Bipolar Disorder

Diagnosing Bipolar Disorder

The Depressive Phase

Clinical depression is more than just feeling sad in reaction to an unpleasant event. A sad or depressed mood is only one of the many signs and symptoms of clinical depression.

Clinical depression is diagnosed when a minimum of five of the following symptoms are present every day, or nearly every day, for at least two weeks:

  1. depressed mood most of the day
  2. loss of interest or pleasure in formerly pleasurable activities
  3. significant decrease or increase in appetite
  4. problems sleeping at night, or sleeping too many hours per day
  5. feeling very physically restless and agitated, or physically slowed down
  6. fatigue or loss of energy
  7. feeling worthless or excessively guilty
  8. problems concentrating or making decisions
  9. recurrent thoughts of death or suicide

The Manic Phase

Mania is diagnosed when at least four or five of the following symptoms have been present for a week or more:

  1. persistent euphoric or very irritable mood, way out of proportion to circumstances
  2. much more self-confident than usual; grandiose
  3. feeling so energetic that only a few hours of sleep are needed
  4. talking so fast that other people have trouble getting a word in
  5. thoughts racing through one's head
  6. distractible, difficulty focusing on only one thing because attention is easily drawn to unimportant things
  7. engaging in many more activities than usual
  8. doing pleasurable things that are out of character and could cause trouble such as spending sprees, driving at high speeds, or engaging in risky sexual behavior

If the mood is euphoric, then 3 other items must be present to diagnose mania; if the mood is predominantly irritable, then 4 other items must be present. 

Hypomania refers to a mild manic episode. Mania is diagnosed if the episode is so severe as to require hospitalization or the person is grossly impaired in their functioning. Bipolar I disorder is diagnosed when a manic episode has occurred; bipolar II disorder is diagnosed when only hypomanic episodes have been present. In a mixed episode symptoms of mania and depression occur at the same time.

Treatment

 

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