Hypomanic Personality Style

Style, Disorder, and the Space Between

McWilliams places people who are mainly depressive, mainly manic, and those who swing between the two at every point on the severity continuum (McWilliams, 2011, p. 235). Because denial is a primitive defense, though, she finds that the manic continuum “loads more heavily” toward the more disturbed levels (McWilliams, 2011, p. 259), and elsewhere describes hypomanic personality as most commonly found at the borderline level (McWilliams, 2011, p. 148). Across the levels of organization:

• Healthy. Mildly hypomanic people can be delightful. Some successfully screen out and transform painful feelings for long periods, though McWilliams adds that their depressive underside is often visible to closer friends (McWilliams, 2011, pp. 106–107). Many people with characterological hypomania have milder versions than the personality disorder Akhtar describes (see below), and are able to love and to act with integrity (McWilliams, 2011, p. 257).
• Neurotic. McWilliams has known people with core hypomanic dynamics whose denial coexisted with an identity too integrated, and a self-observing capacity too keen, for them to be considered borderline (McWilliams, 2011, p. 235). Healthier hypomanic people often seek therapy later in life, when their energy has eased and they can see how fragmented their histories have been (McWilliams, 2011, p. 261).
• Borderline. Otto Kernberg regards hypomanic personality disorder as a borderline condition by definition, because it rests on denial (McWilliams, 2011, p. 235). People here may fear falling apart if they stop moving, a self-fragmentation that often surfaces when their manic defenses fail (McWilliams, 2011, p. 259). In adolescents, the PDM-3 places emerging hypomanic personalities usually at the borderline level, with considerable overlap with emotionally dysregulated personalities (Tanzilli & Sharp, 2026, p. 485).
• Psychotic. In severe personality disorders and temporarily psychotic states, people may feel invulnerable or certain of the success of some grandiose scheme (McWilliams, 2011, p. 258). A manic psychosis can look very like schizophrenia, which is why careful history matters (McWilliams, 2011, pp. 263–264).

Signs that a style has become a disorder include how rigid the denial is (in nearly every circumstance, rather than in response to one overwhelming event), a history of relationships ended abruptly, collapses into depression when the denial wears thin, reliance on substances to slow down, and an inability to bear being alone (McWilliams, 1999, pp. 92, 98; McWilliams, 2011, p. 257).

Official systems handle this territory as mood rather than personality. McWilliams notes that DSM-II accepted cyclothymic personality, and that the diagnosis has not appeared in the DSM since, because all mood-related conditions were moved to a mood disorders section (McWilliams, 2011, pp. 106, 256). DSM-5-TR instead has cyclothymic disorder, one of the bipolar and related disorders: at least two years of recurrent hypomanic and depressive symptoms not severe or persistent enough to count as bipolar disorder or major depressive episodes. ICD-11 has a matching category, and the PDM-3 notes that ICD-11’s cyclothymia rubric includes cycloid and cyclothymic personalities (Mundo, Muzi & Lingiardi, 2026, pp. 785, 790). Bipolar I and II disorders, by contrast, require distinct manic or hypomanic episodes, usually alongside depressive ones (Mundo, Muzi & Lingiardi, 2026, pp. 790–791).

The line between a hypomanic style and a mild bipolar condition is genuinely contested. Some psychiatric researchers regard the hypomanic personality as a subclinical form of bipolar disorder, related to it as schizotypal personality is to schizophrenia (Tanzilli & Sharp, 2026, p. 485). The PDM-3’s position is that careful assessment may point to a bipolar cause in some people and a personality style in others. The difference matters: if the pattern is defensive, interpretation that brings insight can help; if it expresses bipolar disorder, such interventions will do little without effective medication (McWilliams & Shedler, 2026, p. 670).

Inner World

The central tension is between attachment and loss. McWilliams writes that people with a hypomanic pattern are frightened of attachment, because caring about someone means that losing them would be devastating (McWilliams, 2011, p. 259). Hypomania, in her account, is not just the opposite of depression but a point-for-point mirror image of it: elated, energetic, self-promoting, witty, and grandiose (McWilliams, 2011, pp. 256–257).

The characteristic emotions are excitement and elation. When negative feelings do break through, they tend to come out not as sorrow but as anger, sometimes as sudden rages. Underneath the motion, McWilliams senses considerable anxiety, and the delight these people radiate has a somewhat fragile quality; their friends often worry about them. Exhilaration is familiar to them, but a calm serenity may be outside their experience entirely (McWilliams, 2011, pp. 257–258).

Temperament plays a part. Ernst Kretschmer described a “cycloid” temperament in which the sociable, good-natured, warm qualities stay constant while the mood sits nearer the hypomanic or the depressive pole. He called the balance between those poles a person’s “diathetic proportion,” and noted that many hypomanic people carry a small depressive component, just as many melancholic people have a vein of humor (Kretschmer, 1925, pp. 124–128). The PDM-3 reports research suggesting that hypomanic personality involves difficulty regulating the brain’s reward-driven behavioral activation system once it has been triggered (Tanzilli & Sharp, 2026, p. 486).

Typical pathogenic beliefs, put in plain words: If I slow down, I will fall apart. Grief would be unbearable. Anyone who seems to like me has been fooled. McWilliams writes of “manic terrors of grief and self-fragmentation” (McWilliams, 2011, p. 261), and finds the last conviction in manically structured people just as in introjectively depressive ones (McWilliams, 2011, p. 262). Salman Akhtar, as quoted by McWilliams, describes the person with hypomanic personality disorder as “overtly cheerful, highly social” but “covertly guilty about aggression toward others, incapable of being alone” (McWilliams, 2011, p. 257). The PDM-3, drawing on the same author, lists a “conspicuous absence of guilt” among the visible traits (McWilliams & Shedler, 2026, p. 670). One way to reconcile the two: guilt is missing from the surface and present underneath.

Self-esteem is held up, somewhat tenuously, by success at avoiding pain and by the elation of captivating other people (McWilliams, 2011, p. 259). The arrangement can be fragile: when a loss becomes too painful to deny, the defense may give way suddenly to a serious crisis (McWilliams, 2011, p. 259; Tanzilli & Sharp, 2026, p. 485). In the language of the PDM-3 M axis, the capacities most at stake are affect regulation, impulse regulation, and trust and intimacy.

Defenses

McWilliams names the core defenses of manic and hypomanic people as denial and acting out (McWilliams, 2011, p. 258).

• Denial shows in a tendency to ignore, or turn into a joke, events that would alarm anyone else. McWilliams calls mania the clearest example of psychology defined by denial. In manic states people may deny their physical limits, their need for sleep, their finances, their weaknesses, even their mortality (McWilliams, 2011, pp. 106, 258).
• Acting out often takes the form of flight: leaving situations that threaten loss. Intoxication and provocation also serve to escape painful feelings (McWilliams, 2011, p. 258).
• Devaluation is the mirror of the depressive tendency to idealize. It appears especially when the person contemplates a loving attachment they fear will disappoint (McWilliams, 2011, p. 258).
• Omnipotence, in severe disorders and psychotic states, can bring a feeling of invulnerability (McWilliams, 2011, p. 258).
• Humor runs through the whole style. Humor can be among the most adaptive of defenses, but McWilliams singles out a driven need to be constantly funny and to avoid life’s inevitable pain as a feature of hypomanic personality (McWilliams, 2011, p. 148).
• Reaction formation: the PDM-3’s older-adult chapter names reliance on denial and reaction formation as the main challenge in treating hypomanic patients (Del Corno & Plotkin, 2026, p. 931).

Kleinian writers group several of these under the heading of “manic defenses”: denial of psychic reality, contempt for the people one loves, omnipotence, and a feeling of triumph over them (Rudan et al., 2016). On the adaptive side, the same energy and lightness, when they are not used to block feeling entirely, can fuel creativity, sociability, and resilience.

Relationships

People with this style are often the life of the party and the center of a wide social circle. Their friends value them, but sometimes complain that because every serious remark is turned into humor, they are hard to get close to (McWilliams, 2011, p. 257). Some are masterful at attaching others to themselves without investing as deeply in return (McWilliams, 2011, p. 259). The PDM-3 describes the core dynamic: they tend to bolt from relationships that stir feelings of dependency, and may try to master an unconscious terror of being abandoned by abandoning first (McWilliams & Shedler, 2026, p. 670).

Those around them often feel charmed at first, then confused, overstimulated, irritatingly “entertained,” and kept at a distance (McWilliams & Shedler, 2026, p. 670). Because these people are often brilliant and witty, friends and colleagues can be startled to learn how vulnerable they are (McWilliams, 2011, p. 259).

As for origins, the psychodynamic theory parallels the depressive one, only more extreme. In the histories of hypomanic people, McWilliams finds, perhaps even more strikingly than in depressive ones, repeated traumatic separations that the child had no chance to process: deaths that went unmourned, divorces no one talked about, moves without preparation. Criticism and mistreatment are also common in these histories. She suggests that the losses may have been greater, or the attention paid to their emotional meaning even scarcer, than in depressive backgrounds, which would explain the need for a defense as extreme as denial (McWilliams, 2011, pp. 258–259). The PDM-3 adds that emerging hypomanic personalities in adolescence often follow traumatic experiences met with denial, omnipotence, and acting out (Tanzilli & Sharp, 2026, p. 485). These are theories about how a strategy may have made sense once, not judgments of the person or of their family.

In Therapy

Transference means the feelings and expectations a person brings into the therapy relationship from earlier relationships. Countertransference means the therapist’s own emotional reactions, which can be a source of information as well as a risk.

People with a hypomanic style typically come to therapy for help with depressive plunges, and are famous for leaving as soon as their mood lifts (McWilliams, 1999, p. 99). Describing adolescents, the PDM-3 notes that they first come across as interesting, energetic, and stimulating; over time their difficulty forming deep attachments shows, and they tend to flee just when they begin to feel genuinely connected (Tanzilli & Sharp, 2026, p. 486).

Drawing on Akhtar, the PDM-3 lists the traditional picture as mild mood inflation, high energy, a conspicuous absence of guilt, inflated self-esteem, vulnerability to substance misuse, hypersexuality, and wit and charm within rather superficial relationships. It adds that people with this style tend to resist exploratory therapy, and that treatment is usually slow and punctuated by bursts of intense negative feeling and worrying enactments (McWilliams & Shedler, 2026, p. 670).

Therapists often find them winsome, insightful, and fascinating, and also confusing and exhausting (McWilliams, 2011, p. 259). The usual countertransference is a sense of things spinning, moving too fast, and not connecting with feeling (McWilliams, 1999, p. 92). A therapist may sense that someone with such a turbulent history ought to be showing more emotion telling it. McWilliams calls the most dangerous countertransference tendency underestimating how much suffering, and how much potential disorganization, lies beneath the engaging presentation; psychological testing sometimes reveals far more disturbance than an intake team suspected (McWilliams, 2011, p. 260). Paradoxically, people whose distress is more visible can be easier to help, because their discomfort keeps them in treatment (McWilliams, 2011, p. 261).

What tends to help:

• Preventing flight. Many therapists point out early the lifelong pattern of abrupt departures and ask the client to agree that, if they suddenly decide to stop, they will come back for a set number of sessions to understand the decision and end well (McWilliams, 2011, p. 260; McWilliams & Shedler, 2026, p. 670). This may be the first time the person has heard that there is an emotionally appropriate way to end a relationship.
• A steady focus on denied grief and other negative feelings (McWilliams, 2011, p. 260), including teaching that ordinary negative feelings are not catastrophic (McWilliams, 2011, p. 261).
• Going under the defense. Because denial is all-or-nothing, a gentle surface-to-depth approach tends to produce more denial. McWilliams suggests speaking directly to what is being denied, for example naming an unconscious fear that the therapist won’t come back from a vacation (McWilliams, 1999, pp. 98–99; McWilliams, 2011, p. 261).
• Slowness and plain dealing. A deliberate therapist models another way of living with feelings, and a forthright tone matters because many hypomanic people have learned to say whatever works. The therapist may need to ask, from time to time, whether the client is telling the truth or entertaining (McWilliams, 2011, pp. 261–262).
• Interpretation of the defense, where it is a style. The PDM-3 gives the example “It seems like you use a lot of energy trying to avoid feeling sadness” (McWilliams & Shedler, 2026, p. 670).
• Medication and coordination for more disturbed manic conditions. McWilliams calls modern medication a godsend for these patients, and stresses a careful, individualized prescriber and a good working relationship between prescriber and therapist. She also insists that psychotherapy remains valuable: without it, patients may not work through ungrieved losses or learn to love with less fear (McWilliams, 2011, p. 261).

What tends to backfire: mistaking the charm and apparent insight for sturdier health than is really there, which can lose a client after a single interview (McWilliams, 2011, p. 262); the warm, exploratory approach that suits hysterical clients, which can leave a hypomanic person feeling insufficiently held (McWilliams, 2011, p. 262); and a gentle, tactful question about denial, which usually produces more denial (McWilliams, 1999, p. 99). Kernberg and most analysts have considered the outlook guarded, though McWilliams notes that older hypomanic people, like older grandiose narcissistic ones, are sometimes easier to help (McWilliams, 2011, pp. 260–261). With adolescents, the PDM-3 advises proceeding cautiously to prevent both flight and breakdown (Tanzilli & Sharp, 2026, p. 487).

Variations

Part of the depressive spectrum. The PDC-3, the PDM-3’s rating form, lists hypomanic as a subtype of the depressive style, alongside introjective and anaclitic (Gordon & Bornstein, 2025). The first PDM likewise described the hypomanic as the converse of the depressive (Kotan et al., 2018).

Cyclothymic. McWilliams notes that because most people with manic tendencies have periods in which the denial fails and depression surfaces, “cyclothymic” has often been used for their psychology (McWilliams, 2011, p. 256). She understands the oscillation as repeated denial followed by its collapse when the person becomes exhausted (McWilliams, 2011, p. 106).

Across the lifespan. Adolescents with emerging hypomanic personalities are described as excited, optimistic, energetic, overconfident, impulsive, and extraverted, with unstable moods and an exaggerated but superficial sociability (Tanzilli & Sharp, 2026, p. 485). In older adults, the PDM-3 describes brief bursts of subclinical euphoria, sometimes after an attitude of self-absolution, that do not relieve the underlying suffering. It stresses that this alternation between a depressive or self-defeating stance and hypomanic behavior differs from bipolar cycling (Del Corno & Plotkin, 2026, p. 931).

Common blends. Hypomanic people share defensive patterns with grandiose narcissistic people (McWilliams, 2011, p. 261). Escapes from pain can include acts that look psychopathic (McWilliams, 2011, p. 258). Addictions are common, and some people come to individual therapy after a long stretch in a 12-step program (McWilliams, 2011, p. 261).

How Different Thinkers See It

Freud

In “Mourning and Melancholia” (1917), Freud accepted the view that mania wrestles with the same “complex” as melancholia, except that in melancholia the ego has succumbed to it, while in mania it has mastered it or thrust it aside. He compared mania to ordinary moments of triumph and relief, like suddenly being freed of a long burden, adding that in mania what the ego has overcome “remains hidden from it” (Freud, 1925, pp. 164–165).

Karl Abraham

Freud credited Abraham with “the most important of the few analytic studies” of melancholia (Freud, 1925, p. 152). In 1911 he described the manic patient as freed from normal inhibitions, and noted that the flight of ideas lets the patient “glide by means of light allusions over those ideas that are painful to consciousness,” such as ideas of inadequacy (Abraham, 1927, pp. 150–151). In 1924 he described mania as a pleasurable emancipation from a painful relationship with an internalized lost love (Abraham, 1927, p. 475).

Melanie Klein and Donald Winnicott

Klein’s 1935 paper on manic-depressive states made “manic defenses” a central concept. As Rudan and colleagues summarize the Kleinian view, these defenses deny dependence on others through omnipotence, contempt for loved ones, and triumph (Rudan et al., 2016). In his 1935 membership paper to the British psychoanalytic society, Winnicott described the manic defense as the capacity to deny the depressive anxiety inherent in development, the anxiety that belongs to feeling guilt and taking responsibility for one’s own aggression (Winnicott, 2016). For these writers, manic defenses belong to ordinary emotional development. McWilliams’ hypomanic personality describes someone for whom such defenses have become a way of life.

Bertram Lewin

Lewin, deeply influenced by Abraham, wrote original papers on mania, sleep, and dreams and described an “oral triad” of wishes: to eat, to be eaten, and to sleep (Thompson, 2010). McWilliams notes the same oral emphasis in older observations of hypomanic people (McWilliams, 2011, p. 257).

Ernst Kretschmer and temperament

Kretschmer approached the same territory as constitution rather than defense. In Physique and Character he described cycloid people as sociable, good-natured, and warm, with moods alternating between cheerfulness and sadness “in deep, smooth, rounded waves” (Kretschmer, 1925, pp. 124, 128). He added that in his book “hypomanic” always meant something characterological, with nothing to do with the line between healthy and diseased (Kretschmer, 1925, p. 126). Where analysts see denial of loss, Kretschmer saw an inborn temperamental proportion. The two views are not necessarily exclusive.

Akhtar, Kernberg, and McWilliams

Akhtar described hypomanic personality disorder in terms of an overt and a covert self, as quoted above (McWilliams, 2011, p. 257). Kernberg treats it as necessarily borderline. McWilliams disagrees for the healthier cases, and notes that analysts who understand grandiose narcissism in introjective terms recommend a similar approach for both groups (McWilliams, 2011, pp. 235, 263).

Descriptive psychiatry and research

A separate tradition studies hypomanic traits as temperament and as risk. Eckblad and Chapman developed a Hypomanic Personality Scale in 1986 (Eckblad & Chapman, 1986). In a 13-year follow-up, former college students with high scores reported more bipolar disorders, major depressive episodes, psychotic-like experiences, borderline symptoms, and substance use disorders than controls (Kwapil et al., 2000). Akiskal described irritable and hyperthymic variants of a cyclothymic temperament (Akiskal, 1992), and Judd and Akiskal treat hypomanic personality as part of a bipolar spectrum (Tanzilli & Sharp, 2026, p. 485). The PDM-3 notes that some research measures may conflate the defensive style with the mood disorder (McWilliams & Shedler, 2026, p. 670). This is the most important open disagreement about the style.

Examples

Chi Chi

In an American Psychological Association demonstration video, McWilliams interviewed a volunteer whom she saw as having some hypomanic dynamics. Chi Chi was sensitive, funny, and talented, and related with immediate warmth. She described a pattern of dropping or sabotaging things, relationships included, whenever she became emotionally invested. As the daughter of a diplomat she had been uprooted again and again, and her critical mother had tolerated no grief for lost connections. She had been the patient in several demonstration videos and said she liked being on stage. McWilliams wondered whether she was getting therapy in bits and pieces, repeating the dislocations of her childhood. When McWilliams encouraged her to consider long-term work, Chi Chi later said she had not felt safe. McWilliams reflects on this with some pain, as an example of pressing a psychoanalytic idea instead of staying within a client’s comfort zone.

Nancy McWilliams, Psychoanalytic Diagnosis (2nd ed., 2011), pp. 265–266

The spinning top

One of McWilliams’ hypomanic patients described herself as a spinning top. She was keenly aware that she had to keep moving lest she feel something painful. McWilliams uses the image to capture the hypomanic fear that stopping means falling apart. In another treatment, with a hypomanic young woman, McWilliams found herself imagining that her head was in a laundromat dryer, with everything visible but whirling too fast to follow.

Nancy McWilliams, Psychoanalytic Diagnosis (2nd ed., 2011), pp. 259–260

Twenty-six moves

Illustrating the histories of repeated, unprocessed separation she finds in hypomanic people, McWilliams describes a man who had moved 26 times in his first 10 years. More than once he came home from school to find the moving van in the driveway.

Nancy McWilliams, Psychoanalytic Diagnosis (2nd ed., 2011), p. 258

How It Differs From Look-Alikes

Bipolar and cyclothymic disorders

These are mood disorders defined by episodes or by at least two years of fluctuating symptoms (Mundo, Muzi & Lingiardi, 2026, p. 790). The PDM-3 notes that bipolar symptoms are more time-limited and intense, while hypomanic personality styles are relatively stable (Tanzilli & Sharp, 2026, p. 485), and that careful assessment is needed because the same presentation may have either source (McWilliams & Shedler, 2026, p. 670). The PDM-3 also warns of the opposite error: mistaking behavior driven by hypomanic mood states for a narcissistic or histrionic personality (Mundo, Muzi & Lingiardi, 2026, p. 791).

Hysterical personality

Charm, warmth, and apparent insight can make hypomanic clients look hysterical. Clues to the difference include abruptly ended relationships with people of both sexes, traumatic and unmourned losses, and the absence of the hysterical person’s concern with gender and power (McWilliams, 2011, p. 262).

Narcissistic personality (grandiose type)

Both can be grandiose. A good history usually shows that narcissistic people lack the turbulent, fragmented backgrounds of most hypomanic people. Inside, narcissistic people are empty, while hypomanic people hold savagely negative inner voices managed by denial. The risk of sudden flight is also greater with hypomanic clients (McWilliams, 2011, pp. 262–263).

Obsessive-compulsive personality

Both are driven and ambitious, but the similarity is mostly superficial. In the passage McWilliams quotes, Akhtar contrasts the compulsive person’s capacity for deep relationships, mourning, and attention to detail and rules with the hypomanic person’s quick, short-lived rapport and disregard for detail and convention (McWilliams, 2011, p. 263).

Attention-deficit disorder

Hypomanic people are highly distractible. Underlying themes of loss, longing, and self-hatred countered by denial point to the personality pattern. A person can have both (McWilliams, 2011, p. 264).

Emotionally dysregulated personality

Among adolescents, the PDM-3 finds that dysregulated young people show more identity disturbance, impulsivity, emotional dependency, hostility, shame, and guilt than hypomanic ones (Tanzilli & Sharp, 2026, p. 485).

Situational denial

Anyone hearing terrible news may say “Oh, no!” and deny for a while. Interviewers can usually tell a characterologically manic person, who denies in nearly every circumstance, from someone temporarily coping this way with a crisis such as a cancer diagnosis (McWilliams, 1999, p. 92).

History

Psychoanalysis took up mania early. Abraham’s 1911 paper on manic-depressive conditions drew on two “light manic-depressive cases (so-called cyclothymia),” and cited an earlier paper by Jones on a case of hypomania (Abraham, 1927, p. 138). Freud’s 1917 essay extended the analysis of melancholia to mania (Freud, 1925, p. 164), and Abraham returned to mania in his 1924 study (Abraham, 1927, p. 475). In the same years, Kretschmer’s typology linked a cycloid temperament to the manic-depressive psychoses; its English translation appeared in 1925 (Kretschmer, 1925). Klein’s 1935 paper (Rudan et al., 2016), Winnicott’s 1935 paper on the manic defense (Winnicott, 2016), and Lewin’s papers on mania (Thompson, 2010) developed the idea of mania as a defense against loss and dependence.

In 1954 Cohen and colleagues published an intensive study of twelve manic-depressive patients that emphasized their concern with social approval and achievement (Tsuda, 2011); McWilliams notes that this group compared hypomanic and compulsive people (McWilliams, 2011, p. 263).

In official psychiatry, DSM-II (1968) included cyclothymic personality. From DSM-III on, all mood-related patterns were placed in a mood disorders section, and the personality diagnosis disappeared (McWilliams, 2011, pp. 106, 256). DSM-5-TR now lists cyclothymic disorder among the bipolar and related disorders (Mundo, Muzi & Lingiardi, 2026, p. 785). ICD-11 moved cyclothymia, which had been grouped separately in ICD-10, into the core bipolar disorders (Mundo, Muzi & Lingiardi, 2026, p. 785). Research on hypomanic traits as temperament and risk grew from the 1980s, with the Hypomanic Personality Scale and long-term follow-ups (Eckblad & Chapman, 1986; Kwapil et al., 2000). On the psychoanalytic side, Akhtar’s descriptions of hypomanic personality disorder, which McWilliams called the only recent essay on the subject she knew of (McWilliams, 2011, p. 265), kept the personality concept alive. The PDM has described it as the counterpart of the depressive style from its first edition (Kotan et al., 2018) to the third (McWilliams & Shedler, 2026, pp. 669–670).

Sources

• Abraham, K. (1927). Selected papers of Karl Abraham (D. Bryan & A. Strachey, Trans.). Hogarth Press. (Includes “Notes on the psycho-analytical investigation and treatment of manic-depressive insanity and allied conditions,” 1911, and “A short study of the development of the libido, viewed in the light of mental disorders,” 1924.)
• Akiskal, H. S. (1992). Delineating irritable and hyperthymic variants of the cyclothymic temperament. Journal of Personality Disorders, 6(4), 326–342. doi:10.1521/pedi.1992.6.4.326
• Del Corno, F., & Plotkin, D. (2026). Personality styles and disorders in older adults—POA axis. In V. Lingiardi & N. McWilliams (Eds.), Psychodynamic Diagnostic Manual (3rd ed., pp. 926–956). Guilford Press.
• Eckblad, M., & Chapman, L. J. (1986). Development and validation of a scale for hypomanic personality. Journal of Abnormal Psychology, 95(3), 214–222. doi:10.1037/0021-843X.95.3.214
• Freud, S. (1925). Mourning and melancholia (J. Riviere, Trans.). In Collected papers (Vol. 4, pp. 152–170). Hogarth Press. (Original work published 1917)
• Gordon, R. M., & Bornstein, R. F. (2025). Psychodiagnostic Chart–3 (PDC-3): The operationalized PDM-3, adult version [Rating form]. sites.google.com/site/psychodiagnosticchart
• Kotan, V. O., Kotan, Z., & Özçürümez Bilgili, G. (2018). Diagnostic classification systems based on psychoanalytical principles. Archives of Neuropsychiatry, 55(1), 91–97. doi:10.29399/npa.19505
• Kretschmer, E. (1925). Physique and character: An investigation of the nature of constitution and of the theory of temperament (W. J. H. Sprott, Trans.; 2nd ed.). Kegan Paul, Trench, Trubner.
• Kwapil, T. R., Miller, M. B., Zinser, M. C., Chapman, L. J., Chapman, J., & Eckblad, M. (2000). A longitudinal study of high scorers on the Hypomanic Personality Scale. Journal of Abnormal Psychology, 109(2), 222–226. doi:10.1037/0021-843X.109.2.222
• McWilliams, N. (1999). Psychoanalytic case formulation. Guilford Press.
• McWilliams, N. (2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process (2nd ed.). Guilford Press.
• McWilliams, N., & Shedler, J. (2026). Personality styles and disorders—P axis. In V. Lingiardi & N. McWilliams (Eds.), Psychodynamic Diagnostic Manual (3rd ed., pp. 651–708). Guilford Press.
• Mundo, E., Muzi, L., & Lingiardi, V. (2026). Symptom patterns: The subjective experience—S axis. In V. Lingiardi & N. McWilliams (Eds.), Psychodynamic Diagnostic Manual (3rd ed., pp. 760–874). Guilford Press.
• Rudan, D., Jakovljevic, M., & Marcinko, D. (2016). Manic defences in contemporary society: The psychocultural approach. Psychiatria Danubina, 28(4), 334–342.
• Tanzilli, A., & Sharp, C. (2026). Emerging personality styles and disorders in adolescence—PA axis. In V. Lingiardi & N. McWilliams (Eds.), Psychodynamic Diagnostic Manual (3rd ed., pp. 468–522). Guilford Press.
• Thompson, N. L. (2010). Karl Abraham in New York: The contributions of Bertram D. Lewin. Psychoanalysis and History, 12(1), 85–96. doi:10.3366/E1460823509000567
• Tsuda, H. (2011). Revisiting Shimoda’s “Shuuchaku-Kishitsu” (statothymia): A Japanese view of manic-depressive patients. Depression Research and Treatment, 2011, 193742. doi:10.1155/2011/193742
• Winnicott, D. W. (2016). The manic defence. In L. Caldwell & H. Taylor Robinson (Eds.), The collected works of D. W. Winnicott: Vol. 1. 1911–1938 (pp. 359–374). Oxford University Press. doi:10.1093/med:psych/9780190271336.003.0068 (Original work presented 1935)