Case Report of Hemomania: Recurrent Bloodletting and Blood Consumption From Self and Others

Hemomania is a proposed term for incontrollable urges to see, release, or ingest blood which is not a formally recognized diagnostic entity. This behavioral phenomenon overlaps with nonsuicidal self-injury (NSSI), impulse control disorders, and elements of clinical vampirism. We present the case of a 22-year-old female with a longstanding history of bloodletting using syringes, blood ingestion, and collection. The patient collected blood in vials, sometimes mixed them with water and drank it. She also collected and consumed blood from other individuals and animals occasionally. These behaviors did not align with existing diagnostic categories, therefore, conceptualized within the proposed construct of hemomania. She had comorbid major depressive disorder with psychotic features, borderline personality disorder (BPD), and schizotypal traits. Her problems intensified following recent marital discord, which acted as a key emotional trigger. Treatment comprising pharmacotherapy and psychotherapy resulted in partial improvement of symptoms but relapsed within a few months. This case describes an atypical, chronic presentations of exceptionally rare pattern of behavior and highlights the conventional diagnostic and therapeutic challenges underscoring the need for precise diagnostic framing, thorough differential assessment, and individualized treatment approaches for such complex psychiatric presentations.