Hypomania
Hypomania (literally "under
The individual with the condition may experience
Characteristic behaviors of people experiencing hypomania are a notable decrease in the need for sleep, an overall increase in energy, unusual behaviors and actions, and a markedly distinctive increase in talkativeness and confidence, commonly exhibited with a flight of creative ideas. Other symptoms related to this may include feelings of grandiosity,
Signs and symptoms
Individuals in a hypomanic state may have a decreased need for sleep, may be extremely
Distinctive markers
Specifically, hypomania is distinguished from
Hypomania is a feature of bipolar II disorder and cyclothymia, but can also occur in schizoaffective disorder.[8] Hypomania is also a feature of bipolar I disorder; it arises in sequential procession as the mood disorder fluctuates between normal mood (euthymia) 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. Numerous people with bipolar disorder have credited hypomania with giving them an edge in their theater of work.[9][10]
People who experience
Associated disorders
Cyclothymia, a condition of continuous mood fluctuations, is characterized by oscillating experiences of hypomania and depression that fail to meet the diagnostic criteria for either manic or major depressive episodes. These periods are often interspersed with periods of relatively normal (euthymic) functioning.[13]
When a patient presents with a history of at least one episode of both hypomania and major depression, each of which meet the diagnostic criteria, bipolar II disorder is diagnosed. In some cases, depressive episodes routinely occur during the fall or winter and hypomanic ones in the spring or summer. In such cases, one speaks of a "seasonal pattern".[14]
If left untreated, and in those so predisposed, hypomania may transition into
Causes
Often in those who have experienced their first episode of hypomania – by definition without psychotic features – there may be a long or recent history of depression or a mix of hypomania combined with depression (known as mixed-state) prior to the emergence of manic symptoms. This commonly surfaces in the mid to late teens. Because the teenage years are typically an emotionally charged time of life, it is not unusual for mood swings to be passed off as normal hormonal teen behavior and for a diagnosis of bipolar disorder to be missed until there is evidence of an obvious manic or hypomanic phase.[16]
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.[17]
Hypomania can be associated with narcissistic personality disorder.[18]
Psychopathology
Mania and hypomania are usually studied together as components of bipolar disorders, and the pathophysiology is usually assumed to be the same. Given that norepinephrine and dopaminergic drugs are capable of triggering hypomania, theories relating to monoamine hyperactivity have been proposed. A theory unifying depression and mania in bipolar individuals proposes that decreased serotonergic regulation of other monoamines can result in either depressive or manic symptoms. Lesions on the right side frontal and temporal lobes have further been associated with mania.[19]
Diagnosis
The
- pressured speech
- inflated self-esteem or grandiosity
- decreased need for sleep
- flight of ideas or the subjective experience that thoughts are racing
- easily distracted
- increase in goal-directed activity (e.g., social activity, at work, or hypersexuality), or psychomotor agitation
- 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, physical and verbal conflicts, foolish business investments, quitting a job to pursue some grandiose goal, etc.).[20]
Treatment
Medications
Antimanic drugs are used to control acute attacks and prevent recurring episodes of hypomania combined with a range of psychological therapies.[21] The recommended length of treatment ranges from two to five years. Anti-depressants may also be required for existing treatments but are avoided in patients who have had a recent history with hypomania.[22] Sertraline has often been debated to have side effects that can trigger hypomania.[23][24]
These include antipsychotics such as:[25]
Other anti-manic drugs that are not antipsychotics include:
Benzodiazepines such as clonazepam or lorazepam may be used to control agitation and excitement in the short-term.
Other drugs used to treat symptoms of mania/hypomania but considered less effective include:
Etymology
The Ancient Greek physicians
See also
- Bipolar disorder
- Bipolar I
- Bipolar II
- Borderline personality disorder
- Clinical depression
- Creativity and mental illness
- Cyclothymia
- Hyperthymic temperament
- Bertram D. Lewin
- Mania
- Narcissistic personality disorder
- People with bipolar disorder
- Regression (psychology)
- Schizoaffective disorder
References
- Merriam Webster. Retrieved 25 June 2021.
- ^ Drs; Sartorius N, Henderson A, Strotzka H, Lipowski Z, Yu-cun S, You-xin X, Strömgren E, Glatzel J, Kühne GE, Misès R, Soldatos C, Pull C, Giel R, Jegede R, Malt U, Nadzharov R, Smulevitch A, Hagberg B, Perris C, Scharfetter C, Clare A, Cooper J, Corbett J, Griffith Edwards J, Gelder M, Goldberg D, Gossop M, Graham P, Kendell R, Marks I, Russell G, Rutter M, Shepherd M, West D, Wing J, Wing L, Neki J, Benson F, Cantwell D, Guze S, Helzer J, Holzman P, Kleinman A, Kupfer D, Mezzich J, Spitzer R, Lokar J. "The ICD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines" (PDF). www.who.int World Health Organization. Microsoft Word. bluebook.doc. pp. 91, 95. Retrieved 23 June 2021 – via Microsoft Bing.
- ^ Hypomania Hypomanic Episode Psychology Today Retrieved 25 June 2021
- ^ Mania and Hypomania Archived 2015-04-02 at the Wayback Machine
- ^ Understanding Hypomania and Mania Archived 2015-03-27 at the Wayback Machine
- ^ "Bipolar Disorder in Adults" (PDF). NIH Publication No. 12-3679. National Institute of Mental Health. 2012. Archived from the original (PDF) on 2015-05-01.
- .
- ^ ISBN 978-1-85433-441-1. Archivedfrom the original on 9 May 2018. Retrieved 3 December 2015.
- ISBN 978-0-7817-7520-5. Retrieved 3 December 2015.
- ISBN 978-1-316-00362-6. Retrieved 3 December 2015.
- ISBN 978-0-7817-2783-9. Retrieved 4 December 2015.
- ISBN 978-1-59337-585-0. Retrieved 4 December 2015.
hyperthymia.
- ^ "Cyclothymia". BehaveNet Clinical Capsules. Retrieved 2008-01-03.[dead link]
- ^ "Bipolar II Disorder". BehaveNet. Retrieved 2008-01-03.[dead link]
- S2CID 21258139.
- ^ Drug-Induced Dysfunction in Psychiatry. Matcheri S. Keshavan and John S. Kennedy, Editors (Taylor & Francis, 1992).
- ^ Bipolar Disorder: A Summary of Clinical Issues and Treatment Options. Bipolar Disorder Sub-Committee, Canadian Network for Mood and Anxiety Treatments (CANMAT). April 1997
- PMID 20376289.
- PMID 20975827.
- ^ "Hypomanic Episode". BehaveNet Clinical Capsules. Retrieved 2008-01-03.
- ^ "Hypomania and mania". NHS. Archived from the original on 2019-07-04. Retrieved 2019-07-04.
- ^ "Mania and hypomania". bnf. Retrieved 2019-07-03.
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- ^ "Medications used when high (hypomania/mania)". bipolaruk. Retrieved 2019-07-03.
- ^ a b Emanuel Mendel (1881) Die Manie, p. 36: "Hypomanie", Urban & Schwarzenberg, Vienna and Leipzig (in German)
- PMID 15121341.
- ^ Baldwin et al. (1902) Dictionary of Philosophy and Psychology, p. 101: "Monomania", Macmillan: New York; London
- ^ James Johnson, M.D., Ed. (1843) "Notices of Some New Works: Dr. H. Johnson on Mental Disorders", The Medical-Chirurgical Review, Vol. 39, p. 460: Hypomania
- OCLC 706786581
- ISBN 978-0-19803-923-5