Hypomania in clinical practice

‘In hypomania, there is an increased pressure of speech with prolixity, an abnormal liveliness of expressive movements, superficial bustling activity and a tendency to be argumentative and irritable if thwarted in any way. The patient is interested in everything, starts many projects, and finishes none . . . the elated mood leads to faulty judgement and a lack of consideration for others . . . hypersexuality may lead to venereal disease in men and pregnancy in women . . . the mental illness may be obvious only to the relatives and doctors, and other outside observers may merely regard the patient as a cheerful chap or somewhat of a “card” ’ (Fish, quoted by Hamilton, 1974: p. 73).