Individuals affected by hypomania, often present with pressured speech, and show signs of increased self esteem along with grandiosity. There is a decreased urge to sleep, as they have elevated mood levels, and are bloated with creative ideas and thoughts. Such types of individuals get easily distracted and suffer from attention deficit disorder. There are potential signs of psychomotor agitation, with an increased participation in pleasurable activities such as harsh driving, mindless investments, and an uncontrollable buying binge and involving in sexual indiscretions.

The Diagnostic manual of mental disorders – IV TR given by the American Psychiatric Association suggest that, those individuals with elevated mood for a period of 4 days, and any of 3 symptoms, are known to have developed hypomania. Individuals with hypomania, exhibit symptoms which are different from depression, and they have an elevated mood level. Such individuals are closely observed for the pattern of demonstrated behavior [6].

In addition, there are 3 major factors which are not present in cases of hypomania. These include absence of psychosis, symptoms are not so severe to require hospitalization, and there is no marked impairment in functioning. Individuals suffering from hypomania do not show symptoms of psychosis, which include paranoia, hallucinations and delusions.

Hypomania should be promptly treated, in order to avoid onset of serious and debilitating consequences. In the preliminary stages, first line monotherapy is suggested [7]. This is done using olanzapine and risperidone [8]. Other than this, mood stabilizing agents are used. These are considered to be among the most common and optimally effective ways for treating hypomania. The medications employed include lithium carbonate and valproic acid [9].

When these show no effect, benzodiapines are administered, which include clonazepam. In addition, atypical antipsychotic drugs would also be required, such as quetapine and olanzapine. First generation antipsychotic drugs have been proved to be helpful for treating episodes of hypomania. In addition, second generation drugs have also proved to be beneficial, but they have certain side effects associated with them. These include headache, weight gain, sedation, dizziness, akathisia and extrapyrimidal symptoms. Moreover, there may also be elevation of prolactin levels, along with nausea and dyspepsia [10].

Prognosis of hypomania gravely depends on the etiology, as well as the severity of the condition. When drugs are the inducing factors, then by mere withdrawal, mood of the affected individuals stabilizes within a short period. In other cases, medications to calm the individual are enough to do stabilize the condition of patient [5].

Hypomania is often associated with bipolar disorder. The other causes include various medications, which are primarily used in psychopharmacotherapy. When drugs are the cause, then discontinuation of that particular drug, which triggered an episode, quickly normalizes the mood. Such drugs which may trigger an attack of hypomania include amphetamine, steroids, antidepressants and stimulants. Individuals, who have suffered from episodes of depression in the past, are likely to suffer from hypomania [2].

Review of literature carried out on incidence of bipolar and hypomania disorders, suggests an incidence rate of 3 – 6.5%. According to the results presented by Zurich cohort study, prevalence rate of recurrent episodes of hypomania were estimated to be about 2.8%. The same study also revealed findings that state a prevalence rate of 5.5% amongst adult population aged 35 years. In both the subtypes of hypomania, comorbidity, along with anxiety and substance abuse was found. Research has suggested that, recurrent type of hypomania is grouped under bipolar disorders [3].

Hypomania is a distinct disorder from mania, and is mainly differentiated by the absence of grandiosity and psychotic symptoms. Moreover, hypomania episodes are a degree less severe than that of mania attacks. In many circumstances, hypomania is also a characteristic accompaniment of bipolar disorder.

Hypomania can also occur in response to certain drugs, which when withdrawn or dosage lessened, have a subsequent decline in the hypomanic episode. These drugs essentially need not be meant for psychological disorders; but even drugs for treating other types of illnesses can trigger attacks of hypomania. Hypomania primarily occurs due to chemical imbalances in the brain. Neuroimaging studies have focused on the fact that, the modulating pathways in amygdale have a pivotal role to play, in regulation of emotions such as feelings, thoughts and behavior pattern of individuals [4].

It is not always possible to prevent occurrence of hypomania. However, following a strict treatment regime can help in the prevention of recurrent attacks.

Hypomania is a type of manic disorder, which is less severe than full blown mania. A disorder of this sort is characterized by constant non-inhibition and irritable mood. Effected individuals exhibit a peculiar behavior pattern, marked by excessive talking, high energy levels, and a highly confident attitude, which is expressed by the type of creative ideas generated. Individuals with hypomania generally churn out great amount of productivity and excitement as well; but the behavior can turn risky at times, if the high energy levels are not utilized in the right direction [1].

• Definition: Hypomania is characterized by elevated mood levels, wherein the affected individual does not experience depression, and the condition is less severe than mania. Such persons are extremely talkative and are flooded with creative ideas.
• Cause: Hypomania often coexists with bipolar disorder. Certain drugs whether for treatment of mental illness or any other diseases can also trigger attacks of hypomania. In addition, steroids, antidepressants, stimulants can cause onset of hypomania.
• Symptoms: Individuals with hypomania often suffer from pressured speech, increase level of self esteem and decreased desire to sleep. They are flooded with ideas which are often creative in nature. Individuals get easily distracted, and are known to suffer for attention deficit disorder. However, in spite of such symptoms, affected individuals do not suffer from any type of severe symptoms. 
• Diagnosis: Diagnosis of the condition is made, based on the type of symptoms present. Affected individuals do not suffer from depression or any other psychotic symptoms. Moreover, no marked impairment in functioning is noticed; though the symptoms may interfere with daily activities.
• Treatment: Treatment of hypomania is done through first line monotherapy. This is done using risperidone and olanzapine. Mood stabilizers are also indicated in treatment of hypomania. First and second generation of antipsychotics, are also used for treatment of manic episodes. These, however, have several unpleasant side effects.

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• Freeman, MP, Wiegand, et al. Lithium. In: The American Psychiatric Publishing Textbook of Psychopharmacology, 4th, Schatzberg, AF, Nemeroff, CB (Eds), American Psychiatric Publishing, Inc, Washington, D.C. 2009. p.697.
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