[bizi]

hypomania
Hypomania

People with hypomania are generally perceived as being energetic, euphoric, overflowing with new ideas, and sometimes highly confident and charismatic, and unlike full-blown mania, they are sufficiently capable of coherent thought and action to participate in everyday life.

Mixed state (psychiatry)
In the context of bipolar disorder, a mixed state is a condition during which symptoms of mania (or hypomania) and clinical depression occur simultaneously (for example, agitation, anxiety, fatigue, guilt, impulsiveness, insomnia, disturbances appetite, irritability, morbid and/or suicidal ideation, panic, paranoia, psychosis, pressured speech, indecisiveness and rage).

In at least 1/3 of persons with bipolar disorders, the entire attack--or a succession of attacks--occurs as a mixed episode.

Mixed states can be the most dangerous period of mood disorders, during which panic attacks, substance abuse, and suicide attempts increase greatly.
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A hypomanic episode is characterized by a distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the person's usual mood.
During the period of mood disturbance, 3 or more of the following symptoms have persisted (4 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 (e.g., attention too easily drawn to unimportant or irrelevant external stimuli)
• Increase in goal-directed activity (either socially, at work or school, or 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)

A hypomanic episode is associated with a change in functioning that is uncharacteristic of the person. For example, the individual may be far more productive or outgoing and socialable than they usually are. This change in functioning and in mood are not subtle -- the change is directly noticeable by others (usually friends or family members) during a hypomanic episode.
A hypomanic episode is also not severe enough to cause serious impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features. The observable symptoms of a hypomanic episode must not be due to substance use or abuse (e.g., alcohol, drugs, medications) or caused by a general medical condition (e.g., hyperthyroidism or diabetes).