Hypomania is one of the mood states of bipolar disorder. Less extreme than mania, but sharing many of the same symptoms, hypomania is frequently not recognized as a problem, being seen as simply an especially good mood. Hypomania is often a pleasurable experience for the bipolar patient, and family and friends find them enjoyable to be around, so it can be left untreated. This can be dangerous, as hypomania can cycle into either full-blown mania or into depression, increasing the chances of suicide.
According to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders,) published by the American Psychiatric Association, the following criteria must be met for a period of abnormal behavior to be considered a hypomanic episode:
Duration - A period of four days or longer consisting of a continuing elevated, expansive or irritable mood; which is clearly different from the individual's usual non-depressed mood.
Symptoms - An individual must have at least three of the following symptoms during this period. (If this abnormal mood is not elevated or expansive, but is only irritable, then a minimum of four of these symptoms are required):
1. Has a magnified sense of self-esteem or grandiosity
2. Has a reduced need for sleep
3. Is more talkative than usual or feels pressure to keep talking
4. Has flights of ideas or has the subjective experience that their thoughts are racing
5. Is easily distracted
6. Has an increase in goal-directed activity (including hobbies, social activity, and work or school projects,) an increase in sexual activity, or has difficulty remaining still
7. Takes part in unusually high risk behaviors that carry an increased potential for painful consequences (such as buying sprees, sexual encounters, drinking or taking drugs, or risky business investments that would not occur during a normal non-depressed mood.)
In Addition - This behavior is distinctly different from the individual's normal pattern of behavior, and these unusual behaviors can be noticed by others.
Finally - The unusual behavior doesn't require hospitalization, doesn't interfere with daily functioning, has no psychotic features, and is not caused by a substance or a general medical condition.
Hypomanic episodes can be triggered by medications, loss of sleep, the use of alcohol or illegal drugs, and stress; along with triggers specific to the individual. It can also be triggered by the use of herbs (in therapeutic dosages) such as St. Johns Wort, nutmeg, licorice, ginger, purslane, rosemary, ginko biloba, and ginseng; and essential oils such as allspice, ambrette, lemon balm, Canadian balsam, French basil, bergamot, cassie, grapefruit, helichrysum, jasmine, true lavender, orange blossom, rose, clary sage, sandalwood, hemlock spruce, vetiver, and ylang ylang.
The danger in these episodes is that the individual's uninhibited (and frequently inappropriate) behavior may lead to job loss, high levels of debt, loss of relationships, even death. Hypomanic individuals have an impaired ability to judge the safety of their actions, and although this impairment is less than with full-blown mania, it still interferes with their ability to make responsible decisions, and may lead them to discontinue medications in the mistaken belief that they are no longer needed.
Untreated hypomania can cycle into full-blown mania; which includes more extreme versions of all the listed symptoms, and may also involve psychotic behavior. It can also cycle into depression, including suicidal impulses. Depending on the severity of the symptoms, mania or depression can require hospitalization to protect the safety of the patient until their symptoms can be brought under control. This causes further interference with their lives and relationships, and increases the risk of job loss due to missed work and inappropriate behavior.
Sources:
MedicineNet.com. Definition of Hypomania. (retrieved July 14, 2009.) http://www.medterms.com/script/main/art.asp?articlek ey=30745
WebMD.com. Hypomania and Mania in Bipolar Disorder. (retrieved July 14, 2009.)http://www.webmd.com/bipolar-disorder/guide/hypomani a-mania-symptoms
Depression-Guide.com. Hypomania Cause, Symptom, Treatment, and Medication. (retrieved July 14, 2009.)http://www.depression-guide.com/hypomania.htm
Read, Kimberly & Purse, Marcia. (2009). Diagnosing a Hypomanic Episode: DSM Criteria. (retrieved August 3, 2009). http://bipolar.about.com/od/maniahypomani1/a/dsm_hyp omanic.htm
Duke, James A., Ph.D. (1997). The Green Pharmacy. Rodale Press: St. Martins Paperbacks.
Lawless, Julia. (1992). The Encyclopedia of Essential Oils. Harper Collins Publishers: Thorsons.