Bipolar Disorders

 

Learn more about the symptoms of Bipolar I Disorder, Bipolar II Disorder and Cyclothymic Disorder. The most common treatments for bipolar disorders are mood stabilizers and psychotherapy.


Bipolar I Disorder

For a diagnosis of bipolar disorder, it is necessary to meet the criteria for a manic episode.  Hypomanic or major depressive episodes may occur before or after a manic episode but are not necessary for the diagnosis.

Manic Episode

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and increased goal-directed activity or energy that occurs nearly every day, most of the day for at least one week or any amount of time if hospitalization is necessary.

B. During the period of mood disturbance and increased energy or activity, at least three of the following symptoms are present (four if the mood is only irritable) and this represents a change from usual behavior:

  • Grandiosity or inflated self-esteem.
  • Decreased need for sleep.
  • More talkative than usual.
  • Flight of idea or racing thoughts.
  • Easily distracted.
  • Increased goal-oriented activity or psychomotor agitation (increased purposeless movements).
  • Excessive involvement in activities that have a high potential for negative consequences (such as shopping sprees or increased sexual activity).

C. The mood disturbance is severe enough to cause impairment in social or work life, requires hospitalization to prevent harm to self or others, or there are psychotic features.

D. The episode is not caused by a substance or other medical condition. 

Major Depressive Episode

A major depressive episode is present when five or more of the following symptoms have been present for two weeks and at least one of the symptoms is depressed mood or loss of interest or pleasure:

  • Depressed mood most of the day, almost every day.
  • Decreased interest in pleasure or activities.
  • Significantly decreased sleep or significantly increased sleep.
  • Significant weight loss or weight gain (or decrease or increase in appetite).
  • Psychomotor agitation (increased purposeless movements) or psychomotor retardation (moving slower).
  • Feeling worthless or guilty.
  • Feeling tired or loss of energy.
  • Decreased ability to think, concentration or make decisions.
  • Recurrent thoughts of death or suicide.

The above symptoms cause impairment in work, school and/or social life and are not due to any other substance or medical condition.

Bipolar II Disorder

For a diagnosis of Bipolar II disorder, it is necessary to meet the criteria for a current or past hypomanic episode and the criteria for a current or past major depressive episode.

Hypomanic Episode

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and increased activity or energy, for at least four consecutive days, most of the day.

B. During the period of mood disturbance and increased energy or activity, at least three of the following symptoms are present (four if the mood is only irritable) and this represents a change from usual behavior:

  • Grandiosity or inflated self-esteem.
  • Decreased need for sleep.
  • More talkative than usual.
  • Flight of idea or racing thoughts.
  • Easily distracted.
  • Increased goal-oriented activity or psychomotor agitation (increased purposeless movements).
  • Excessive involvement in activities that have a high potential for negative consequences (such as shopping sprees or increased sexual activity).

C.  The episode causes a change in functioning that is unusual for the individual when not symptomatic.

D.  The disturbance in mood and change in functioning are observable by others.

E.  The episode is not severe enough to cause significant impairment in social or work functioning and does not require hospitalization.

F.  The episode is not caused by a substance or other medical condition.

Major Depressive Episode

A major depressive episode is present when five or more of the following symptoms have been present for two weeks and at least one of the symptoms is depressed mood or loss of interest or pleasure:

  • Depressed mood most of the day, almost every day.
  • Decreased interest in pleasure in activities.
  • Significantly decreased sleep or significantly increased sleep.
  • Significant weight loss or weight gain (or decrease or increase in appetite).
  • Psychomotor agitation (increased purposeless movements) or psychomotor retardation (moving slower).
  • Feeling worthless or guilty.
  • Feeling tired or loss of energy.
  • Decreased ability to think, concentration or make decisions.
  • Recurrent thoughts of death or suicide.

The above symptoms cause impairment in work, school and/or social life and are not due to any other substance or medical condition.

Cyclothymic Disorder

  • For at least two years in adults or one year in children and adolescents, there have been numerous periods with hypomanic symptoms that do not meet the full criteria for a hypomanic episode and numerous periods with depressive symptoms that that not meet the full criteria for a major depressive episode.
  • During the above period, the hypomanic and depressive periods have been present for half the time and the individual has not been without symptoms for more than two months at a time.
  • Criteria for a major depressive episode, manic or hypomanic episode have never been met.
  • The symptoms are not better explained by another substance, medical condition or mental condition. 
  • The symptoms cause significant distress or impairment in social, work or other important areas of functioning.
 

The above criteria are adapted from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).