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Hypomania

February 16, 2024

Hypomania (literally "under mania" or "less than mania")[1] is a mental and behavioral disorder,[2] characterised essentially by an apparently non-contextual elevation of mood (euphoria) that contributes to persistently disinhibited behaviour.

The individual with the condition may experience irritability,[3] not necessarily less severe than full mania;[citation needed] in fact, the presence of marked irritability is a documented feature of hypomanic and mixed episodes in bipolar type II.[citation needed] According to DSM-5 criteria, hypomania is distinct from mania in that there is no significant functional impairment; mania, by DSM-5 definition, does include significant functional impairment and may have psychotic features.

Characteristic behaviors of people experiencing hypomania are a notable decrease in the need for sleep, an overall increase in energy, unusual behaviors and actions, and a markedly distinctive increase in talkativeness and confidence, commonly exhibited with a flight of creative ideas. Other symptoms related to this may include feelings of grandiosity, distractibility, and hypersexuality.[4] While hypomanic behavior often generates productivity and excitement, it can become troublesome if the subject engages in risky or otherwise inadvisable behaviors, and/or the symptoms manifest themselves in trouble with everyday life events.[5] When manic episodes are separated into stages of a progression according to symptomatic severity and associated features, hypomania constitutes the first stage of the syndrome, wherein the cardinal features (euphoria or heightened irritability, pressure of speech and activity, increased energy, decreased need for sleep, and flight of ideas) are most plainly evident.

Signs and symptoms edit

Individuals in a hypomanic state may have a decreased need for sleep, may be extremely gregarious and competitive, and have a great deal of energy. They are, otherwise, often fully functioning (unlike individuals experiencing a manic episode).[6]

Distinctive markers edit

Specifically, hypomania is distinguished from mania by the absence of psychotic symptoms, and by its lesser degree of impact on functioning.[7][8]

Hypomania is a feature of bipolar II disorder and cyclothymia, but can also occur in schizoaffective disorder.[8] Hypomania is also a feature of bipolar I disorder; it arises in sequential procession as the mood disorder fluctuates between normal mood (euthymia) and mania. Some individuals with bipolar I disorder have hypomanic as well as manic episodes. Hypomania can also occur when moods progress downwards from a manic mood state to a normal mood. Hypomania is sometimes credited with increasing creativity and productive energy. Numerous people with bipolar disorder have credited hypomania with giving them an edge in their theater of work.[9][10]

People who experience hyperthymia, or "chronic hypomania",[11] encounter the same symptoms as hypomania but on a longer-term basis.[12]

Associated disorders edit

See also: Kindling model

Cyclothymia, a condition of continuous mood fluctuations, is characterized by oscillating experiences of hypomania and depression that fail to meet the diagnostic criteria for either manic or major depressive episodes. These periods are often interspersed with periods of relatively normal (euthymic) functioning.[13]

When a patient presents with a history of at least one episode of both hypomania and major depression, each of which meet the diagnostic criteria, bipolar II disorder is diagnosed. In some cases, depressive episodes routinely occur during the fall or winter and hypomanic ones in the spring or summer. In such cases, one speaks of a "seasonal pattern".[14]

If left untreated, and in those so predisposed, hypomania may transition into mania, which may be psychotic, in which case bipolar I disorder is the correct diagnosis.[15]

Causes edit

Often in those who have experienced their first episode of hypomania – by definition without psychotic features – there may be a long or recent history of depression or a mix of hypomania combined with depression (known as mixed-state) prior to the emergence of manic symptoms. This commonly surfaces in the mid to late teens. Because the teenage years are typically an emotionally charged time of life, it is not unusual for mood swings to be passed off as normal hormonal teen behavior and for a diagnosis of bipolar disorder to be missed until there is evidence of an obvious manic or hypomanic phase.[16]

In cases of drug-induced hypomanic episodes in unipolar depressives, the hypomania can almost invariably be eliminated by lowering medication dosage, withdrawing the drug entirely, or changing to a different medication if discontinuation of treatment is not possible.[17]

Hypomania can be associated with narcissistic personality disorder.[18]

Psychopathology edit

Mania and hypomania are usually studied together as components of bipolar disorders, and the pathophysiology is usually assumed to be the same. Given that norepinephrine and dopaminergic drugs are capable of triggering hypomania, theories relating to monoamine hyperactivity have been proposed. A theory unifying depression and mania in bipolar individuals proposes that decreased serotonergic regulation of other monoamines can result in either depressive or manic symptoms. Lesions on the right side frontal and temporal lobes have further been associated with mania.[19]

Diagnosis edit

The DSM-IV-TR defines a hypomanic episode as including, over the course of at least four days, elevated mood plus three of the following symptoms OR irritable mood plus four of the following symptoms, when the behaviors are clearly different from how the person typically acts when not depressed:

  • pressured speech
  • inflated self-esteem or grandiosity
  • decreased need for sleep
  • flight of ideas or the subjective experience that thoughts are racing
  • easily distracted
  • increase in goal-directed activity (e.g., social activity, at work, or hypersexuality), or psychomotor agitation
  • 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, reckless driving, physical and verbal conflicts, foolish business investments, quitting a job to pursue some grandiose goal, etc.).[20]

Treatment edit

Medications edit

Antimanic drugs are used to control acute attacks and prevent recurring episodes of hypomania combined with a range of psychological therapies.[21] The recommended length of treatment ranges from two to five years. Anti-depressants may also be required for existing treatments but are avoided in patients who have had a recent history with hypomania.[22] Sertraline has often been debated to have side effects that can trigger hypomania.[23][24]

These include antipsychotics such as:[25]

Other anti-manic drugs that are not antipsychotics include:

Benzodiazepines such as clonazepam or lorazepam may be used to control agitation and excitement in the short-term.

Other drugs used to treat symptoms of mania/hypomania but considered less effective include:

Etymology edit

The Ancient Greek physicians Hippocrates and Aretaeus called one personality type "manic" (Greek: μαινόμενοι, mainómenoi).[26][27] In 19th-century psychiatry, when mania had a broad meaning of insanity, hypomania was equated by some to concepts of "partial insanity" or monomania.[28][29][30] German neuro-psychiatrist Emanuel Ernst Mendel introduced hypomania ("hypo" meaning "under" in Greek) as a specific type of mania in 1881, writing, "I recommend, taking into consideration the word used by Hippocrates, to name those types of mania that show a less severe phenomenological picture, 'hypomania'".[26][31] Narrower operational definitions of hypomania were developed in the 1960s and 1970s.

See also edit

References edit

  1. ^ "History and Etymology for hypomania". www.merriam-webster.com Merriam Webster. Retrieved 25 June 2021.
  2. ^ Drs; Sartorius, Norman; Henderson, A.S.; Strotzka, H.; Lipowski, Z.; Yu-cun, Shen; You-xin, Xu; Strömgren, E.; Glatzel, J.; Kühne, G.-E.; Misès, R.; Soldatos, C.R.; Pull, C.B.; Giel, R.; Jegede, R.; Malt, U.; Nadzharov, R.A.; Smulevitch, A.B.; Hagberg, B.; Perris, C.; Scharfetter, C.; Clare, A.; Cooper, J.E.; Corbett, J.A.; Griffith Edwards, J.; Gelder, M.; Goldberg, D.; Gossop, M.; Graham, P.; Kendell, R.E.; Marks, I.; Russell, G.; Rutter, M.; Shepherd, M.; West, D.J.; Wing, J.; Wing, L.; Neki, J.S.; Benson, F.; Cantwell, D.; Guze, S.; Helzer, J.; Holzman, P.; Kleinman, A.; Kupfer, D.J.; Mezzich, J.; Spitzer, R.; Lokar, J. "The ICD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines" (PDF). www.who.int World Health Organization. Microsoft Word. bluebook.doc. pp. 91, 95. Retrieved 23 June 2021 – via Microsoft Bing.
  3. ^ Hypomania Hypomanic Episode Psychology Today Retrieved 25 June 2021
  4. ^ Mania and Hypomania 2015-04-02 at the Wayback Machine
  5. ^ Understanding Hypomania and Mania 2015-03-27 at the Wayback Machine
  6. ^ (PDF). NIH Publication No. 12-3679. National Institute of Mental Health. 2012. Archived from the original (PDF) on 2015-05-01.
  7. ^ Goodwin, Guy (2 January 2018). "Hypomania: What's in a name?". British Journal of Psychiatry. 181 (2): 94–95. doi:10.1192/bjp.181.2.94.
  8. ^ a b British Psychological Society, National Collaborating Centre for Mental Health (Great Britain), National Institute for Health and Clinical Excellence (Great Britain) (2006). Bipolar Disorder: The Management of Bipolar Disorder in Adults, Children and Adolescents, in Primary and Secondary Care. Leicester; London: British Psychological Society; Royal College of Psychiatrists. ISBN 978-1-85433-441-1. from the original on 9 May 2018. Retrieved 3 December 2015.
  9. ^ Doran, Christopher (2008). The hypomania handbook : the challenge of elevated mood. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 16. ISBN 9780781775205. Retrieved 3 December 2015.
  10. ^ Kaufman, James (2014). Creativity and mental illness. Cambridge: Cambridge University Press. p. 214. ISBN 9781316003626. Retrieved 3 December 2015.
  11. ^ Ghaemi, S Nassir (2003). Mood disorders : a practical guide. Philadelphia: Lippincott Williams & Wilkins. p. 48. ISBN 9780781727839. Retrieved 4 December 2015.
  12. ^ Bloch, Jon (2006). The everything health guide to adult bipolar disorder : reassuring advice to help you cope. Avon, Mass.: Adams Media. p. 12. ISBN 9781593375850. Retrieved 4 December 2015. hyperthymia.
  13. ^ "Cyclothymia". BehaveNet Clinical Capsules. Retrieved 2008-01-03.[dead link]
  14. ^ "Bipolar II Disorder". BehaveNet. Retrieved 2008-01-03.[dead link]
  15. ^ Post Robert M (2007). "Kindling and sensitization as models for affective episode recurrence, cyclicity, and tolerance phenomena". Neuroscience & Biobehavioral Reviews. 31 (6): 858–873. doi:10.1016/j.neubiorev.2007.04.003. PMID 17555817. S2CID 21258139.
  16. ^ Drug-Induced Dysfunction in Psychiatry. Matcheri S. Keshavan and John S. Kennedy, Editors (Taylor & Francis, 1992).
  17. ^ Bipolar Disorder: A Summary of Clinical Issues and Treatment Options. Bipolar Disorder Sub-Committee, Canadian Network for Mood and Anxiety Treatments (CANMAT). April 1997
  18. ^ Daniel Fulford; Sheri L. Johnson; Charles S. Carver (December 2008). "Commonalities and differences in characteristics of persons at risk for narcissism and mania". J Res Pers. 42 (6): 1427–1438. doi:10.1016/j.jrp.2008.06.002. PMC 2849176. PMID 20376289.
  19. ^ Hilty, Donald M.; Leamon, Martin H.; Lim, Russell F.; Kelly, Rosemary H.; Hales, Robert E. (8 January 2017). "A Review of Bipolar Disorder in Adults". Psychiatry (Edgmont). 3 (9): 43–55. ISSN 1550-5952. PMC 2963467. PMID 20975827.
  20. ^ "Hypomanic Episode". BehaveNet Clinical Capsules. Retrieved 2008-01-03.
  21. ^ . NHS. Archived from the original on 2019-07-04. Retrieved 2019-07-04.
  22. ^ "Mania and hypomania". bnf. Retrieved 2019-07-03.
  23. ^ Mendhekar, D. N.; Gupta, D.; Girotra, V. (13 June 2003). "Sertraline‐induced hypomania: a genuine side‐effect". Acta Psychiatrica Scandinavica. wileyonlinelibrary. 108 (1): 70–72. doi:10.1034/j.1600-0447.2003.00080.x. PMID 12807380. S2CID 36573538.
  24. ^ Mendhekar, D. N.; Gupta, D.; Girotra, V. (1 July 2003). "Sertraline‐induced hypomania: a genuine side‐effect". Department of Psychiatry. DCBI. 108 (1): 70–4. doi:10.1034/j.1600-0447.2003.00080.x. PMID 12807380. S2CID 36573538.
  25. ^ "Medications used when high (hypomania/mania)". bipolaruk. Retrieved 2019-07-03.
  26. ^ a b Emanuel Mendel (1881) Die Manie, p. 36: "Hypomanie", Urban & Schwarzenberg, Vienna and Leipzig (in German)
  27. ^ Thomas, P (April 2004). "The many forms of bipolar disorder: a modern look at an old illness". Journal of Affective Disorders. 79: 3–8. doi:10.1016/j.jad.2004.01.001. PMID 15121341.
  28. ^ Baldwin et al. (1902) Dictionary of Philosophy and Psychology, p. 101: "Monomania", Macmillan: New York; London
  29. ^ James Johnson, M.D., Ed. (1843) "Notices of Some New Works: Dr. H. Johnson on Mental Disorders", The Medical-Chirurgical Review, Vol. 39, p. 460: Hypomania
  30. ^ Henry Johnson (1843) On the Arrangement and Nomenclature of Mental Disorders, Longmans, London, OCLC 706786581
  31. ^ Edward Shorter (2005) A Historical Dictionary of Psychiatry, p.132, Oxford University Press, US ISBN 978-0-19803-923-5

External links edit

    February 16, 2024
    hypomania, literally, under, mania, less, than, mania, mental, behavioral, disorder, characterised, essentially, apparently, contextual, elevation, mood, euphoria, that, contributes, persistently, disinhibited, behaviour, individual, with, condition, experienc. Hypomania literally under mania or less than mania 1 is a mental and behavioral disorder 2 characterised essentially by an apparently non contextual elevation of mood euphoria that contributes to persistently disinhibited behaviour The individual with the condition may experience irritability 3 not necessarily less severe than full mania citation needed in fact the presence of marked irritability is a documented feature of hypomanic and mixed episodes in bipolar type II citation needed According to DSM 5 criteria hypomania is distinct from mania in that there is no significant functional impairment mania by DSM 5 definition does include significant functional impairment and may have psychotic features Characteristic behaviors of people experiencing hypomania are a notable decrease in the need for sleep an overall increase in energy unusual behaviors and actions and a markedly distinctive increase in talkativeness and confidence commonly exhibited with a flight of creative ideas Other symptoms related to this may include feelings of grandiosity distractibility and hypersexuality 4 While hypomanic behavior often generates productivity and excitement it can become troublesome if the subject engages in risky or otherwise inadvisable behaviors and or the symptoms manifest themselves in trouble with everyday life events 5 When manic episodes are separated into stages of a progression according to symptomatic severity and associated features hypomania constitutes the first stage of the syndrome wherein the cardinal features euphoria or heightened irritability pressure of speech and activity increased energy decreased need for sleep and flight of ideas are most plainly evident Contents 1 Signs and symptoms 1 1 Distinctive markers 1 2 Associated disorders 2 Causes 3 Psychopathology 4 Diagnosis 5 Treatment 5 1 Medications 6 Etymology 7 See also 8 References 9 External linksSigns and symptoms editIndividuals in a hypomanic state may have a decreased need for sleep may be extremely gregarious and competitive and have a great deal of energy They are otherwise often fully functioning unlike individuals experiencing a manic episode 6 Distinctive markers edit Specifically hypomania is distinguished from mania by the absence of psychotic symptoms and by its lesser degree of impact on functioning 7 8 Hypomania is a feature of bipolar II disorder and cyclothymia but can also occur in schizoaffective disorder 8 Hypomania is also a feature of bipolar I disorder it arises in sequential procession as the mood disorder fluctuates between normal mood euthymia and mania Some individuals with bipolar I disorder have hypomanic as well as manic episodes Hypomania can also occur when moods progress downwards from a manic mood state to a normal mood Hypomania is sometimes credited with increasing creativity and productive energy Numerous people with bipolar disorder have credited hypomania with giving them an edge in their theater of work 9 10 People who experience hyperthymia or chronic hypomania 11 encounter the same symptoms as hypomania but on a longer term basis 12 Associated disorders edit See also Kindling model Cyclothymia a condition of continuous mood fluctuations is characterized by oscillating experiences of hypomania and depression that fail to meet the diagnostic criteria for either manic or major depressive episodes These periods are often interspersed with periods of relatively normal euthymic functioning 13 When a patient presents with a history of at least one episode of both hypomania and major depression each of which meet the diagnostic criteria bipolar II disorder is diagnosed In some cases depressive episodes routinely occur during the fall or winter and hypomanic ones in the spring or summer In such cases one speaks of a seasonal pattern 14 If left untreated and in those so predisposed hypomania may transition into mania which may be psychotic in which case bipolar I disorder is the correct diagnosis 15 Causes editOften in those who have experienced their first episode of hypomania by definition without psychotic features there may be a long or recent history of depression or a mix of hypomania combined with depression known as mixed state prior to the emergence of manic symptoms This commonly surfaces in the mid to late teens Because the teenage years are typically an emotionally charged time of life it is not unusual for mood swings to be passed off as normal hormonal teen behavior and for a diagnosis of bipolar disorder to be missed until there is evidence of an obvious manic or hypomanic phase 16 In cases of drug induced hypomanic episodes in unipolar depressives the hypomania can almost invariably be eliminated by lowering medication dosage withdrawing the drug entirely or changing to a different medication if discontinuation of treatment is not possible 17 Hypomania can be associated with narcissistic personality disorder 18 Psychopathology editMania and hypomania are usually studied together as components of bipolar disorders and the pathophysiology is usually assumed to be the same Given that norepinephrine and dopaminergic drugs are capable of triggering hypomania theories relating to monoamine hyperactivity have been proposed A theory unifying depression and mania in bipolar individuals proposes that decreased serotonergic regulation of other monoamines can result in either depressive or manic symptoms Lesions on the right side frontal and temporal lobes have further been associated with mania 19 Diagnosis editThe DSM IV TR defines a hypomanic episode as including over the course of at least four days elevated mood plus three of the following symptoms OR irritable mood plus four of the following symptoms when the behaviors are clearly different from how the person typically acts when not depressed pressured speech inflated self esteem or grandiosity decreased need for sleep flight of ideas or the subjective experience that thoughts are racing easily distracted increase in goal directed activity e g social activity at work or hypersexuality or psychomotor agitation 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 reckless driving physical and verbal conflicts foolish business investments quitting a job to pursue some grandiose goal etc 20 Treatment editMedications edit Antimanic drugs are used to control acute attacks and prevent recurring episodes of hypomania combined with a range of psychological therapies 21 The recommended length of treatment ranges from two to five years Anti depressants may also be required for existing treatments but are avoided in patients who have had a recent history with hypomania 22 Sertraline has often been debated to have side effects that can trigger hypomania 23 24 These include antipsychotics such as 25 Aripiprazole Clozapine Haloperidol Olanzapine Paliperidone Quetiapine Risperidone ZiprasidoneOther anti manic drugs that are not antipsychotics include Carbamazepine Lithium Oxcarbazepine ValproateBenzodiazepines such as clonazepam or lorazepam may be used to control agitation and excitement in the short term Other drugs used to treat symptoms of mania hypomania but considered less effective include Gabapentin Lamotrigine Levetiracetam TopiramateEtymology editThe Ancient Greek physicians Hippocrates and Aretaeus called one personality type manic Greek mainomenoi mainomenoi 26 27 In 19th century psychiatry when mania had a broad meaning of insanity hypomania was equated by some to concepts of partial insanity or monomania 28 29 30 German neuro psychiatrist Emanuel Ernst Mendel introduced hypomania hypo meaning under in Greek as a specific type of mania in 1881 writing I recommend taking into consideration the word used by Hippocrates to name those types of mania that show a less severe phenomenological picture hypomania 26 31 Narrower operational definitions of hypomania were developed in the 1960s and 1970s See also editBipolar disorder Bipolar I Bipolar II Borderline personality disorder Clinical depression Creativity and mental illness Cyclothymia Hyperthymic temperament Bertram D Lewin Mania Narcissistic personality disorder People with bipolar disorder Regression psychology Schizoaffective disorderReferences edit History and Etymology for hypomania www merriam webster com Merriam Webster Retrieved 25 June 2021 Drs Sartorius Norman Henderson A S Strotzka H Lipowski Z Yu cun Shen You xin Xu Stromgren E Glatzel J Kuhne G E Mises R Soldatos C R Pull C B Giel R Jegede R Malt U Nadzharov R A Smulevitch A B Hagberg B Perris C Scharfetter C Clare A Cooper J E Corbett J A Griffith Edwards J Gelder M Goldberg D Gossop M Graham P Kendell R E Marks I Russell G Rutter M Shepherd M West D J Wing J Wing L Neki J S Benson F Cantwell D Guze S Helzer J Holzman P Kleinman A Kupfer D J Mezzich J Spitzer R Lokar J The ICD 10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines PDF www who int World Health Organization Microsoft Word bluebook doc pp 91 95 Retrieved 23 June 2021 via Microsoft Bing Hypomania Hypomanic Episode Psychology Today Retrieved 25 June 2021 Mania and Hypomania Archived 2015 04 02 at the Wayback Machine Understanding Hypomania and Mania Archived 2015 03 27 at the Wayback Machine Bipolar Disorder in Adults PDF NIH Publication No 12 3679 National Institute of Mental Health 2012 Archived from the original PDF on 2015 05 01 Goodwin Guy 2 January 2018 Hypomania What s in a name British Journal of Psychiatry 181 2 94 95 doi 10 1192 bjp 181 2 94 a b British Psychological Society National Collaborating Centre for Mental Health Great Britain National Institute for Health and Clinical Excellence Great Britain 2006 Bipolar Disorder The Management of Bipolar Disorder in Adults Children and Adolescents in Primary and Secondary Care Leicester London British Psychological Society Royal College of Psychiatrists ISBN 978 1 85433 441 1 Archived from the original on 9 May 2018 Retrieved 3 December 2015 Doran Christopher 2008 The hypomania handbook the challenge of elevated mood Philadelphia Wolters Kluwer Health Lippincott Williams amp Wilkins p 16 ISBN 9780781775205 Retrieved 3 December 2015 Kaufman James 2014 Creativity and mental illness Cambridge Cambridge University Press p 214 ISBN 9781316003626 Retrieved 3 December 2015 Ghaemi S Nassir 2003 Mood disorders a practical guide Philadelphia Lippincott Williams amp Wilkins p 48 ISBN 9780781727839 Retrieved 4 December 2015 Bloch Jon 2006 The everything health guide to adult bipolar disorder reassuring advice to help you cope Avon Mass Adams Media p 12 ISBN 9781593375850 Retrieved 4 December 2015 hyperthymia Cyclothymia BehaveNet Clinical Capsules Retrieved 2008 01 03 dead link Bipolar II Disorder BehaveNet Retrieved 2008 01 03 dead link Post Robert M 2007 Kindling and sensitization as models for affective episode recurrence cyclicity and tolerance phenomena Neuroscience amp Biobehavioral Reviews 31 6 858 873 doi 10 1016 j neubiorev 2007 04 003 PMID 17555817 S2CID 21258139 Drug Induced Dysfunction in Psychiatry Matcheri S Keshavan and John S Kennedy Editors Taylor amp Francis 1992 Bipolar Disorder A Summary of Clinical Issues and Treatment Options Bipolar Disorder Sub Committee Canadian Network for Mood and Anxiety Treatments CANMAT April 1997 Daniel Fulford Sheri L Johnson Charles S Carver December 2008 Commonalities and differences in characteristics of persons at risk for narcissism and mania J Res Pers 42 6 1427 1438 doi 10 1016 j jrp 2008 06 002 PMC 2849176 PMID 20376289 Hilty Donald M Leamon Martin H Lim Russell F Kelly Rosemary H Hales Robert E 8 January 2017 A Review of Bipolar Disorder in Adults Psychiatry Edgmont 3 9 43 55 ISSN 1550 5952 PMC 2963467 PMID 20975827 Hypomanic Episode BehaveNet Clinical Capsules Retrieved 2008 01 03 Hypomania and mania NHS Archived from the original on 2019 07 04 Retrieved 2019 07 04 Mania and hypomania bnf Retrieved 2019 07 03 Mendhekar D N Gupta D Girotra V 13 June 2003 Sertraline induced hypomania a genuine side effect Acta Psychiatrica Scandinavica wileyonlinelibrary 108 1 70 72 doi 10 1034 j 1600 0447 2003 00080 x PMID 12807380 S2CID 36573538 Mendhekar D N Gupta D Girotra V 1 July 2003 Sertraline induced hypomania a genuine side effect Department of Psychiatry DCBI 108 1 70 4 doi 10 1034 j 1600 0447 2003 00080 x PMID 12807380 S2CID 36573538 Medications used when high hypomania mania bipolaruk Retrieved 2019 07 03 a b Emanuel Mendel 1881 Die Manie p 36 Hypomanie Urban amp Schwarzenberg Vienna and Leipzig in German Thomas P April 2004 The many forms of bipolar disorder a modern look at an old illness Journal of Affective Disorders 79 3 8 doi 10 1016 j jad 2004 01 001 PMID 15121341 Baldwin et al 1902 Dictionary of Philosophy and Psychology p 101 Monomania Macmillan New York London James Johnson M D Ed 1843 Notices of Some New Works Dr H Johnson on Mental Disorders The Medical Chirurgical Review Vol 39 p 460 Hypomania Henry Johnson 1843 On the Arrangement and Nomenclature of Mental Disorders Longmans London OCLC 706786581 Edward Shorter 2005 A Historical Dictionary of Psychiatry p 132 Oxford University Press US ISBN 978 0 19803 923 5External links editHypomanic Episode Bipolar Disorder Retrieved from https en wikipedia org w index php title Hypomania amp oldid 1207360138, wikipedia, wiki, book, books, library,

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