According to the National Institute on Mental Health, more than 14 million Americans are plagued by depression. Depression comes in different forms: major depressive disorder, dysthymic disorder, psychotic depression, postpartum depression and seasonal affective disorder (SAD). Manic depression, also referred to as bipolar disorder, affects more than 5 million Americans. Manic depression is characterized by cycles of mood changes ranging from extreme happy and elevated to severely depressed. The Diagnostic and Statistical Manual, Fourth Edition, published by the American Psychiatric Association, outlines criteria for diagnosing manic depression.
Step 1
Assess changes in mood and the duration of the changes. Criteria A for manic depression requires that a patient have experienced an abnormally elevated, expansive or irritable mood for at least one week. If the patient was hospitalized as a result of her change in mood, the duration criteria is waived.
Step 2
Assess behavioral symptoms. Criteria B requires that the patient have exhibited three or more of the following symptoms related to mania during the period in question: inflated sense of self or grandiosity, decreased need for sleep (i.e. sleeping only two to three hours each night yet feeling rested), being extremely talkative or feeling undue pressure to continue talking, racing thoughts or inability to capture thoughts, distractability, drastic increase in goal-directed activity (i.e. taking on an unreasonable amount of unnecessary work at work or school or even sexual activity) or excessive involvement in pleasurable activities (i.e. reckless shopping sprees, promiscuity or spending money irresponsibly). If the mood was primarily irritable, the required number of symptoms is four.
Step 3
Rule out other disease variations. Criteria C requires assessment to determine if the behavior is strictly manic and not a part of a mixed episode (manic and major depressive symptoms).
Step 4
Assess the level of impairment. Criteria D requires that the symptoms or changes in behavior have caused significant, evident impairment in general functioning in a variety of areas (i.e. home, school, work, etc.).
Step 5
Rule out other potential causes. Criteria E requires that an assessment of substance use or the presence of medications to treat another illness are not the cause.
