Q. Recently, I've been staying up until 3 or 4 in the morning to work on my oil paintings. I know I should feel tired, but I don't. One of my friends said that I might be hypomanic. What is that?
A. Hypomania is usually described as a mood state or energy level that's elevated above normal, but not as extreme as mania. In other words, it is "hypo" -- or less than -- mania.
The decreased need for sleep that you describe is one of the hallmarks of both hypomania and mania. Some people sleep only a few hours a day, and yet they say they feel rested. At the same time, many creative people are energetic and while they are in the "flow" may need less sleep than normal. That does not necessarily mean they (or you) are hypomanic except in an informal, descriptive sense.
In addition to needing less sleep, symptoms may include:
--Inflated self-esteem or grandiosity
--Racing thoughts or ideas
--Agitation or increased activity
--Excessive participation in activities that are pleasurable but invite personal or financial harm (such as shopping sprees, sexual indiscretions, impulsive business investments).
If you truly have none of the other symptoms described above, then maybe you are one of the lucky people who can burn the midnight oil without troubling consequences.
But if you run into trouble because of sleeplessness -- it might show up in periods of depressed mood, or relationships or work may suffer, or you may notice some of the other listed symptoms -- you should consider consultation with a professional.
Severe episodes may require one of the medications used to stabilize mood. For mild or moderate episodes, however, it may be possible to manage symptoms by adopting basic healthy lifestyle habits. That means eating regular meals, doing physical activity every day (a great way to burn off some extra energy), and trying to get at least seven or eight hours of sleep per night. Also cutting way back on caffeine can help.
(Michael Craig Miller, M.D., is editor-in-chief of the Harvard Mental Health Letter. He is an Assistant Professor of Psychiatry at Harvard Medical School and an associate physician at Beth Israel Deaconess Medical Center, Boston, Mass.)
(For additional consumer health information, please visit www.health.harvard.edu.)
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