Hypomania - AbsoluteAstronomy.com

This article is an expansion of a section titled Hypomania from within the main article: Bipolar disorder

Bipolar disorder

Bipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or...

Hypomania (literally, "below mania") is a mood

Mood (psychology)

A mood is a relatively long lasting emotional state. Moods differ from emotions in that they are less specific, less intense, and less likely to be triggered by a particular stimulus or event....

state characterized by persistent and pervasive elevated (euphoric) or irritable mood, as well as thoughts and behaviors that are consistent with such a mood state. Many people also experience signature hypersexuality

Hypersexuality

Hypersexuality is extremely frequent or suddenly increased sexual urges or sexual activity. Hypersexuality is typically associated with lowered sexual inhibitions. Although hypersexuality can be caused by some medical conditions or medications, in most cases the cause is unknown...

Presentation

Individuals in a hypomanic state have a decreased need for sleep, are extremely outgoing and competitive, and have a great deal of energy. However, unlike with full mania

Mania

Mania, the presence of which is a criterion for certain psychiatric diagnoses, is a state of abnormally elevated or irritable mood, arousal, and/ or energy levels. In a sense, it is the opposite of depression...

, those with hypomanic systems are fully functioning, and are often more productive than usual.

Distinctive markers

Specifically, hypomania is distinguished from mania

Mania

by the absence of psychotic symptoms and grandiosity, and by its lesser degree of impact on functioning. Hypomania is a feature of bipolar II disorder

Bipolar II disorder

Bipolar II disorder is a bipolar spectrum disorder characterized by at least one hypomanic episode and at least one major depressive episode; with this disorder, depressive episodes can be more frequent and are more intense than hypomanic episodes...

and cyclothymia

Cyclothymia

Cyclothymia is a mood and mental disorder in the bipolar spectrum that causes both hypomanic and depressive episodes. It is defined medically within the bipolar spectrum and consists of recurrent disturbances between sudden hypomania and dysthymic episodes. The diagnosis of cyclothymic disorder is...

, but can also occur in schizoaffective disorder

Schizoaffective disorder

Schizoaffective disorder is a psychiatric diagnosis that describes a mental disorder characterized by recurring episodes of elevated or depressed mood, or of simultaneously elevated and depressed mood, that alternate with, or occur together with, distortions in perception.Schizoaffective disorder...

. Hypomania is also a feature of bipolar I disorder

Bipolar I disorder

Bipolar I disorder is a mood disorder that is characterized by at least one manic or mixed episode. There may be episodes of hypomania or major depression as well...

as it arises in sequential procession as the mood disorder fluctuates between normal mood and mania. Some individuals with bipolar I disorder have hypomanic as well as manic episodes. Hypomania can also occur when moods progress downwards from a manic mood state to a normal mood. Hypomania is sometimes credited with increasing creativity and productive energy. A significant number of people with creative talents have reportedly experienced hypomania or other symptoms of bipolar disorder

Bipolar disorder

and attribute their success to it. Classic symptoms of hypomania include mild euphoria, a flood of ideas, endless energy, and a desire and drive for success. A lesser form of hypomania is called hyperthymia.

Definitions

Hypomania is also a side effect of numerous medications, often—though not always—those used in psychopharmacotherapy. Patients suffering from severe depression who experience hypomania as a side effect of antidepressants (for example), may prove to have a form of bipolar disorder that has previously gone unrecognized. However, drug-induced hypomania is not invariably indicative of bipolar affective disorders. The difference between uni- and bi-polar disorders is essential for analysis of switches (mood changes). Consequently, it is important for researchers and mental health professionals to distinguish drug-induced hypomania in bipolar patients from drug-induced hypomania in unipolar (non-bipolar) depressives. Nevertheless, if antidepressants trigger the first episode of hypomania, it is strongly suggestive of an underlying diagnosis of bipolar disorder, particularly if the manic symptoms (mild, moderate or severe) last for a lengthy period of time after they start.
In cases of true drug-induced hypomania, cessation of the antidepressant or whichever drug has triggered this mood state—for example steroid therapy or stimulants such as amphetamine

Amphetamine

Amphetamine or amfetamine is a psychostimulant drug of the phenethylamine class which produces increased wakefulness and focus in association with decreased fatigue and appetite.Brand names of medications that contain, or metabolize into, amphetamine include Adderall, Dexedrine, Dextrostat,...

—usually causes a fairly swift return to normal mood. It is far less likely to be a side effect in those with pure Clinical Unipolar Depression, unless for example tricyclic antidepressant

Tricyclic antidepressant

Tricyclic antidepressants are heterocyclic chemical compounds used primarily as antidepressants. The TCAs were first discovered in the early 1950s and were subsequently introduced later in the decade; they are named after their chemical structure, which contains three rings of atoms...

s are given in very high doses. SSRIs are less likely to trigger manic symptoms except in those individuals where there is an underlying bipolar disorder, particularly if administered without a mood stabilizer

Mood stabilizer

A mood stabilizer is a psychiatric medication used to treat mood disorders characterized by intense and sustained mood shifts, typically bipolar disorder.-Uses:...

Occurrence

Often in those who have experienced their first episode of hypomania (which is a level of mild to moderate mania) - generally without psychotic features - there will have been a long or recent history of depression prior to the emergence of manic symptoms, and commonly this surfaces in the mid to late teens. Due to this being an emotionally charged time, it is not unusual for mood swings to be passed off as hormonal or teenage ups and downs and for a diagnosis of Bipolar Disorder to be missed until there is evidence of an obvious manic/hypomanic phase.

Hypomania may also occur as a side effect of pharmaceuticals prescribed for conditions/diseases other than psychological states or mood disorders. In those instances, as in cases of drug-induced hypomanic episodes in unipolar depressives, the hypomania can almost invariably be eliminated by lowering medication dosage, withdrawing the drug entirely, or changing to a different medication if discontinuation of treatment is not possible.

Some, such as Johns Hopkins psychologist John Gartner, argue that hypomania is better understood as a stable non-pathological temperament rather than an episode of mental illness The DSM however clearly defines hypomania as an aberrant state, not a stable trait.

Symptomatic recognition

The DSM-IV-TR defines a hypomanic episode as including, over the course of at least four days, elevated mood plus three of the following symptoms OR irritable mood plus four of the following symptoms:

pressured speech
inflated self-esteem
Self-esteem
Self-esteem is a term in psychology to reflect a person's overall evaluation or appraisal of his or her own worth. Self-esteem encompasses beliefs and emotions such as triumph, despair, pride and shame: some would distinguish how 'the self-concept is what we think about the self; self-esteem, the...

or grandiosity
Grandiosity
Grandiosity is chiefly associated with narcissistic personality disorder, but also commonly features in manic or hypomanic episodes of bipolar disorder....
decreased need for sleep
flight of ideas or the subjective experience that thoughts are racing
easy distractibility and attention-deficit similar to attention deficit hyperactivity disorder
increase in psychomotor agitation
Psychomotor agitation
Psychomotor agitation is a series of unintentional and purposeless motions that stem from mental tension and anxiety of an individual. This includes pacing around a room, wringing one's hands, pulling off clothing and putting it back on and other similar actions...
involvement in pleasurable activities that may have a high potential for negative psycho-social or physical consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, reckless driving, or foolish business investments).

Possible benefits

Some commentators believe that hypomania actually has an evolutionary advantage. People with hypomania are generally perceived as being energetic, euphoric, visionary, overflowing with new ideas, and sometimes over-confident and very charismatic, yet—unlike those with full-blown mania—are sufficiently capable of coherent thought and action to participate in everyday activities.
Like mania

Mania

, there seems to be a significant correlation between hypomania and creativity

Creativity

Creativity refers to the phenomenon whereby a person creates something new that has some kind of value. What counts as "new" may be in reference to the individual creator, or to the society or domain within which the novelty occurs...

. A person in the state of hypomania might be immune to fear and doubt and have little social

Social inhibition

Social inhibition is a conscious or subconscious constraint by a person of behaviour of a social nature. The constraint may be in relation to behavior, appearance, or a subject matter for discussion, besides other matters. There are a number of reasons for social inhibitions, including that the...

and sexual

Sexual inhibition

A sexual inhibition is a conscious or unconscious constraint or curtailment by a person of behaviour relating to specific sexual matters or practices or of a discussion of sexual matters....

inhibition. People experiencing hypomania are often the "life of the party." They may talk to strangers easily, offer solutions to problems, and find pleasure in small activities.
Such advantages may render them unwilling to submit to treatment, especially when disadvantages are minimal.

Relationship with disorders

Cyclothymia

is a condition of continued mood fluctuations between hypomania and depressive symptoms that do not meet the criteria for a major depressive episode

Major depressive episode

A major depressive episode is the cluster of symptoms of major depressive disorder. The description has been formalised in psychiatric diagnostic criteria such as the DSM-IV and ICD-10, and is characterized by severe, highly persistent depression, and a loss of interest or pleasure in everyday...

. These are often interspersed with periods of normal moods.

When a patient presents with a history of one or more hypomanic episodes and one or more depressive episodes that meet the criteria for a major depressive episode

Major depressive episode

, bipolar II disorder

Bipolar II disorder

is diagnosed.

If left untreated, hypomania can transition into mania

Mania

and sometimes psychosis

Psychosis

Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...

, in which case, bipolar I disorder

Bipolar I disorder

Bipolar I disorder is a mood disorder that is characterized by at least one manic or mixed episode. There may be episodes of hypomania or major depression as well...

is often diagnosed.
(See also, Kindling model

Kindling model

Kindling is a commonly used model for the development of seizures and epilepsy in which the duration and behavioral involvement of induced seizures increases after seizures are induced repeatedly. The kindling model was first proposed in the late 1960s by Goddard and colleagues...

)

Treatment

Medications typically prescribed for hypomania include mood stabilizers such as valproic acid

Valproic acid

Valproic acid is a chemical compound that has found clinical use as an anticonvulsant and mood-stabilizing drug, primarily in the treatment of epilepsy, bipolar disorder, and, less commonly, major depression. It is also used to treat migraine headaches and schizophrenia...

and lithium carbonate

Lithium carbonate

Lithium carbonate is a chemical compound of lithium, carbon, and oxygen with the formula Li2CO3. This colorless salt is widely used in the processing of metal oxides and has received attention for its use in psychiatry. It is found in nature as the rare mineral zabuyelite.-Properties:Like almost...

as well as atypical antipsychotics such as olanzapine

Olanzapine

Olanzapine is an atypical antipsychotic, approved by the FDA for the treatment of schizophrenia and bipolar disorder...

and quetiapine

Quetiapine

Quetiapine , is an atypical antipsychotic approved for the treatment of schizophrenia, and bipolar disorder....

Notable individuals with hypomanic symptoms

For more information, please see List of people affected by bipolar disorder.

John Gartner's book The Hypomanic Edge claims notable people including Christopher Columbus

Christopher Columbus

Christopher Columbus was an explorer, colonizer, and navigator, born in the Republic of Genoa, in northwestern Italy. Under the auspices of the Catholic Monarchs of Spain, he completed four voyages across the Atlantic Ocean that led to general European awareness of the American continents in the...

, Alexander Hamilton

Alexander Hamilton

Alexander Hamilton was a Founding Father, soldier, economist, political philosopher, one of America's first constitutional lawyers and the first United States Secretary of the Treasury...

, Andrew Carnegie

Andrew Carnegie

Andrew Carnegie was a Scottish-American industrialist, businessman, and entrepreneur who led the enormous expansion of the American steel industry in the late 19th century...

, Howard Zinn

Howard Zinn

Howard Zinn was an American historian, academic, author, playwright, and social activist. Before and during his tenure as a political science professor at Boston University from 1964-88 he wrote more than 20 books, which included his best-selling and influential A People's History of the United...

and Louis B. Mayer

Louis B. Mayer

Louis Burt Mayer born Lazar Meir was an American film producer. He is generally cited as the creator of the "star system" within Metro-Goldwyn-Mayer in its golden years. Known always as Louis B...

owe their innovation and drive, as well as their eccentricities, to hypomanic temperaments. Gartner suggests that the constructive behaviors associated with hypomania may contribute to bipolar disorder's evolutionary survival. Critics charge that Gartner vastly overstates his case, however.

External links

Hypomanic Episode - Bipolar Disorder
Depression and Bipolar Support Alliance - Depression and Bipolar Support Alliance
Advice for Bipolar Disorder Sufferers and Their Loved Ones

The source of this article is wikipedia, the free encyclopedia. The text of this article is licensed under the GFDL.