Diagnostic+Criteria

There are a number of criteria that must be met before a diagnosis of bipolar disorder is given. This diagnosis relies heavily on the criteria listed in the Diagnostic and Statistical Manuel of Mental Disorders, which serves as a guideline for clinicians.

A) A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least one week (or any duration if hospitalization is necessary)
 * Manic episodes are characterized by:**

B) 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:


 * 1) Increased self-esteem or grandiosity [[image:admh13-besy/DSM-magnifying-glass-FJ.jpg width="243" height="238" align="right"]]
 * 2) Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
 * 3) More talkative than usual or pressure to keep talking Flight of ideas or subjective experience that thoughts are racing
 * 4) Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
 * 5) Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
 * 6)  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) (APA, 2000, p. 362).

C) The symptoms do not meet criteria for a mixed episode.

D) The mood disturbance is sufficiently service cause marked impairment in occupation functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features

E) The symptoms are not due to direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatments) or a general medical conditions (hyperthyroidism).

Requires two or more major depressive episodes, with a diagnostic criteria of:
 * Depressive Episodes Criteria**

Depressed mood and/or loss of interest or pleasure in life activities for at least two weeks and at least five of the following symptoms that cause clinically significant impairment in social, work, or other important areas of functioning almost every day


 * 1) Depressed mood most of the day.
 * 2) Diminished interest or pleasure in all or most activities.
 * 3) Significant unintentional weight loss or gain.
 * 4) Insomnia or sleeping too much.
 * 5) Agitation or psychomotor retardation noticed by others.
 * 6) Fatigue or loss of energy.
 * 7) Feelings of worthlessness or excessive guilt.
 * 8) Diminished ability to think or concentrate, or indecisiveness.
 * 9)  Recurrent thoughts of death (APA, 2000, p.356)


 * Changes in the DSM V **

There are some slight changes in the diagnosis of bipolar disorder between the DSM IV and the new and current DSM V. A new specifier, “with mixed features” has replaced the pervious “mixed episode” specifier of bipolar I disorder. Before in order for a person to meet the criteria of a mixed episode he or she needed to simultaneously meet full criteria for both mania and major depressive episode. Now with the mixed feature, a person may have features of either mania or depressive episode but will not need to meet the full criteria for both simultaneously (APA, 2013). There is also more focus on changes in activity and energy as well as mood, and less rigid day requirements for a diagnosis of hypomania.