Mania and hypomania
Symptoms of mania, manic episodes, or hypomania
- increased energy, activity, and restlessness
- excessively high, overly good, euphoric mood
- extreme irritability
- racing thoughts and talking very fast, jumping from one idea to another
- distractibility, cannot concentrate well
- little sleep needed
- unrealistic beliefs in one’s abilities and powers
- poor judgement
- spending sprees
- a lasting period of behaviour that is different from usual
- increased sexual drive
- abuse of drugs, particularly cocaine, alcohol, and sleeping medications
- provocative, intrusive, or agressive behaviour
- denial that anything is wrong
Diagnosis of mania
For at least one week (or less if hospitalised): Mood elevated, expansive or irritable out of keeping with patients circumstances. At least three of the symptoms of mania have to be present. The DSM-IV diagnosis of mania breaks the severity of symptoms into further subgroups:
- Mild: symptoms barely meet criteria for an episode of mania.
- Moderate: There is an extreme increase in either activity level or impaired judgment.
- Severe without psychotic features: The patient requires continuous supervision to prevent physical harm to self or to others.
- Severe with psychotic features: The patient has delusions or hallucinations which may be mood-congruent or mood-incongruent.
Diagnosis of hypomania
At least four days of sustained or persistent elevation or irritability of mood, and the presence of at least three of the symptoms of mania (DSM-IV states at least four if the only abnormality of mood is irritability). Both ICD-10 and DSM-IV agree that there are no features of psychosis, hallucinations, or delusions associated with hypomania.