Monday, November 4, 2013

Hypomania as Bipolar Lite

Hypomania is a sense of increased well-being that lasts for several days or more and is related to bipolar disorder but is less intense and disruptive. 

The word hypomania combines hypo, which is a familiar prefix when used in hypochondria and hypodermic but is perhaps puzzling attached to mania. Moreover, hypo can be confused with the prefix hyper, which means overly (as in hyperactive), the opposite of hypo, which means under or less than as in hypoallergenic (less likely to trigger allergies than a non-hypoallergenic item).

On the positive side, hypomanic people may enjoy a sense of well-being and competence and may be more creative and energetic than usual. On the other hand, they can be irritable and easily annoyed. They also can be more competitive, which may or may not be a good thing depending on whether they are in a situation generally accepted as competitive or are, for instance, competing aggressively with their coworkers or boss. Another risk with hypomania may be that it lowers inhibitions and sometimes triggers risky behaviors involving drugs, sex, and even shopping.

For bipolar people, hypomania can devolve into mania or depression. A therapist may be able to suggest strategies for dealing most effectively with hypomania in bipolar patients. Some patients, however, enjoy hypomania and do not want any treatment that will bring them down.

The disadvantages and risks of hypomania seem to be offset for some creative people by the boost it gives to their talents. Stephen Fry, who is bipolar, asked numerous bipolar people if they would give up being bipolar if offered the opportunity. None said they would. This may be in part because of hypomanic periods of enhanced accomplishment.

Hypomania does not necessarily occur naturally. It may a side effect of pharmaceutical drugs or steroid therapy, for example. It may also be triggered by stress or exhaustion. And in teenagers, hypomania may be the first indication of bipolar disorder.

In his book The Hypomanic Edge, John Gartner claims that hypomania is a quality of temperament rather than a mental illness. He sees it as a benefit to civilization that has given us some of our most productive people, from Christopher Columbus to Bill Clinton. His theory does not appear to have won converts in the community of mental health experts, and he focuses only on men to illustrate his theory, which may raise question in some minds about his own mental state.

Ideally, the first time anyone experiences hypomania, she or he will see a psychotherapist for diagnosis and advice.