Diagnostic criteria for Bipolar Disorder(1 & 2)

Discussion in 'Mental Health Disorders' started by catecholamine, Aug 21, 2012.

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  1. catecholamine

    catecholamine Well-Known Member

    THIS IS NOT MEANT TO BE USED TO SELF-DIAGNOSE. I can’t stress this enough. It is meant as educational material, either to better understand your diagnosis or to use as a talking point with your doctor or other qualified mental health professional.
    The DSM (Diagnostic and Statistical Manual of Mental Disorders – currently in edition IV) is used in the United States (and in some other places, too) to diagnose mental illnesses. This info comes straight from it, copied by me as I own a copy for my classes.

    The diagnosis of Bipolar can be complicated and only a mental health professional should diagnose it. To list the criteria of Bipolar 1 and 2 means I must also list the criteria for a Major Depressive Episode, Manic Episode, Mixed Episode, and Hypomanic Episode.
    Also, if this was helpful to you, please post and let me know it was useful. I spent over an hour typing all this up. Thanks!

    Major Depressive Episode
    A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
    Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.
    (1) Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful)
    Note: In children and adolescents, can be irritable mood.
    (2) Markedly diminished intrest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)
    (3) Significant weight loss when not dieting or weight gain (e.g., a change in more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
    Note: In children, consider failure to make expected weight gains.
    (4) Insomnia or hypersomnia nearly every day
    (5) Psychomotor agitation or retardation nearly every day (observable by others not merely subjective feelings or restlessness or being slowed down)
    (6) Fatigue or loss of energy nearly every day
    (7) Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
    (8) Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
    (9) Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

    B. The symptoms do not meet criteria for a Mixed Episode
    C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
    D. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g. hypothyroidism).
    E. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked ****ional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.


    Manic Episode
    A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary).
    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) 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 pressure to keep talking
    (4) Flight of ideas or subjective experience that thoughts are racing
    (5) Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
    (6) Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
    (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)
    C. The symptoms do not meet criteria for a Mixed Episode
    D. The mood disturbance is sufficiently severe to cause marked impairment in occupational 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 the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).
    Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder.

    Mixed Episode
    A. The criteria are met both for a Manic Episode and for a Major Depressive Episode (except for duration) nearly every day during at least a 1-week period.
    B. The mood disturbance is sufficiently sever to cause marked impairment in occupational function 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.
    C. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).
    Note: Mixed-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder.


    Hypomanic Episode
    A. A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood.
    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) 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 pressure to keep talking
    (4) Flight of ideas or subjective experience that thoughts are racing
    (5) Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
    (6) Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
    (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)
    C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic.
    D. The disturbance in mood and change in functioning are observable by others.
    E. The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.
    F. The symptoms are note due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).
    Note: Hypomanic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar II Disorder.

    CATECHOLAMINE’S NOTE: The symptoms for a manic episode and hypomanic are the same, but the severity (and also duration) is where it differs. Manic symptoms are more severe, more extreme, and can often require hospitalization while hypomanic symptoms do not. Also, hypomanic episodes do not include psychotic symptoms like manic episodes can (i.e. visual or auditory hallucinations, delusions).


    CATECHOLAMINE’S NOTE…AGAIN: There are six separate criteria sets of Bipolar 1, all based on what episode (manic, mixed, depressive) was most recently, whether it was a single one or more, and then there’s specifiers for various features. I am too lazy to list all these criteria sets after having written all these, so I will just do one. The listing is short, basically all it requires is a manic episode having been present and it not being superimposed on a disorder that can cause psychosis.


    296.4x Bipolar 1 Disorder, Most Recent Episode Manic
    A. Currently (or most recently) in a Manic Episode | CATECHOLAMINE NOTE: This is because of it being "Most Recent Episode Manic" - it's not required that it be the most recent episode to be diagnosed Bipolar.
    B. There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed Episode
    C. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.

    296.89 Bipolar II Disorder (Recurrent Major Depressive Episodes with Hypomanic Episodes)
    A. Presence (or history) of one or more Major Depressive Episodes.
    B. Presence of at least one Hypomanic Episode
    C. There has never been a Manic Episode or Mixed Episode
    D. The mood symptoms in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified
    E. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
     
    Last edited by a moderator: Aug 21, 2012
  2. mulberrypie

    mulberrypie Well-Known Member

    thank you. i don't think i'm bipolar.
     
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