Anonymous asks: Is it normal to miss hypomania?

Long story short, it is very common to miss hypomania. Hypomanic mood symptoms are below the threshold for mania, which is typically associated with more heightened energy and mood levels as well as the possibility for psychotic features, thus typically leading to pronounced difficulty functioning. However, a more mild euphoric mood that does cross in this territory can feel really enjoyable. When hypomanic, patients often report feeling more energetic, productive, and sociable. Further, it can feel like a reprieve from the emotionally draining and painful symptoms that accompany depressive episodes. While hypomania has less potential for more extreme behaviors, it is very common for patients to report more impulsivity (an increase in spending, substance abuse, sexual behavior) that can have consequences and often lead to treatment. Sleeplessness can only last for so long before people tend to crash. Thus for short periods, hypomania may feel good, but long-term it is unsustainable and best treated with medication and behavioral modification (structured routines and effective management of stressors).

Dr. Stephanie Freitag PhD is a licensed clinical psychologist based in Brooklyn, New York. She runs her own private practice where she treats patients in seven states (CA, CT, FL, GA, MA, NJ, NY). As a specialist in bipolar disorder, she uses Interpersonal and Social Rhythm Therapy (IPSRT) to support patients in individual and group therapy. She most recently trained at the Emory School of Medicine where she is currently an assistant adjunct faculty member who publishes research on bipolar disorder and intimate partner violence. Beyond her clinical work and research she is passionate about advocacy and believes strongly in fighting the stigma associated with mental illness.