Hypomania is a phase of bipolar disorder characterized by euphoria, increased energy, decreased need for sleep, and increased productivity. While these symptoms may seem desirable, hypomania often precedes full manic episodes involving disabling symptoms that can lead to hospitalization or job loss. Additionally, the "high" of hypomania does not last and will inevitably flip into a depressive state. Portrayals like Claire Danes' character on Homeland provide a realistic example of the disconnected thought processes and nonstop speech that occur during hypomanic episodes.

1. DR. SANJAY GUPTA
How Can Happiness Be The
Symptom of a Disease?
Bipolar illness has a 'good' phase called
hypomania, characterized by euphoria, increased
energy and decreased need for sleep. The
problem is, it doesn't last.
Sanjay Gupta, MD, Everyday Health: You have
depression, you have mania, and then there’s
hypomania. How do you define hypomania?
Katherine Burdick, PhD, Associate Professor,
Psychiatry, The Icahn School of Medicine at
Mount Sinai: So the symptoms that we see
typically in hypomania include euphoria, so very
high, heightened, a lot of happiness, increased
levels of energy, typically that’s also associated
with increased productivity. So people who are
creative might do a lot of writing during that
period or painting during that period. They tend
not to need as much sleep. And you’ll typically
see patients very pressured, so they speak very
quickly, and thoughts will come to them very
quickly.

2. Dr. Gupta: Increased productivity, increased
energy, decreased need for sleep, I mean these
all seem like good things.
Dr. Burdick: Absolutely. Hypomania is a state that
most of us would like to achieve and remain in.
The problem, of course, is the flipside of the
hypomania. Hypomania often precedes full
mania. This means that they’ve reached a
disabling component of the illness where they’re
either hospitalized or they’re fired from their job
or they’ve behaved in some way that might
disrupt relationships.
Dr. Gupta: Claire Danes’ character on Homeland.
I think it’s one of the first times we’ve seen such
a detailed portrayal of someone with bipolar
illness. What do you think of that portrayal, how
accurate is it?
Dr. Burdick: I think they actually did a very, very
nice job. They presented the illness in a way that
I think was quite realistic. Patients talk nonstop
and can go for hours without literally sounding
like they’re taking a moment to just take a
breath. The flow of language and the way in
which some of these words will connect, it’s quite
different. So you see the way the person’s brain
is just functioning in a different way – in some
ways quite interesting and quite impressive, but

3. at the same time, you can see the sort of
disconnect with reality.
Dr. Gupta: How do you describe this to someone
who’s never experienced any of these symptoms,
what it's like to be in these different phases?
Dr. Burdick: So I think that the depressive phase
of the illness is probably one that is the easiest
for most people to understand. The severity of it
is the thing that I think is very difficult for people
who have never experienced these episodes to
understand. People suggesting, “Just get up out
of bed and just go do something, you'll feel
better.” The just getting up out of bed is really a
different problem for a patient with clinical
depression. Mania, I think, is probably a little bit
more difficult. If something very, very good
happens to you, you WIN THE LOTTERY or you
have some really great news that comes in and
you just feel elated and very happy, very
energetic. One of the important things that
differentiates those very good moments in life
from mania is the durability of it. Eventually, that
elation, the sort of intensity of that feeling, wears
off. In individuals with mania, it doesn’t.
Last Updated:09/15/2014
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