From the Guidelines
Hypomania is a mood state characterized by abnormally elevated energy, mood, and behavior that is less severe than full mania, typically lasting at least four consecutive days and representing a noticeable change from normal behavior, as described in the DSM-IV-TR criteria 1.
Definition and Characteristics
Hypomania is often marked by increased energy, reduced need for sleep, racing thoughts, and heightened productivity, with individuals experiencing unusually happy, excited, or irritable moods. According to the study by Geller et al. 1, hypomania can be characterized by elation and grandiosity, with a cycle of manic symptoms lasting as short as 4 hours, and at least one cycle daily for 2 weeks.
Diagnosis and Assessment
The diagnostic assessment of hypomania should incorporate both current and past history regarding symptomatic presentation, treatment response, psychosocial stressors, and family psychiatric history, as recommended by the practice parameter for the assessment and treatment of children and adolescents with bipolar disorder 1.
Treatment and Management
Treatment typically involves mood stabilizers like lithium, valproate, or lamotrigine, sometimes combined with antipsychotics or therapy, as supported by the study by Findling et al. 1.
Risk Factors and Outcomes
The risk factors for hypomania include a strong genetic component, with a four- to sixfold increased risk of disorder in first-degree relatives of affected individuals, as well as premorbid psychiatric problems, such as difficulties with disruptive behavior disorders, irritability, and behavioral dyscontrol 1.
- The study by Geller et al. 1 found that hypomania can be characterized by elation and grandiosity, with a cycle of manic symptoms lasting as short as 4 hours, and at least one cycle daily for 2 weeks.
- The practice parameter for the assessment and treatment of children and adolescents with bipolar disorder 1 recommends that the diagnostic assessment of hypomania should incorporate both current and past history regarding symptomatic presentation, treatment response, psychosocial stressors, and family psychiatric history.
- The study by Findling et al. 1 supports the use of mood stabilizers like lithium, valproate, or lamotrigine, sometimes combined with antipsychotics or therapy, for the treatment of hypomania.
From the Research
Definition of Hypomania
- Hypomania is a state characterized by an elevated or irritable mood, increased energy, and decreased need for sleep, among other symptoms 2, 3.
- It is often associated with bipolar disorder, but can also be induced by certain medications, such as selective serotonin reuptake inhibitors (SSRIs) 2, 3.
Symptoms and Diagnosis
- Symptoms of hypomania may include increased self-esteem, decreased need for sleep, increased talkativeness, and impulsive behavior 3.
- Hypomania can be difficult to diagnose, as it may be mistaken for other conditions, such as major depressive disorder or anxiety disorders 4, 5.
Relationship with SSRIs
- SSRIs, such as sertraline and fluoxetine, have been shown to induce hypomania in some patients, particularly those with a history of bipolar disorder 2, 3.
- The risk of hypomania associated with SSRIs is higher in patients with bipolar I disorder than in those with bipolar II disorder 3.