William H. Reading, MD
Psychiatric Disorders
Bipolar I Disorder (Manic Depressive) Disorder
Requirement for Bipolar I Disorder
In order to have a bipolar disorder, an individual must have had at least one manic or mixed episode. The individual may have depressive episodes as well either before or after the manic episode. A mixed episode is when both the criteria for a manic episode and a depressive episode are simultaneously present.
Mania
The Manic Episode
A manic episode consists of a distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary). Note that a manic episode does not consist of “mood swings”
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 a significant degree:
- Inflated self-esteem or grandiosity
- Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
- More talkative than usual or pressure to keep talking
- Rapid change in thoughts as observed or the experience of rapidly occurring thoughts
- Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
- Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
- Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)