How to Recognize a Manic or Hypomanic Episode

Learn to watch out for signs like spending money and talking excessively.

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, it is a good idea to know the signs and symptoms that point to a potential 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. 

Symptoms of Mania or Hypomania

Most symptoms of manic and hypomanic episodes are shared.

The main difference is that manic symptoms are more extreme and can lead to hospitalization. A hypomanic episode does not require hospitalization.

In addition, a manic episode lasts at least one week whereas a hypomanic episode may only last 4 days.

Here are common manic and hypomanic symptoms and behaviors to look out for:

Decreased Need for Sleep

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.

Engaged in Many Activities at Once

Is your friend or loved one restlessly searching for ways to work off extra energy? Washing the car every day? Make note of this manic behavior.

Talking A Lot

Be alert to increased talkativeness. If her mouth runneth over, this could be another symptom, especially if the talk seems pressured. Talking loudly and quickly is also another sign of a potential manic or hypomanic episode. 

Easily Distracted

Be aware if someone starts making "clang" associations (for example, gets distracted by the sounds of words such as going on about microphones, xylophones and ice cream cones.)

Increased Desire for Sex

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.

Increase in Other Risky Behaviors like Gambling and Spending

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.

Rapid Thinking

Notice if he or she complains that his thoughts are racing uncontrollably.

Grandiosity

Be on the alert if your friend or loved one 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.")

It is important to note that 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.

​​Hostility and/or Increased Irritability

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.

​​Excessive Religious Dedication

Increased religious zeal or involvement can be another manic symptom. Make note of this if you see it.

Bright Clothing

During a manic or hypomanic episode, a person is likely to wear brightly colored or flamboyant clothing. Of course, most people who wear bright colored clothing are not experiencing a manic or hypomanic episode. This is a subtle clue and can be helpful if it occurs with other manic or hypomanic symptoms. 

When to Seek Immediate Help

If your friend or loved one describes auditory or visual hallucinations or shows paranoid or other delusional behavior, contact their psychiatrist immediately. These are serious manic symptoms. (Hallucinations and paranoid delusions are not present in hypomania.)

If manic/hypomanic behaviors start following a change in medications, contact the prescribing doctor promptly.

A Word from Verywell

This is not an exhaustive list of manic/hypomanic symptoms. Be vigilant in observing behavior that resembles any of the aforementioned signs. You may consider keeping a notebook 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.

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.

Sources:

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).

American Psychiatric Association. (2015). What are Bipolar Disorders?

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