Episodes
According to the
DSM-IV-TR, a
hypomanic episode includes, over the course of at least 4 days, elevated mood plus three of the following symptoms OR irritable mood plus four of the following symptoms:
- pressured speech; rapid talking
- inflated self-esteem or grandiosity;
- decreased need for sleep;
- flight of ideas or the subjective experience that thoughts are racing;
- easy distractibility and attention-deficit (superficially similar to attention deficit hyperactivity disorder);
- increase in psychomotor agitation; and
- steep involvement in pleasurable activities that may have a high potential for negative psycho-social or physical consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments). [2]
In the hypomanic state, people may feel like they can't slow their mind down, and that the speeding thoughts are crafted exceptionally well. Some examples are speaking or writing in
rhyme or
alliteration without planning it first; quick responses to people talking; or the ability to
improvise easily on the spot.
Another type of behavioral response sometimes included as a symptom is emotional flattening or
blunted affect. A person may seem unusually cold, uncaring, or arrogant, showing little or no emotional responsiveness.[
citation needed]
People in hypomanic episodes do not have delusions or hallucinations. They do not lose touch with reality in the sense that they know who they are and what is real. What can be a problem, however, is that they tend to overestimate their capabilities and fail to see the obvious risks involved in their ventures. For example, if they are in business, they may suddenly decide to expand in a way that is not really practical or set up schemes for which they are ill prepared.
Other forms of less inhibited behavior include reckless driving, gambling, spending sprees and sexual adventures. They may also have lots of new ideas but do not follow them through. They are often very jolly to be with but can quickly become very impatient or unpleasant if they cannot get what they want.
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