The Hypomanic Episode

Criteria for Hypomanic Episode based on American Psychiatric Association DSM-IV

Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either;

  • A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood.
  • During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
    • inflated self-esteem or grandiosity
    • decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
    • more talkative than usual or pressure to keep talking
    • flight of ideas or subjective experience that thoughts are racing
    • distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
    • increase in goal-directed activity (either socially, at work or school, sexually) or psychomotor agitation
    • excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
  • The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic.
  • The disturbance in mood and the change in functioning are observable by others.
  • The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.
  • The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

Note: Hypomanic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar II Disorder.