According to the DSM-IV-TR (2000) Bipolar disorders affect up to 1.6 percent of the population. There are two categories of bipolar disorders, bipolar I and bipolar II. Previously called manic depression, bipolar I and II are mood disorders and are characterized by mood fluctuations that cycle between periods of mania or hypomania, and normalcy or depression. There are specific criteria for different combinations between these mood states. To account for this, there are multiple bipolar I diagnostic criteria. It is important to note that none of the symptoms are secondary to substance use.
Bipolar I: Most Recent Episode Depressed
This diagnosis specifies that the current mood state (or most recent symptomatic mood state) meet the criteria for major depressive episode. Major depressive episode is characterized by persistent symptoms (lasting at least two weeks) of insomnia or hypersomnia (sleeping too much), unplanned weight loss or gain, feelings of sadness, hopelessness, guilt, low self-esteem and suicidal ideation. In addition, there must be a past history of at least one manic or mixed episode.
Bipolar I: Most Recent Episode Manic
The most recent episode manic diagnosis specifies a current or most recent state of mania. Mania refers to an extremely elevated mood and is characterized by symptoms such as a lack of a need for food or sleep, over-inflated self-esteem, and impulsive or reckless behavior. In addition there must be a history of at least one major depressive episode, manic episode or mixed episode.
Bipolar I: Most Recent Episode Mixed
Mixed symptoms are defined by mood states that meet the criteria for both mania and major depression nearly every day for at least one week. This diagnosis requires a current (or most recent) mixed mood state. In addition, there must be a history of at least one previous mixed, manic or major depressive episode.
Bipolar I: Most Recent Episode Hypomanic
This diagnosis specifies a current, or most recent, hypomanic state. Hypomania refers to an elevated mood that is less severe than full mania. In addition, the criteria specify that there must be a history of at least one manic episode or one episode with mixed symptoms. The impact of the hypomanic mood must cause significant hardship or impairment in occupational, social or educational functioning.
Bipolar I: Single Manic Episode
A bipolar I diagnosis of single manic episode is appropriate if there is no history of a major depressive episode. In order for this disorder to be considered recurrent, periods of mania must occur at least two months apart with periods of normalcy or feeling "blue" in between.
Bipolar II Disorder
Bipolar II differs from bipolar I in that the symptoms do not include states of mania. Instead, the mood cycles between depression and hypomania. The criteria specify at least one previous episode of major depression and at least one previous episode of hypomanic behavior. In addition, there is no previous history of manic or mixed episodes. Lastly, the symptoms must cause significant impairment or disruption in occupational, educational or social functioning.
References
- American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.
