Hypomania: hyperactivity and willingness to move mountains

Hypomania is a deviation in human behavior, expressed in prolonged hyperactivity. This mild form of mania is also considered a mental disorder. Main symptoms of the syndrome:

• excessive talkativeness;
• excessive social activity;
• obsessive professional activity;
• inadequacy of judgment.

Hypomania is understood as a mild degree of mania, in which changes in mood and behavior are long-term and pronounced, and are not accompanied by delusions and hallucinations. Elevated mood manifests itself in the sphere of emotions as joyful calmness, irritability, in the sphere of speech as increased talkativeness with relief and superficial judgments, increased contact. In the sphere of behavior, there is an increase in appetite, sexuality, distractibility, a decrease in the need for sleep, and certain actions that violate moral boundaries. Subjectively, ease of associations, increased performance and creative productivity are felt. Objectively, the number of social contacts and success increase.

Hypomania

Hypomania can be hidden and obvious, the so-called pure. Both types of the syndrome have their own additional signs and causes, which are taken into account when determining the treatment strategy. Basic complex therapy includes medication and psychotherapeutic sessions.

Causes of hypomania

If time pressure arises at work (lack of time to think about a decision), it is quite understandable that a person may become hyperactive. Sometimes there really is a need to “give it your all” in order to complete a project on time. But when work is completed, the natural reaction is to sleep and rest to replenish lost energy right away. This behavior is normal.

It’s another matter when a person cannot “slow down”, relax and switch his attention to rest. The energy becomes uncontrollable, like an overclocked train. This feature of the nervous system easily develops into a disorder called “hypomania.”

A common cause of emotional and mental overexcitement, which provokes hypomania, is the abuse of stimulants:

• strong tea and coffee (many cups a day);
• energy drinks;
• medications that stimulate brain activity.

Hypomania can also have causes in hormonal disorders. For example, hyperthyroidism (thyroid pathology), menopause or postpartum syndrome. Dysfunctions in the hormonal system are usually accompanied by low-grade fever (prolonged increase in body temperature within 37-38 degrees Celsius).

In some cases, hyperactivity occurs some time after food irritation, anorexia (refusal of food) or fasting.

Emotional overexcitement combined with hyperactivity can be provoked by uncontrolled use of potent medications, not to mention narcotic substances.

Psychoses in bipolar affective disorder

Most often, psychoses develop against the background of a manic episode if the patient does not take prescribed medications. Modern psychiatry understands psychosis as a significant disorder of mental activity that separates a person from the real world. This could be paranoia, overvalued ideas, “delusions of grandeur”; psychosis may be accompanied by hallucinations.

It is impossible to accurately name the signs of psychosis. It proceeds differently depending on the level of personal development of the patient, his lifestyle, medical history, even his inherent cultural code. Psychosis due to bipolar disorder can be provoked by other factors (postpartum, alcohol, other types of psychoses), but it also occurs without external causes.

Treatment of acute psychosis is carried out in a dispensary (if the patient’s actions threaten the life of himself or those around him, even forced hospitalization is allowed). If psychosis occurs while taking medications for bipolar disorder, adjustment of drug therapy is necessary.

Treatment of acute psychosis is carried out in a dispensary and only under the supervision of a licensed psychiatrist.

Symptoms of hypomania

Among the many signs of hypomania is a mood indicator. It is either elevated, or the person is in an irritated state, which is unusual for a given individual, and lasts for several days. Also, in order to assume that a person is suffering from hypomania, the following symptoms must be identified. For example, the individual must be overly active and show signs of physical restlessness. He has increased talkativeness, has difficulty focusing his attention on something specific, and is physically restless. Such a person does not need long sleep, his sexual energy does not know fatigue. In addition, there may be manifestations of irresponsible behavior bordering on recklessness. When communicating with people, a person is overly familiar.

Hypomania is a form of manic syndrome

What is hypomania and how does it manifest? According to ICD 10 (International Classification of Diseases, Tenth Revision), hypomania (F30.0) is a mild degree of mania, but without severe delusions and hallucinations. But still there is the so-called manic triad (symptoms) of manic syndrome:

1. An overly positive mood background unjustified by external factors;
2. Increased pace of mental activity;
3. Excessive physical activity.

Moreover, all three signs must be simultaneous, combined, each of them can be different in intensity. And be observed for a long time. In psychiatry, mild cases of mania are recognized as hypomania. It may be (according to many experts) the initial stage of manic-depressive disorder. At its core, it is an affective disorder (a disorder of the emotional background or mood).

Behavior of a person suffering from hypomania

It can be said that patients with hypomania behave in much the same way as individuals with mania. The defense mechanism in their behavior is the constant idealization of their own person. In addition, such people completely deny everything negative that has to do with their behavior and activities. Sometimes there are hypomanic fantasies in which a person with hypomania considers himself irresistible and a particularly outstanding character. But the difference is that, compared to mania, with hypomania there is no all-consuming nature of fantasies, and there is no one-sided impact on a person’s thinking and actions.

Clinical example: Patient O., 32 years old. By nature he is sociable and active, by profession he is an employee of a small company. Over the last week I have been sleeping less due to the fact that I was implementing a new project at my job. He believed that everyone at home was bothering him, so he had to work at night. He was detained by the police at night due to the fact that he was riding roller skates at high speed along the central streets, loudly singing songs. A few days later he came into conflict with the restaurant staff when, as he believed, he was served an incorrectly prepared dish. He got into arguments with everyone at work because he believed that “his ideas are the most advanced.”

Treatment

Treatment of hypomania often combines several typologies. If there are no noticeable changes in occupational activities, social activities or interpersonal relationships during hypomania, then hospitalization is not required.

Sociopath - going over the heads to his goal

Pharmacological treatment can be prescribed for two to five years or even lifelong. This treatment may include:

• A mood stabilizer or thymoregulator that is neither a stimulant nor a sedative, and the main 3 components of which are lithium, valproate and carbamazepine;
• Atypical antipsychotic (APA): Olanzapine, Risperidone, Aripiprazole and Quetiapine.

Recent research suggests that over one or two years, combining a mood stabilizer with an APA is a therapeutic strategy that produces better results than taking either medication alone. Psychotherapy is also necessary to treat hypomania.

In addition to this, you need:

Behavioral and cognitive therapy. Good eating habits, including eating fruits and vegetables and controlling weight. Psychotherapy helps develop coping strategies or prevent episodes of mania by regulating sleep, diet, and physical activity.

The danger of hypomania

Some people perceive the disease as a gift of fate, because the person does not want to sleep and is constantly working and communicating. All this negatively affects physical health.

An ordinary person cannot adequately evaluate his actions, he begins to overestimate his capabilities, resulting in apathy, loss of strength, and a decrease in quality of life.

Hypomania leads to chronic lack of sleep, a person cannot concentrate, his memory deteriorates, and fatigue accumulates in large quantities. When a person does not sleep and constantly works, he is drowsy and has a fog in his head.

The diet is also often disrupted; gluttony ends in obesity and vitamin deficiency. Immunity is completely reduced and the disease may worsen.

A person takes life lightly and has financial problems. Then apathy sets in, because the patient cannot pull himself together. The danger of hypomania is that it leads to serious depression. The longer the takeoff lasted, the harder it was to get out of apathy.

Due to the fact that a person perceives reality inadequately, he ceases to control situations, constantly conflicts at work, and cannot communicate with loved ones.

Hypomania is often characteristic of a creative person. Composers and writers suffer from it. First they create a masterpiece, the takeoff begins, and therefore burnout lasts a long time. Because of this, many begin to drink, use drugs, and everything ends in failure and failure.

Hypomania is dangerous because the patient wants to regain his energy, for this he uses various stimulant drugs, which negatively affect his health.

Why is it dangerous?

Most patients are in no hurry to go to the hospital when emotional disorders occur. They are sure that everything is fine and there is no need to visit a psychotherapist. Patients who have undergone treatment describe their condition as a new stage of life when there is no need to sleep. There is more time for work, creative development and interaction with other people around you.

The patient overestimates his strength and cannot adequately compare possibilities with reality. Low mood and general fatigue of the body lead to discomfort, reducing the quality of life.

Hypomania in psychology is a serious disease that provokes numerous consequences:

When a patient does not adequately perceive the world around him, he often has serious conflicts in the family, at work with colleagues. This is especially dangerous if his activities involve responsibility for other people.

Many creative workers suffer from hypomanic syndrome. They forget about sleep and food and create masterpieces. And then comes a period of physical and emotional exhaustion.

In most cases, hypomania cannot be fully treated. Psychology experts are trying to reduce the number of seizures that occur in a person. The prognosis of the disease depends on the cause against which hypomania develops. The same applies to the degree of its development and the individual characteristics of the human body.

Diagnosis of hypomania

The main criteria are:

1. Elevated or irritable mood that is abnormal for the individual and persists for at least 4 days.
2. At least 3 symptoms from the following must be present:

• increased activity or physical restlessness;
• increased talkativeness;
• difficulty concentrating or distractibility;
• decreased need for sleep;
• increased sexual energy;
• episodes of reckless or irresponsible behavior;
• increased sociability or familiarity.

Symptoms

There are three main symptoms of hypomania: hyperactivity, sudden mood swings, and excessive irritability. However, depending on the severity of the symptoms, hidden and overt (pure) hypomania are distinguished, which have additional, more extensive symptoms.

Pure (obvious) hypomania

Pure hypomania is characterized by pronounced symptoms and outbursts of aggression.

1. Dispersion. Such people are distracted by noises, conversations, and find it difficult to think about one thing. Due to the inability to concentrate on a task, attacks of rage occur.
2. Increased need for communication. Despite their intolerance towards society, the desire for communication among such people is very high.
3. Perfectionism. The desire to do all the work perfectly and in the shortest possible time takes away people’s strength and leads to insomnia.
4. Heightened self-esteem. Any criticism is unacceptable for people with hypomania; they are confident in their ideality and uniqueness.

Hidden hypomania

The symptoms of latent hypomania are similar to pure hypomania, the difference being the absence of aggression and irritability. Also, signs of hidden hypomania include naivety and high spirits. It’s as if they live with rose-colored glasses: they don’t notice problems, nothing can upset them.

Symptoms of hypomania

Differential diagnosis

Hypomanic episodes are possible with hyperthyroidism, in this case they are combined with autonomic reactions, increased temperature, Graefe's symptom, exophthalmos, and tremor are noticeable. Patients o. Hypomania can also occur during the food arousal phase of anorexia or when fasting treatment is used. With true hypomania, on the contrary, appetite is increased. Hypomania is also characteristic of intoxication with certain 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.

Types of disorder

There is also another classification of this disorder, it is based on the predominance of certain qualities in the symptomatic picture.

1. Cheerful. Characterized by an unreasonably good mood that is absolutely unshakable. People are talkative and lead an active social life. They are energetic and try to get as many things done as possible. A person has an irresistible craving for new acquaintances. Differs in ambition and self-confidence.
2. Angry. This type is rude and grumpy. Intolerance towards people and a negative reaction to constructive criticism appear. There is increased sensitivity, attacks of anger, and aggression. It is not uncommon to lose relationships and friendships. They begin to make demands on people, failure to comply with which leads to conflict. They are confident in their superiority and blame all failures on others.
3. Childish. This type of hypomania is characterized by childish behavior, stupid, inappropriate jokes that hurt the feelings of others. People with this type play to the public; they need everyone's approval. There is no desire for relationships, they only require spectators for jokes and ridiculous behavior. Patients find it difficult to concentrate at work.
4. Indifferent. This type implies complete indifference to everything that happens around. Attacks of apathy and depression are possible. Idlers do not strive for success.
5. Intolerant. Such hypomania is characterized by complete hostility towards all living things. Any manifestation of social life depresses patients. Such people are most prone to depression.

A classification can be made depending on the course of the disease.

1. Remittent. The period of emotional distress gives way to remission, and then the disease gains momentum again.
2. Repetitive. With this type there is no remission, attacks replace each other.
3. Double. One attack follows another, but has the opposite emotional background.

Prevention

There are a number of warning signs of hypomania. If patients can be taught to recognize such early warning signs, they will be more likely to use a variety of techniques that will help reduce the likelihood of acting out and the negative consequences of misbehaving that can be associated with hypomania. Addressing such warning signs can also give patients and their doctors more time to adjust medications or initiate more careful monitoring to reduce the potential harm from inappropriate behavior.

Here are some of the typical early warning signs of an impending hypomanic episode:

• sleep disturbance;
• reduction of causeless anxiety;
• high levels of optimism without proper thoughtful planning and problem solving (for example, believing that everything will be fine even though nothing has been done to make it happen);
• an increased desire to be with others coupled with relatively poor listening skills (eg, having a long conversation with someone who clearly wants to leave);
• decreased mental concentration (such as difficulty completing a task or more disorganization than usual);
• increased libido to the extent that it affects other areas of life (for example, dressing more provocatively than usual, or inappropriate conversations or jokes about sex);
• increasing goal-directed behavior to the point that the person appears to be controllable.

According to CBT, if a patient can be taught to recognize the signs of an impending hypomanic episode early enough, he or she will have the time needed to practice the various techniques already discussed to help avoid the negative consequences of potentially risky activities.

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Definition

A hypomanic episode is a special period of time, lasting at least four days, during which a person's mood is persistently elevated, expansive, or irritable and differs from his or her usual non-depressed mood. Episodes of hypomania are common in both bipolar II disorder and cyclothymic disorder. They can also occur as a transition phase from euthymia (a feeling of well-being often associated with people with bipolar disorder when they are not having a manic or depressive episode) to mania in cases of bipolar I disorder.