Difference Between Mania and Hypomania?

“What is the difference between mania and hypomania?  Can someone have both at separate times?”

Individuals in a hypomanic state have a decreased need for sleep, are extremely outgoing and competitive, and have a great deal of energy.  Unlike with full mania, and its extreme form, hypermania, those with hypomanic symptoms are functional and often actually more productive than usual

In addition, hypomania is distinguished from mania and hypermania by the absence of psychotic symptoms and the high sense of grandiosity and by a lesser degree or impact on functioning.  In fact, some noted authorities, such as John Gartner at Johns Hopkins, argue that a mild form of hypomania is better understood as a stable, non-pathological temperament rather than an episode of mental illness.  Most mental health professionals differ, and the DSM clearly defines hypomania as an aberrant state, not a stable trait.

It is also important to note that hypomania, mania and hypermanic symptoms can be an unexpected effect of medications that have been prescribed for conditions and diseases other than psychological states as well as for perceived psychiatric disorders.

Hypermania is a severe form of mania.  There is the need for diagnosis by a specialist in mental disorders, a psychologist or psychiatrist.  Hypermania is a subcategory of bipolar disorder but rarely if ever is there a “low.”  The symptoms include an overwhelming feeling of happiness or elation without cause, very high activity level with little need for sleep, difficulty falling asleep due to racing thoughts and flight of ideas, lack of coping skills or just not coping at all with anything that would be upsetting, sporadic behavior like taking off on an unplanned road trip to see a beautiful sunset 1100 miles away because it seems like a great idea.  There also might be spending sprees, excessive gambling, promiscuity, and generalized risk taking.

While almost all of these symptoms are also symptoms of hypomania, in hypomania they exist to a lesser degree.  In other words, hypermania is more apt to lead to, or already include extreme suspiciousness, to the point of serious paranoia and other symptoms of psychosis.  Persons at this stage might well begin to imagine they are being followed, that the government is tracking their movements, that they hear voices, sometimes telling them what to do, and might even believe that they are someone else in a foreign body.

One can suffer from rapid cycling in which case hypermania and hypomania alternate and the intensity of the symptomatic behavior is like a roller coaster ride, sometimes without a safety bar.  One can also suffer from mixed states, in which the rapid cycling is so pronounced that they appear to exist simultaneously.  I would not however unequivocally state that they “coexist.”

Hopefully this contributes to your understanding of these conditions.  As usual, I recommend to anyone with symptoms to seek out a proper diagnosis from a well-qualified psychologist or psychiatrist.

~Dr. Manuel S. Silverman, PhD