Depressed and Mildly Manic

Many people treated for depression also have mild symptoms of bipolar disorder

April 28, 2011 / Author:  / Reviewed by: Joseph V. Madia, MD

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(dailyRx News) Most of the time you suffer from the blues. You're more down than up. But on some of your good days, you have lots of energy, get tons of things done and feel really, really good.

These good days may actually be what's called "subthreshold hypomania," a mild form of mania that does not fully meet current diagnostic criteria for bipolar disorder.

A recent study shows that a large percentage of people being treated for major depression also have undiagnosed symptoms of a mild form of bipolar disorder.

"Many adults with major depression suffer mild symptoms of bipolar disorder."

The definitions are key. Hypomania is a milder form of mania, which is seen in all forms of bipolar disorder. Hypomania is defined as a period of elevated mood that includes increased energy, irritability and euphoria, an exaggerated feeling of well-being that doesn't match external reality.

A study published last year in the American Journal of Psychiatry found that 40 percent of those identified as having major depression also had symptoms of subthreshold hypomania. People suffering this mix:

  • Tended to be younger at the age when depression was diagnosed
  • Had additional health problems
  • Had more episodes of depression and more suicide attempts
  • Had a family history of mania

The researchers suggest that depression and mania may be defined as dimensions, rather than as discrete diagnostic categories.

The Study

  • Full spectrum of mania identified by hypomanic episodes that last less than four days among those diagnosed with major depression
  • This type of hypomania defined as "subthreshold hypomania"
  • Used data from 5,692 respondents of the National Comorbidity Survey Replication, a nationally representative survey of American adults ages 18 and older
Reviewed by: 
Review Date: 
April 27, 2011
Last Updated:
April 28, 2011