ABSTRACT
Occurring in the context of depression, and also anxiety in some instances, is what appears to be another naturally occurring entity, hypomania-mania. In contrast to depression and anxiety, the issue of whether hypomania-mania symptoms are continuous seems to provoke less controversy. Th is occurrence is refl ected in the diagnostic criteria of DSM-IV, DSM-5, and ICD-10 (American Psychiatric Association, 2013; First et al, 2002; World Health Organization, 1992). In DSM-IV and DSM-5 the criteria are for manic/hypomanic episodes, and not just one or the other (American Psychiatric Association, 2013; First et al, 2002). Symptoms consist of infl ated self-esteem or grandiosity, decreased need for sleep, more talkative than usual or pressure to keep talking, fl ight of ideas or subjective experience that thoughts are racing, distractibility, and increase in goal directed behavior or psychomotor agitation. With mania there must be marked impairment in functioning or psychosis, although the criteria for hypomania also include marked impairment in functioning. For both, there needs to be abnormally elevated, expansive, or irritable mood lasting a week, with DSM-5 including increased energy or activity (American Psychiatric Association, 2013; First et al, 2002). A hypomanic episode must last at least 4 days (American Psychiatric Association, 2013; First et al, 2002).
