Hypomania

By Sheila Wilson

Episodes of depression and hypomania are common experiences of people with bipolar II disorder. During a hypomanic episode, the person has symptoms of mania that are not severe enough or last long enough to be considered a manic episode.

Another psychiatric condition that causes hypomanic episodes is cyclothymic disorder. In cyclothymic disorder, the person must have numerous hypomanic episodes for at least two years.

Hypomania causes a person to have an elevated or irritable mood that is abnormal for the individual. To be considered a hypomanic episode, the mood disturbance must last at least four days. For a manic episode, the abnormally elevated or irritable mood and other symptoms must last at least a week or be severe enough to require hospitalization.

According to the Diagnostic and Statistical Manual (DSM) by the American Psychiatric Association, the person must have at least three other symptoms of mania during the mood disturbance or four or more symptoms if the mood disturbance is irritibility for it to be considered a hypomanic episode. During an episode of hypomania, the person may develop distractibility and an inflated self-esteem or gradiosity which are two symptoms of mania.

Possible symptoms of mania include a decreased need for sleep, increased talkativeness, and racing thoughts. The decreased need for sleep can cause the person to sleep much less than usual, often as little as three hours a day, without a resulting fatigue or tiredness.

Another symptom of hypomania is a focus on goal-oriented behavior. The person may have a renewed and even obsessive pursuit of a goal. The goal may be related to work, personal achievement, social activities, or interpersonal relationships.

A person having a hypomanic episode may have unusual behavior that is pleasurable without regard to the consequences. Drug use, sexual promiscuity, and excessive spending are common types of behavior that may be unusual for the individual, but may be a frequent activity for the person during a hypomanic episode.

The symptoms of a hypomanic episode must be severe enough to cause a change in functioning that is observable. However, the change in functioning must not cause a significant impairment in social or occupational functioning.

The hypomania may be reclassified as a manic episode if the symptoms become severe enough to cause an occupational or social impairment or the symptoms persist for more than a week. Since the defining symptom of bipolar I disorder is the presence of a manic episode, the diagnosis may change from cyclothymic disorder or bipolar II disorder to bipolar I disorder. - 29881

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