Although 1 or 2 symptoms such as irritation or edginess following antidepressant use are not sufficient for diagnosis of a hypomanic episode
, Matthew's potential hypomania was more elaborate and may be associated with antidepressant use.
All participants were also not currently experiencing a manic or hypomanic episode
(YMRS scores <5, Young et al.
The investigators compared responses on the Mood Swings Questionnaire (MSQ) and the Mood Disorders Questionnaire (MDQ) from 315 adult patients diagnosed with bipolar II (BP II) disorder whose hypomanic episodes
lasted less than 4 days, and 186 whose episodes met the DSM criteria of lasting 4 or more days.
The effects of a hypomanic episode
often include rapid, forceful and loud speech, a quick flitting between disparate ideas and increased energy, hyperactivity and lack of need for sleep, according to WebMD.
The previous proposal listed both catatonic and psychotic features as potential specifiers for a hypomanic episode
, which are both considered exclusions for hypomania.
Chopin's description of Edna's change in behavior does not conform to a psychotic manic episode, but it does conform to what is called a hypomanic episode
and, combined with the hints of major depressive episodes, this would justify considering Edna under the DSM-IV category of Bipolar II Disorder.
The essential feature of a Hypomanic Episode
is a distinct period in which the predominant mood is either elevated, expansive, or irritable and there are associated symptoms of the Manic Syndrome.
Many vacations come with substantial and protracted sleep deprivation, and sleep deprivation is an excellent way to trigger a hypomanic episode
G2 There were never in the life of the individual sufficient hypomanic or manic symptoms, to meet the criteria for the manic or hypomanic episode
Since the first manic or hypomanic episode
may not emerge until after multiple depressive episodes, reevaluation of depressive episodes is indicated, particularly if there are additional red flags.
Antidepressant medications are often ineffective or can trigger a switch to a manic or hypomanic episode
Still, our findings indicate that, in most individuals presenting with a major depressive episode without a prior manic or hypomanic episode
, unrecognized bipolarity does not appear to be a major determinant of treatment resistance.