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Hyperthymia is an overlooked mood temperament marked by high energy, optimism, and self-confidence.

Hyperthymic temperament may be mistaken for narcissistic personality disorder.

Greater awareness of mood temperaments may improve psychiatric diagnosis and treatment.

As a psychodynamic therapist, I have spent much of my career studying and treating personality disorders, particularly borderline personality disorder. Yet in recent years, another topic has increasingly captured my attention: mood temperament.

Much of the credit belongs to my friend and colleague, psychiatrist Nassir Ghaemi of Tufts University and Harvard Medical School. Through our many conversations about mood disorders, bipolar illness, and psychiatric diagnosis, he introduced me to a concept that receives surprisingly little attention in contemporary psychiatry and psychotherapy: hyperthymic temperament.

Most mental health professionals are familiar with depression and mania. Far fewer are familiar with the idea that some people possess enduring, biologically based mood styles that exist between health and illness. These affective temperaments were first described by Emil Kraepelin more than a century ago and later elaborated by Hagop Akiskal and his colleagues. They include depressive, cyclothymic, irritable, anxious, and hyperthymic temperaments. In fact, up to 20 percent of the general population has a marked affective temperament (Rihmer et al., 2010).

Hyperthymic temperament is perhaps the most intriguing of this group.

Individuals with hyperthymia tend to be energetic, optimistic, confident, productive, socially outgoing, and enthusiastic about life. They often........

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