Readers following Wayne County Circuit Judge Wade McCree's Judicial Tenure Commission hearing might be wondering about hypomania, the condition that Judge McCree's lawyer reportedly offered as an explanation for some of the conduct at issue in the hearing. The British Journal of Psychiatry is skeptical that it can be defined, as explained in Hypomania: what's in a Name?:
‘When I use a word,’ Humpty Dumpty said, in a rather scornful
tone, ‘It means just what I choose it to mean — neither more nor
less.’
(Lewis Carroll, Through the Looking Glass and what Alice found
there, 1871)
The use of the term hypomania in this and other countries impressively
follows the Humpty Dumpty principle. Indeed, in the UK many, perhaps a
majority of, inpatients are diagnosed to be ‘hypomanic’, perhaps
partly out of a sense of politeness. The term manic does, after all, have a
pejorative flavour to some ears (paceJamison, 1996). The original
Greek sense of the word is that hypomania is hierarchically below or beneath
mania. It fills a gap between the full syndrome and more everyday states of
elation. The issue is simply where to draw the line with mania, on the one
hand, and with normality, on the other. If we actually use them,
operationalised diagnostic criteria should permit us to do this reliably.
The 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10), the World Health Organization medical classification list, says:
The terms "mania" and "severe depression" are used in this classification to denote the opposite ends of the affective spectrum; "hypomania" is used to denote an intermediate state without delusions, hallucinations, or complete disruption of normal activities, which is often (but not exclusively) seen as patients develop or recover from mania. ... here is a persistent mild elevation of mood (for at least several days on end), increased energy and activity, and usually marked feelings of well-being and both physical and mental efficiency. Increased sociability, talkativeness, overfamiliarity, increased sexual energy, and a decreased need for sleep are often present but not to the extent that they lead to severe disruption of work or result in social rejection. Irritability, conceit, and boorish behaviour may take the place of the more usual euphoric sociability.
The controversial new DSM-5 officially coronated this week apparently doesn't offer much more assistance. It basically sticks to the script of DSM-4, except that it refines and adds more emphasis to symptoms of heightened activity or energy. DSM-4 defined a hypomanic episode as: