The gift of pure hypomania?

A forthcoming study from the Journal of Affective Disorders looked at people who seem to have the ‘ups’ of manic depression but none of the ‘downs’. While people with pure hypomania were more likely to have had legal troubles and be impulsive, they were also more likely to earn more and be married.

The study looked at people who had never been diagnosed with a mood disorder but, during a general population survey, seem to have experiences akin to hypomania – an upswing in activity and energy that falls short of the extremes that can lead to psychosis in full blown mania.

This is normally only classified when it accompanies depression, which could lead to one of the bipolar disorder diagnoses.

In contrast, the study found ‘pure hypomania’ was generally not distressing, had its benefits, but could lead to complications.

Pure hypomanics were characterised by physical and social overactivity, elevated and irritable mood, as well as increases in extraversion, sexual interest, and risk-taking behaviors.

They had higher monthly incomes and were more often married than controls. Subjective distress due to hypomanic symptoms was virtually absent.

Quality of life and treatment rates for mood and anxiety were not different from controls, although sleep disturbances, substance abuse and binge eating were more frequent.

The absence of subjective distress is interesting, as it is part of a realisation that psychiatry has traditionally based its ideas about psychopathology on a sample bias – it’s only studied people who are treated by psychiatrists.

This means that classifications have often based on people who are either distressed or impaired. People who experience similar symptoms but who didn’t become significantly disabled by them were not considered.

In the last 20 years, efforts have been made to survey the community and discover who has benign ‘symptoms’. For example, a ground breaking study by Romme and Escher found that only one third of people who hear voices had ever needed psychiatric help, despite the fact is traditionally considered a tell-tale sign of mental illness.

Link to abstract of ‘pure hypomania’ study.

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