Recognizing and Treating the Lesser-Known Symptoms of Hypomania

“When I hear people talking about their hypomania, sometimes I get jealous,” Ellen says. “I’ve read articles from Stephen Fry talking about amazing bursts of creativity and heard from people in my support group about the great energy they get and how productive they are. But I don’t get any of that.” Ellen, now 26, was diagnosed with bipolar II disorder at 18. But her disorder doesn’t look like what many people expect; in fact, her symptoms of hypomania are different from the stereotype, and she often feels alienated from others who experience more common mood symptoms. “I don’t get really happy. I don’t become euphoric or clean my house for hours or get a week’s worth of work done in a night. I just get anxious and angry. And that can feel unfair.”

Pleasurable Presentations

Bipolar II disorder is known for its depressive episodes that often last for weeks, months, or even years. Along with these dark periods, people with this form of bipolar disorder experience hypomania, a milder form of mania that often manifests in heightened energy, decreased need for sleep, euphoria, and flights of ideas. For many, hypomania is a kind of consolation prize; it is often when people gain heightened creativity, find that their mood elevates, and have the energy to engage with the world. As Dr. Russ Federman describes it:

You’re waking up earlier in the morning and your energy is readily available – no more desire to pull the blankets over your head and return to the soothing cocoon of sleep. Your thoughts are moving faster, you’re connected to your creativity and you’re experiencing the desire to open up and blossom, just like everything else around you. You breeze through your day with a fair amount of energy and when evening comes along you don’t really want to wind down. There is so much more still to do and sleep feels like interference.

These experiences can be extraordinarily seductive, particularly after emerging from a period of depression in which you may have struggled to even get out of bed, and the pleasures of hypomania can act as a significant barrier to treatment, as people sometimes fear losing the highs of hypomanic episodes.

The Other Side of Hypomania

However, hypomania isn’t always a pleasurable experience. For many, bipolar II disorder has no euphoric component, no rush of creative thought, no augmented productivity. Instead, the symptoms of hypomania take a very different and uncomfortable form characterized by agitation, anxiety, and irritability, experiences that can increase distress, contribute to interpersonal difficulties, and greatly reduce your quality of life. As Natasha Tracy writes,

For me it’s a highly irritating time. I want to lash out at people simply because I feel so agitated. I want to get mad at people for no reason other than the fact that I just want to get mad to get this annoying energy out of me.

Acting on the impulses of this form of hypomania can be deeply harmful to relationships, both personal and professional, and can cause you to act against your true nature even with those you care about most. During these periods, you may take your agitation out on others and try to externalize your feelings of discomfort by picking fights, starting arguments, or being angry. However, these hypomanic symptoms are about more than your relationships with others; they can also greatly affect your relationship with yourself. Tracy vividly describes how hypomania can invade your mind and body, leaving you trapped with explosive energy and overwhelmed by anxiety, anger, and agitation:

[Hypomania is] like torment from the pulsating cell walls that won’t shut up for one moment and let you think. Like anxiety created from not being able to quell the millions of thoughts or being able to facilitate the 1000s of movements being demanded of the human body at once. Like a million other things all happening at once inside one tiny head unable to contain them all.

These experiences can be extraordinarily disruptive and impair your everyday function. Worse still, they can damage your trust in your own judgement, thoughts, and feelings, damaging your confidence and your ability to make good choices. Sometimes, they can even be overwhelmingly physical, making you feel deeply uncomfortable in your own skin.

Coping with Symptoms of Hypomania

Most treatment for bipolar II disorder tends to focus on the depressive side of the illness. After all, for most people with the disorder, that is the most enduring and severe symptom. However, hypomania can be a severely distressing state and coping with the anxiety, agitation, anger, and irritability that accompany this state is vital to restoring emotional wellness and improving your quality of life. As such, it is critical that your bipolar disorder treatment includes focused treatments that address the lesser-known symptoms of hypomania and their effects on your life.

At Bridges to Recovery, we offer comprehensive, personalized treatment designed to meet each client’s individual needs. Using a synergistic array of therapeutic modalities, we create healing experiences that seek to create multiple pathways toward recovery, including:

  • Pharmacological Therapy: Today there is a range of medications available that successfully alleviate hypomanic symptoms, including mood stabilizers and atypical antipsychotics. Although finding the right medication can be a process of trial and error, working with a psychiatrist who has the training and experience to design effective, well-tolerated medication protocols for people suffering from agitated hypomania can optimize your chances of finding the right treatment as quickly as possible.
  • Psychotherapy: Both individual and group psychotherapy led by clinicians who understand the diverse range of symptoms of hypomania can be critical to helping you handle distress as well as identifying any triggers that cause hypomania to take hold. Not only can these therapeutic forms allow you to develop the concrete skills you need to cope with and minimize hypomanic symptoms, they also serve as a safe space to explore how your hypomania has impacted your life, and begin to repair the damage it has caused in your relationship with yourself and your relationships with others.
  • Holistic Therapies: Holistic therapies such as massage, meditationacupuncture, and yoga can be deeply grounding and allow you to relieve hypomanic energy while reconnecting you with your body in a healthy way. While participating in holistic therapies, you are given the time and space to explore nonverbal avenues toward healing, learn vital relaxation techniques, and allow yourself to experience yourself in the present moment to achieve equilibrium of mind, body, and spirit.

With the support of experienced clinicians and compassionate peers, you can break free from the pain of hypomania and create a richer, more balanced, and more joyful life.

Bridges to Recovery offers comprehensive residential treatment for people suffering from bipolar II disorder as well as co-occurring substance addiction, eating disorders, and process addictions. Contact us for more information about how our innovative program can help you or your loved one start the journey toward healing.