Hypomania and Hypomanic Episodes Defined
Not everyone who becomes manic experiences the full-blown syndrome of a manic episode. Hypomanic individuals show an expansive, energized and sometimes elated mood, with rapid thinking and pressured speaking in evidence. At a minimum (for the label hypomania to be appropriately applied), this expanded mood state must persist for at least four straight days.
As is the case with manic episodes, hypomanic episodes are also characterized by the presence of characteristic symptoms. At least three of the following must be present (for at least four days) before the diagnosis of hypomanic episode is appropriate:
- an inflated or expansive and even grandiose (but not delusional; not completely out of touch with reality) sense of self
- reduced sleep needs compared to normal
- talks more than usual
- subjective sensation of racing thoughts (often called a "flight of ideas")
- distraction or derailment of thought occurring significantly more often than normal
- an increase in goal-directed activity, or physical agitation
- a marked increase in participation in risky but pleasurable behavior (such as unprotected sex, gambling, unrestrained shopping, etc.)
You'll notice that these are essentially the same criteria that are applied to manic episodes. What is suggested (and what is intended) by this duplication of criteria is that what separates a hypomanic episode from a manic episode is mostly the degree of intensity (or energy) present in the behaviors the manic person emits (and not in their variety). When the observed energy level is above average but still within normal limits, you have a hypomanic state on your hands. When the energy level goes off the normal scale entirely, you have a manic episode.
People experiencing a hypomanic state are not necessarily unrelentingly sunny in disposition; they may experience irritable mood states too, as is also the case with full manic episodes. However, whatever level of irritability may be present during a hypomanic episode is by definition nowhere near as severe as what might occur during a fully manic episode.
Since hypomania is less severe than mania, people experiencing a hypomanic episode may retain sound judgment and not engage in self-destructive behavior. In fact, their sharpened intellect and ability to function with little sleep contributes to hypomanic individuals' increased productivity compared to non-manic people. This is to say, hypomania can create a distinct advantage in the workplace, because it helps people to be maximally productive and get more things done than their peers. This positive aspect of hypomania is often seen as a benefit by people who have bipolar disorder. Hypomanic individuals are likely to be creative risk-takers, who can bring creative ideas to fruition. Numerous historical and contemporary figures, including composer Ludwig van Beethoven, pioneering physicist Issac Newton, authors Charles Dickens and Edgar Allen Poe, artist Vincent van Gogh, statesmen Abraham Lincoln, Winston Churchill and Theodore Roosevelt, and media mogul Ted Turner have been documented to have experienced severe and debilitating recurrent mood swings. Some authors (e.g., John Gartner, MD [Hypomanic Edge] have even suggested that America's unique entrepreneurial character and spectacular economic achievements achieved over the last century are due in large part to a high incidence of hypomania among American entrepreneurs. While we can neither confirm or discard this interesting speculation, we can say that there is more to hypomania than a simple business advantage. When you are hypomanic on a regular basis, you have a mild form of what can be a disabling illness. There is no guarantee that your hypomania will stay stable as hypomania. When left untreated, the underlying causes that produce hypomania can and do sometimes worsen until full manic episodes occur.