The underlying causes of hypomania aren't fully understood, but genetics and environment both likely play a role. Hypomania and bipolar spectrum conditions tend to run in families — having a parent or sibling with bipolar disorder raises your likelihood of experiencing it yourself.
Other risk factors include emotional trauma, family conflict, or brain injury, which has been linked to a higher risk of manic and hypomanic episodes. All of these contribute to vulnerability rather than determining whether you'll experience hypomania.
If you have hypomania, triggers are experiences that can push you closer to an episode, though they won't cause hypomania in someone who doesn't already have it.
Triggers can include:
Medication reactions (e.g., antidepressants or steroids): Sometimes experiencing hypomanic episodes along with depression can be misdiagnosed as depression alone, followed by a prescription for an antidepressant (usually an SSRI). Research shows antidepressants and the supplement St. John's wort can sometimes trigger hypomanic episodes in people prone to them.
If you’re wondering if either interaction may impact you, consult with the professional who oversees your psychiatric medications. It is never recommended to make abrupt changes in your medication without speaking to your doctor or licensed prescriber first.
Ongoing stress or trauma exposure: Repeated stress or trauma, including around major life events like getting married, changing jobs, or moving can increase your likelihood of a hypomanic episode.
Disruptions in sleep patterns or circadian rhythm: Getting less sleep or having major shifts in your sleep schedule can come before an episode. Hypomania has also been linked to occurring in spring and summer, possibly because increased daylight disrupts circadian rhythms.
Menstruation and hormone events: Hormonal shifts during the menstrual cycle, particularly around the premenstrual or mid-cycle phases, may trigger mood episodes in some menstruating people.
Substance use or substance use disorder: Recreational stimulant use and cannabis use are the most commonly named substances that can trigger hypomania. High amounts of caffeine have also been associated with triggering episodes, though the evidence is not fully conclusive.