The Difference Between Mania and Hypomania?

Question: Can you describe the difference between hypomania and mania?

 

Answer: This is a great question and many people have trouble telling mania and hypomania apart at first because they are really quite similar. So let’s start by looking at the ways that they are alike, before we talk about how they’re different.

 

Hypomania and mania are very similar in terms of the thoughts, feelings, and behaviors that go along with them. They include:

• Inflated self-esteem or grandiosity;
• Decreased need for sleep;
• More talkative than usual;
• Flight of ideas, racing thoughts;
• Distractibility;
• Increase in goal directed activity, agitation;
• Activities that have a high potential for painful consequences.

 

In the DSM they describe both hypomania and mania as “a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy.”

 

The way they differentiate the two is based on how long the episodes last. For mania they say the episode needs to last for at least 1 week, whereas for hypomania they specify it lasts for at least 4 days. 

 

We can see how this isn’t really a clear difference, nor is it explained in a way that is very useful when you’re at home with someone who seems to be either manic or hypomanic. So an easier, less clinical, way for family and friends to tell the difference is that you can think of hypomania a little like it’s “mania-lite”. 

 

Hypomania is going to be a little bit less intense than mania. For example, the symptom of decreased need for sleep might mean with hypomania that the individual is sleeping only 4 or 5 hours a night, whereas with full blown mania they’ll might not be sleeping at all.

 

In children the time frames given are also pretty unhelpful because kids can rapid cycle through mania, hypomania, and depression in a matter of hours. So, the 4 days vs. 1 week measurement isn’t going to have any practical application.

 

An more obvious indicator in kids can be that with hypomania you may find that they can, with some effort, be redirected and you can get their attention for short periods of time. With full mania that becomes much more difficult and they often spin-out like a top with either silly, giddy, euphoria or irritable, angry, rages until they’ve exhausted themselves. Parents often describe that during mania their child gets “the look” on their faces and when they look into their child’s eyes they report their child “isn’t there”. 

 

During mania episodes, parents often find their first and only concern is the safety of their child and the people around them because mania kids can often engage in the symptom of activities that have a high potential for painful consequences. 

 

That’s a fairly long answer, but put simply, you can think of the difference between hypomania and mania as the difference between a pot of water that’s just started to simmer (hypomania), and a pot of water that’s at a rolling boil (mania). One’s a lot easier to turn down than the other.