. This is an exceptionally dangerous time for someone with bipolar disorder. The desire to somehow “turn off the mind” can become so strong that it leads to suicide. Although depression, the other half of the bipolar II experience, is often linked to suicidal episodes, hypomania can be just as deadly, even more so if the recurring thought is self-injurious. The person’s energy level and desire to “do something” can make suicide more likely.
Not everyone commits suicide, but there are other inherent risks during a hypomanic episode. People often use alcohol or illegal drugs to try to level or control moods. Hypomania explains the relationship between alcoholism and bipolarity because it is the easiest substance to obtain that can create temporary peace of mind. The result is temporary and tends to create greater mood instability. The desire to maintain mood balance can fuel an increased addiction to alcohol.
The inflated sense of self and lowered judgment threshold also make the hypomanic episode problematic. It’s easy for people to make life decisions they’ll regret, like quitting their jobs or being in relationships with the wrong people. Overspending, overeating, and compulsive gambling are other potential pitfalls. Anger levels can also be deeply disturbing in one’s personal and professional life and create significant harm.
Bipolar II is managed with medication and therapy. If a person is taking medication, a hypomanic episode indicates an insufficient medication regimen and a psychiatrist should be consulted immediately. People who think they are hypomanic should also see a psychiatrist. There are many different combinations of medications that treat this condition. However, it often takes some time to find the right combination.
Medications to address bipolar II disorder include lithium or anticonvulsants (valproic acid, lamotrigine, or carbamazepine), and may also include sedatives or atypical antipsychotics. There is much debate as to whether antidepressants are appropriate. Their use can create hypomania, but other times very small amounts of antidepressants effectively treat higher levels of depression.
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