What is Hypomania?
Hypomania is understood as a mild degree of mania, in which changes in mood and behavior are long-term and pronounced, not accompanied by delusions and hallucinations. Elevated mood manifests itself in the sphere of emotions as joyful cloudlessness, irritability, in the sphere of speech as increased talkativeness with lightness and superficial judgments, increased contactiness. In the sphere of behavior, there is an increase in appetite, sexuality, distractibility, a decrease in the need for sleep, individual acts that violate the framework of morality. Subjectively felt ease of association, increased efficiency and creative productivity. Objectively, the number of social contacts and success.
Symptoms of Hypomania
Partial symptoms of latent mania can be monosymptoms of the following type: disinhibition in childhood and adolescence, reduced need for sleep, episodes of increased creative productivity with feelings of inspiration, bulimia, increased sexual attraction (satiriasis and nymphomania).
Clinical example: Patient O., 32 years. By nature, sociable and active, by specialty – an employee of a small company. Last week I began to sleep less due to the fact that I was implementing a new project at my work. He believed that at home everyone was disturbing him, so he had to work at night. He was detained by the police at night due to the fact that with great speed he was riding on roller skates along the main streets, singing a loud song. A few days later he came into conflict with the restaurant staff, when, he believes, they brought him an incorrectly prepared dish. He entered into disputes with everyone at work, because he believed that “his ideas are the most advanced.”
Hypomania Diagnosis
Diagnostics
The main criteria are:
- Increased or irritable mood, which is abnormal for a given individual and lasts for at least 4 days.
- At least 3 of the following symptoms should be presented:
– increased activity or physical anxiety;
– increased talkativeness;
– difficulty concentrating or distracting;
– reduced need for sleep;
– increase sexual energy;
– episodes of reckless or irresponsible behavior;
– increased sociability or familiarity.
Differential diagnostics
Hypomanic episodes are possible with hyperthyroidism, in which case they are combined with vegetative reactions, fever, Gref’s symptom, exophthalmos, tremor are noticeable. Patients say “internal tremor”. Hypomania can also be in the phase of food stimulation in anorexia or in the treatment of fasting. In true hypomania, the appetite on the contrary is increased. Hypomania is also characteristic of intoxication with some psychoactive substances, such as amphetamines, alcohol, marijuana, cocaine, but in this case there are other signs of intoxication: changes in the size of the pupils, tremor, vegetative reaction.
Hypomania treatment
In therapy, small and medium doses of lithium carbonate or other lithium preparations (Litosan, Litobid), small doses of carbamazepine are used.