Into the DSM - Bipolar I Disorder

To meet criteria for bipolar I disorder, a manic episode is required--it may be followed by a hypomanic or major depressive episode. (For bipolar II, a hypomanic episode + a current or past major depressive episode are required.) Here are the criteria for a manic episode:

A. Distinct period of abnormally and persistently elevated, expansive, or irritable mood with increased goal-directed activity or energy, lasting at least 1 week.

B. Three or more of the following during the mood disturbance:

1. Inflated self-esteem or grandiosity
2. Decreased need for sleep
3. Increased talkativeness
4. Racing thoughts or flight of ideas
5. Distractibility
6. Increased goal-directed activity or psychomotor agitation
7. Excessive risk-taking

C. Mood disturbance severe enough to cause impairment.

D. Episode is not attributable to effects of a substance or another medical condition.

Hypomanic episodes include many of the same symptoms, but are not severe enough to cause marked impairment in social or occupational functioning or to require hospitalization.

Specifiers for bipolar I disorder include:

• With anxious distress
• With mixed features
• With rapid cycling
• With melancholic features
• With atypical features
• With mood-congruent psychotic features
• With mood-incongruent psychotic features
• With catatonia
• With peripartum onset
• With seasonal pattern

Risk factors include:

• Having a first-degree relative (e.g., parent or sibling) with the disorder.
• Substance abuse
• High stress
• Major life changes (e.g., death of loved one)

For further study: Bipolar I Disorder at MayoClinic.org