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Hypomanic Episode (Hypomania)

According to the DSM-IV-TR, Hypomania is similar to a Manic Episode in all respects except the following: 

  1. The condition needs to be present for only 4 days for a diagnosis to be made (rather than 1 week).
  2. The person's level of functioning in social or occupational settings is not markedly impaired.  By definition, a Hypomanic Episode does not require hospitalization, for this would automatically render the episode classified as Manic.  Although there needs to be a clear change in the person's usual level of functioning for a diagnosis of Hypomania to be made, in many cases the person may in fact be functioning at a higher level than their norm, such as being more efficient at work or more creative artistically.  (In a Manic Episode, the person's level of functioning is impaired.)
  3. By definition, psychosis or catatonia cannot occur during a Hypomanic Episode, for this would automatically render the episode classified as Mania.

Otherwise, the criteria for a Hypomanic Episode are exactly the same as that for Mania, including an elevated, expansive or irritable mood, as well as 3 of the other 7 symptoms of Mania (or 4 if the mood is predominantly irritable).

Being in a state of Hypomania can be intensely pleasurable for a person, especially if they are able to function at a level higher than their norm and to experience more ease in social situations.  However, the danger is always that, without treatment, the symptoms may worsen into a full-blown Manic Episode in a person who has Bipolar I Disorder, or that a Major Depressive Episode may ensue in a person with Bipolar I or II Disorder

Alternatively, a person in a Hypomanic state may experience mainly irritable moods, which are not pleasurable at all, but instead lead them to have angry outbursts over minor problems or to become very impatient and testy.

Of note, if hypomanic symptoms are caused by a particular drug or medication, or are due to a general medical condition, then a diagnosis of Hypomania is not made, though this person will still require medical attention. This is true even if the Hypomania was caused by an antidepressant, though clinically such cases are usually treated like regular Hypomanic Episodes [ref].

 

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Manic Episode (Mania)

Major Depressive Episode