Important Terms to Know

Manic Episode

A.    A distinct period during which there is an abnormally elevated or irritable mood of at least one week in duration (less if hospitalization required).

B.    The mood disturbance must be accompanied by at least three additional symptoms (four required if mood is irritable) including:
1)    inflated self-esteem or grandiosity
2)    decreased need for sleep
3)    pressure of speech,
4)    flight of ideas
5)    distractibility
6)    increased involvement in goal-directed activities or psychomotor agitation
7)    excessive involvement in pleasurable activities with a high potential for painful consequences.
 

Hypomanic Episode

A.    A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood.

B.    During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if
       the mood is only irritable) and have been present to significant degree:
1)    inflated self-esteem or grandiosity
2)    decreased need for sleep (feels rested after only three hours of sleep)
3)    more talkative than usual or pressure to keep talking
4)    flight of ideas or subjective experience that thoughts are racing
5)    distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
6)    increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
7)    excessive involvement in pleasurable activities that have high potential for painful consequences (e.g.,
       engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

C.    The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic.

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

E.    The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.
 

Mixed Episode

A.    The criteria are met for both a Manic Episode and for a Major Depressive Episode (except for duration) nearly every day during at least a 1-week period.

B.    The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
 
 

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VARIATIONS AMONG BIPOLAR DISORDER DIAGNOSES