How to Recognize a Manic or Hypomanic Episode

The symptoms and treatment of bipolar disorder and life event triggers

Money flies out the window
Reckless spending can be a symptom of bipolar mania and hypomania.. Credit: Hiroshi Watanabe / Digital Vision / Getty Images

If someone you know has or may have bipolar disorder, you need to know the signs that point to a manic or hypomanic episode. If you see a group of these behaviors, you (if possible and appropriate) or the individual in question should contact a doctor. Going to an emergency room may be the right choice, depending on how extreme the behavior is. Keep a notebook just for recording manic (and depressive) symptoms for yourself.

If a loved one suffers with bipolar disorder, have them share their experiences so that you can journal for them.

Symptoms of Mania or Hypomania

Most symptoms of manic and hypomanic episodes are shared. Those that are not are indicated below. Here we outline common symptoms and behaviors to look out for:

  1. Make note of any changes in sleeping patterns, especially if your friend or loved one has lots of energy on just a few hours of sleep.
  2. Is he restlessly searching for ways to work off extra energy? Washing the car every day? Make note of this manic behavior.
  3. Be alert to increased talkativeness. If her mouth runneth over, this could be another symptom, especially if the talk seems pressured. (See Pressured Speech)
  4. Be aware if someone starts making "clang" associations, i.e., gets distracted by the sounds of words - such as going on about microphones, xylophones and ice cream cones. (See Clang Associations)
  1. If your spouse/partner is suddenly more sexually demanding, it could be a symptom. Hypersexuality is often a manic or hypomanic symptom. Other deviant sexual behavior such as pornographic websites, online interactions and seeking out liasons is another symptom.
  2. Mania can cause disastrous spending sprees so if you're in the care of someone with bipolar disorder, consider taking the cards and checkbook away while your loved one is exhibiting manic behaviors.

  1. Notice if he or she complains that his thoughts are racing uncontrollably.(See Racing Thoughts)

  2. Be on the alert if she starts having delusions of grandeur - for example, making statements like "Justin Bieber is sending me love letters," or "We have to move to Yemen this weekend, I've been named president there." Note: Delusions of grandeur are not present in hypomania, but grandiose thinking like "I'm going to quit my job and write a novel!" is a possible manic or hypomanic symptom.

  3. Watch out for unreasonable irritability or hostility. This is not just a symptom - it can be dangerous. Be cautious and get help if you see this type of behavior. Do not try to handle the situation on your own.

  4. Increased religious zeal or involvement can be another manic symptom. Make note of this if you see it.
  5. If she describes auditory or visual hallucinations or shows paranoid or other delusional behavior, contact her psychiatrist immediately. These are serious manic symptoms. (Hallucinations and paranoid delusions are not present in hypomania.) (See Delusions, Hallucinations, and Paranoia)
  1. During a manic or hypomanic episode, a person is likely to wear brightly colored or flamboyant clothing. Note this if it occurs with other symptoms.
  2. If manic/hypomanic behaviors start following a change in medications, contact the prescribing doctor promptly.

Be Vigilant

This is not an exhaustive list of manic/hypomanic symptoms. Be vigilant in observing behavior that resembles any of the aforementioned signs. Unfortunately things can escalate quickly, so pay attention and act to protect your loved one and yourself. If a life event happens, such as a change in job, breakup, move, or other change that's major, be on the lookout. These could be triggers to an episode.

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