Bipolar Symptoms

Symptoms of Bipolar Disorder

Here are the classical clinical symptoms of bipolar disorder, as listed in the DSM-IV, the Diagnostic and Statistical Manual of Mental Disorders.

Criteria for a Depressed Episode

Five or more of the following symptoms must be present during the same two-week period and represent a change from previous functioning:

  1. Depressed mood most of the day, nearly every day. In children and adolescents, can be irritable mood.
  2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day;
  3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. In children, consider failure to make expected weight gains.
  4. Having trouble sleeping or sleeping too much;
  5. Feelings of restlessness, or fatigue;
  6. Feelings of worthlessness or excessive or inappropriate guilt;
  7. Diminished ability to think or concentrate, or indecisiveness;
  8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

Criteria for a Manic Episode

It must be a distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary). There must be three or more of the following symptoms (four if the mood is only irritable), present to a significant degree:

  1. Inflated self-esteem or grandiosity
  2. Decreased need for sleep;
  3. More talkative than usual;
  4. Flights of ideas, or feels that thoughts are racing;
  5. Distractibility
  6. Increase in goal-directed activity (either socially, at work or school, or sexually);
  7. 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)

Criteria for Mixed Episode

Meets the criteria for both a manic episode and a major depressive episode nearly every day during at least a 1-week period.

Criteria for Hypomanic Episode

A distinct period of persistently elevated, expansive, or irritable mood, lasting at least 4 days. Three (or more) of the following symptoms must persist (four if the mood is only irritable), and have been present to a significant degree:

  1. Inflated self-esteem or grandiosity;
  2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep);
  3. More talkative than usual, or feels pressure to keep talking;
  4. Flight of ideas or feels that thoughts are racing;
  5. Distractibility;
  6. Increase in goal-directed activity (either socially, at work or school, or sexually);
  7. 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)
 

Medically Reviewed by Allison Young, MD

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