Diagnosing a Hypomanic Episode

DSM Criteria

There are a number of check-points your doctor will review with you to determine if you are having a hypomanic episode as defined by the guidelines in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

Hypomania is a period of emotional problems similar to mania, but the extremes of mood are experienced to a lesser degree. It is a hallmark symptom of bipolar II disorder. But to be more precise, hypomania is a cluster of symptoms that are associated with one aspect of bipolar disorder. To determine if you are currently having a hypomanic episode or if you’ve had one in the past, your doctor will determine if:

1. Your symptoms have lasted long enough to meet the duration requirement of a hypomanic episode, which is at least four days of continuous problems. During this period you’ve persistently had an elevated, expansive, or irritable mood and these are clearly different from your usual non-depressed mood.

2. During this time, you have experienced three or more of the following symptoms. If one of your difficult mood is only irritability (not elevated or expansive), then four of these symptoms are required.
   • You are demonstrating inflated self-esteem or grandiosity.

   • You have a decreased need for sleep.

   • You are more talkative than usual or feel pressure to keep talking.

   • You are experiencing flight of ideas or a subjective experience that your thoughts are racing.

   • You are easily distracted.

   • Your are driven toward accomplishing specific goals(either socially, at work or school, or sexually) or you are experiencing psychomotor agitation.

   • You are excessively getting involved with pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).

3. The behavior or emotions that you are experiencing are distinctly different from your normal patterns.

4. The problems you are experiencing or causing have been noted by others in your life.

5. These issues, while causing problems, are not disrupting your daily life. You do not require hospitalization nor have you had any psychotic features.

6. Your symptoms are caused by a drug (legal or otherwise) or another medical problem (see Ruling Out Other Physical Conditions).

If your doctor, with your input, determines that points one through four are yes while points five and six are no, your symptoms will most likely be considered a hypomanic episode.

As noted above, these criteria have been established through the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. It is the primary system used to classify and diagnose all mental disorders.

As per this formal classification system, bipolar disorder is a clinical disorder within the category of mood disorders. The manual recognizes four types of bipolar disorder. Each specific type of bipolar disorder is distinguished by the others through the nature of episodes experienced.

• Bipolar Disorders
  • Criteria for Bipolar I Disorder
  • Criteria for Bipolar II Disorder
  • Criteria for Cyclothymic Disorder
  • Criteria for Bipolar Disorder Not Otherwise Specified
• Episodes
  • Criteria for a Manic Episode
  • Criteria for a Hypomanic Episode
  • Criteria for a Depressive Episode
  • Criteria for a Mixed Episode

_Source:

_{American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IV-TR).}