What Is Hypomania? When Is Feeling Too Good a Sign?

What is hypomania and what are its symptoms? Learn when your euphoric, energetic periods may be a sign of a mood change and what you should look out for.

Once or twice a year, some people feel "switched on": they wake up before the alarm, the to-do list is done in a day, ideas chase one another, and they become the centre of attention in every social setting. This state is usually enjoyable and missed when it is gone. So are these periods just a good mood, or are they a sign of the mood change called hypomania? This question is often asked only after a heavy crash that follows those bright weeks. In this article we look at what hypomania is, which symptoms identify it, how it differs from an ordinary period of feeling good, why it is so easily missed and how you can see your own elevated periods more clearly.

What Is Hypomania?

Hypomania is a period lasting at least several days in which a person's mood, energy and level of activity rise clearly above their usual state. The prefix "hypo" in the name means "below"; in other words, hypomania is a step below mania. The symptoms resemble mania but are milder: the person keeps their grip on reality, things do not reach a level requiring hospital treatment, and often work or school life does not suffer; from the outside it may even look brighter than usual.

Hypomania matters clinically because, especially when it occurs alongside depressive episodes, it is a core component of bipolar II disorder. In bipolar II disorder there is no full manic episode; what really strains a person's life are the long, wearing depressions that follow hypomanic periods. This is why recognising elevated periods is also part of understanding depression correctly. We looked at this distinction in detail in our article on the difference between bipolar disorder and depression.

Shorter and milder fluctuations resembling hypomania may also be part of other pictures. Long-lasting ups and downs that meet the criteria for neither full elevation nor full depression are called cyclothymia. Telling which picture is involved requires a specialist assessment.

What Are the Symptoms of Hypomania?

During this period, several of the following changes appear together and are clearly different from the person's usual self:

• A reduced need for sleep: Sleeping three or four hours instead of five and waking up refreshed.
• Increased energy and activity: Taking on several tasks at once, an endless urge to work.
• Talkativeness: Talking much more than usual, not letting go of the conversation, making a great many phone calls.
• Racing thoughts: Ideas chasing one another, jumping from one topic to the next.
• Increased self-confidence: Feeling more talented, attractive and intelligent than usual.
• Distractibility: Drifting easily to something else, unfinished tasks.
• Impulsivity: Unplanned shopping, sudden decisions, riskier choices than usual.
• Irritability: Feeling that everyone is too slow, intolerance of small delays.

It is important to remember that each of these symptoms can appear in all of us from time to time. Sleeping little one night and being energetic the next day, or talking a lot after good news, does not mean a mood episode. What matters is that the symptoms appear as a cluster, last for days and break away from the person's usual self; in other words, that they form an episode.

When Is Feeling Too Good a Sign?

This is the real question for anyone wondering about their elevated periods. The criteria below can help distinguish an ordinary period of feeling good from a clinical elevation.

Is There a Reason, and Is It Proportionate?

Getting a promotion, recovering from a long illness or meeting someone you love can make a person happy for weeks. This is a natural reaction. In a clinical elevation, however, mood is either not linked to any clear event, or grows out of proportion to the event and gains a momentum of its own.

Do Other People Notice?

One of the diagnostic criteria is that the change is observable to those around you as well. If you hear sentences such as "What's happened to you, you're so different lately" or "Slow down a bit, we can't keep up", that is information.

Is Sleep Getting Shorter Without Any Tiredness?

Someone who feels good still gets their sleep. In an elevated period, the person sleeps little and does not experience it as a lack. This symptom is one of the most reliable signs for making the distinction.

Are You Like Yourself?

Some people describe these periods as "This is the real me." However, decisions made during these periods often turn out, in hindsight, not to fit the person's values: expensive equipment bought but never used, resignations handed in overnight, friendships damaged for no reason.

What Comes Afterwards?

Let us say a 27-year-old software developer spends a few weeks every spring writing code until midnight, starting three separate side projects at weekends and going for a run every morning. Then at the end of May, almost every year, they go through a crash lasting weeks with no explanation: they can barely get out of bed, cannot go to work and feel useless. For this person the real clue is not the spring enthusiasm but the regular rhythm between enthusiasm and crash.

One way to understand whether an elevated period is good or a sign is to look at what comes after it.

Why Is Hypomania So Easily Missed?

This picture is perhaps the most "rewarded" cluster of symptoms in mental health. People who work fast, sleep little, produce many ideas and liven up a room are praised at work and admired on social media. Descriptions such as "entrepreneurial spirit", "hyperactive but very successful" or "you can't keep up with their energy" stop these periods from being seen as a problem.

Working conditions in Turkey increase this invisibility too. Because long working hours, weekend work, trying to make ends meet with a second job and staying up all night in exam periods have already become normal, sleeping little and working a lot do not attract attention. Nobody finds it strange when a student studies until three in the morning in the last months before the YKS (Turkey's university entrance exam), or when a shopkeeper rushes around non-stop in the weeks before a religious holiday. Yet what matters is not external conditions but whether the person's inner rhythm has changed.

Another reason is that people fear losing these periods. Someone who has lived through the weight of depressive episodes welcomes this energy as "I'm finally myself again." Telling a specialist about these periods can feel like risking the only good thing they have. This worry is very understandable and is something that should be talked about openly in therapy.

In women, these periods sometimes appear in the first weeks after giving birth and are interpreted as "new-mother joy" or "baby excitement". A mother who never gets tired despite a newborn baby, reorganises the whole house at night instead of sleeping, and phones everyone to talk for hours may be greeted by those around her with "Mashallah, what energy!" Yet the postnatal period is a sensitive time when mood fluctuations can begin; both the elevation and the crash that follows it should be watched carefully.

Finally, when people go to a specialist, they usually talk only about their current difficulties. Nobody complains, "I was very well last spring." So if these periods are not specifically asked about during an assessment, they may never come up.

What Can You Do to Notice Your Elevated Periods?

The suggestions below are not for making a diagnosis but for getting to know your own rhythm and, if necessary, sharing a clearer picture with a specialist.

Define Your "Usual" Self

To notice an elevation, you first need to know what your usual self looks like. How many hours do you sleep, how many people do you talk to in a day, how often do you shop? Your answers to these questions during a balanced period become a starting point for comparing later changes.

Keep a Simple Mood Log

Each evening, take a minute to note three things: how many hours you slept, how you would rate your energy from 1 to 10 and one notable event of the day. After a few months, this record reveals patterns your memory cannot show. Links with seasonal patterns, annual leave, exam periods or the month of Ramadan may become clear.

List Your Own Early Signs

Look back at your past elevated periods: what changed first? For some, the first sign is making a new business plan at night instead of watching a new series; for others it is turning the music up; for others still it is messaging everyone. Writing this list down helps you notice earlier next time.

Set a Waiting Rule for Big Decisions

Make it a rule to put decisions such as large purchases, resigning, moving house or starting a business on hold for at least a few days during periods when you feel unusually energetic. Not acting on a decision without first discussing it with someone you trust is also an effective brake.

Protect Your Sleep

Although sleep may seem unnecessary during elevated periods, protecting your sleep times is one of the important steps that can stop the elevation from growing. Switching screens off early at night, fixing your bedtime and limiting stimulating drinks in the evening all contribute to this.

Ask for the Observations of People Close to You

Asking one or two people you trust, "If you see me different from usual, sped up, will you tell me?" lets you see what you cannot see on your own. Talking about this during a balanced period makes it less likely that the warning will later feel like criticism. You can even agree in advance on the sentence you would like to be warned with; for example, a gentle question such as "You're a bit fast this week, how's your sleep?" is, for many people, an easier reminder to accept.

When Should You Seek Professional Support?

It is advisable to see a psychiatrist and a clinical psychologist in the following situations:

• If your elevated periods are regularly followed by deep crashes,
• If decisions you made in these periods have caused financial, professional or relationship damage,
• If you experienced unusual speeding up while being treated for depression,
• If there is a history of bipolar disorder in your family,
• If elevated periods are getting longer, more intense or more dominated by irritability.

Diagnosis and any necessary medication are the domain of the psychiatrist. These periods can sometimes progress to mania; we described the symptoms of that state in our article on mania symptoms. If at any point thoughts of ending your life appear, if you feel at risk of harming yourself or notice that your grip on reality is weakening, call 112 (emergency services) without delay or go to the nearest emergency department.

How Is Hypomania Addressed in Therapy?

Psychotherapy, in collaboration with the treatment managed by a doctor, helps a person get to know their own mood rhythm and build a safer relationship with it. The main themes in work on depression and mood are:

• A mood map: The person's past elevated and low periods are placed on a timeline alongside life events. This map often shows the person the whole of their own story for the first time.
• Working with the sense of loss: The worry about "losing" the energy, creativity and self-confidence that elevated periods bring is discussed openly. The aim is not to extinguish the person's vitality but to reduce the destructive crashes that follow it.
• Cognitive Behavioural Therapy (CBT): Beliefs such as "I'm only worth something if I work at this speed" or "If I slow down I'll be ordinary" are noticed and tested. Concrete braking strategies are developed for impulsive decisions.
• Rhythm and routine work: Plans are made for regulating sleep, meal and working times, and for protecting rhythm especially during busy work periods.
• Preparing for depressive episodes: Small steps the person can take without blaming themselves when a crash comes are set out in advance.

Frequently Asked Questions

Does everyone who experiences hypomania get a diagnosis of bipolar disorder?

No. A diagnosis of bipolar II requires, alongside hypomanic periods, depressive episodes that meet certain criteria. In some cases periods resembling hypomania may be due to other causes, for example substance use or a medical condition. A specialist assessment is needed to make the distinction.

Do hypomanic periods end on their own?

Often they do; but it is common for a depressive episode to follow. So rather than waiting because "it'll pass anyway", talking through the pattern of these periods with a specialist helps you to be prepared for later crashes.

I feel very ashamed of the money I spent during a hypomanic period. What can I do?

This shame is very common and can deepen a depressive episode. It helps to first go over the concrete damage with someone you trust, then make a repayment plan. In therapy it is possible to turn this experience from self-blame into understanding and to develop braking measures for the next period.

Does my creativity come from hypomania, and will treatment destroy it?

This is a question often asked by artists and people in creative work. Creativity belongs to the person; an elevated mood can only increase its speed and intensity. The aim of treatment is not to suppress this capacity but to reduce the destructive side of the fluctuations; it is important to share this concern openly with your doctor and your therapist.

• #hypomania
• #bipolar disorder
• #mood
• #energy

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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