9- What is Bipolar Disorder?

Source: https://www.youtube.com/watch?v=3lox1FC4zPM

Correct Answer: C. A mental illness marked by extreme mood elevations and depressions that impair functioning

Explanation:
Bipolar disorder involves pathologic mood extremes (mania/hypomania and depression) that significantly affect sleep, thinking, behavior, and overall functioning—not normal emotional changes.

Which best defines bipolar disorder?

A. A condition characterized by normal mood swings in response to life stress
B. A personality disorder involving unstable relationships
C. A mental illness marked by extreme mood elevations and depressions that impair functioning
D. A disorder caused primarily by trauma

Correct Answer: C. At least one manic episode

Explanation:
A diagnosis of Bipolar I requires at least one manic episode. A depressive episode is not required.

Which symptom is essential for the diagnosis of Bipolar I disorder?

A. Major depressive episode
B. Hypomanic episode
C. At least one manic episode
D. Chronic anxiety

Correct Answer: B. At least 7 days, or any duration if hospitalization is required

Explanation:
Mania must last ≥7 days, or any duration if hospitalization occurs, which is an important diagnostic clarification.

According to DSM-5, how long must a manic episode last to meet criteria for Bipolar I?

A. At least 4 days
B. At least 7 days, or any duration if hospitalization is required
C. At least 2 weeks
D. At least 1 month

Correct Answer: C. Elevated mood plus three symptoms for 7 days

Explanation:
Mania requires elevated or expansive mood plus ≥3 symptoms for 7 days or more. If mood is only irritable, 4 symptoms are required.

Which of the following symptom sets meets criteria for mania?

A. Elevated mood plus two symptoms for 4 days
B. Irritable mood plus three symptoms for 7 days
C. Elevated mood plus three symptoms for 7 days
D. Depressed mood plus four symptoms for 2 weeks

Correct Answer: B. Pressured and rapid speech

Explanation:
Mania often presents with pressured, rapid speech, decreased need for sleep, flight of ideas, and increased activity.

Which symptom is commonly seen in mania?

A. Excessive need for sleep
B. Pressured and rapid speech
C. Persistent guilt
D. Social withdrawal

Correct Answer: B. Substance-induced mood disorder

Explanation:
Mania can be caused by substances (e.g., cocaine, steroids) or medical conditions (e.g., thyroid disease), which must be ruled out.

Which condition must be ruled out before diagnosing Bipolar I disorder?

A. Major depressive disorder
B. Substance-induced mood disorder
C. Adjustment disorder
D. Generalized anxiety disorder

Correct Answer: C. Psychosis indicates mania, not hypomania

Explanation:
Psychotic features automatically indicate mania, which means Bipolar I, not Bipolar II.

Which statement about psychosis in bipolar disorder is correct?

A. Psychosis can occur in hypomania
B. Psychosis only occurs during depression
C. Psychosis indicates mania, not hypomania
D. Psychosis excludes bipolar disorder

Correct Answer: B. Duration and severity

Explanation:
Hypomania is shorter (≥4 days) and less severe, with no psychosis or marked functional impairment, unlike mania.

What is the defining difference between mania and hypomania?

A. Presence of depressive symptoms
B. Duration and severity
C. Type of mood (happy vs irritable)
D. Age of onset

Correct Answer: B. At least 4 consecutive days

Explanation:
Hypomania requires ≥4 consecutive days of elevated or irritable mood with ≥3 symptoms.

How long must hypomania last to meet DSM-5 criteria?

A. At least 2 days
B. At least 4 consecutive days
C. At least 7 days
D. At least 14 days

Correct Answer: C. Hypomanic episode plus major depressive episode

Explanation:
Bipolar II requires both hypomania and a major depressive episode. Mania or psychosis would indicate Bipolar I.

Which is required for a diagnosis of Bipolar II disorder?

A. At least one manic episode
B. Hypomanic episode only
C. Hypomanic episode plus major depressive episode
D. Psychotic features

Correct Answer: C. Marked functional impairment or hospitalization

Explanation:
Hypomania does not cause marked impairment or require hospitalization. If it does, the episode qualifies as mania.

Which feature distinguishes hypomania from mania?

A. Elevated mood
B. Flight of ideas
C. Marked functional impairment or hospitalization
D. Increased activity

Correct Answer: C. Mood episodes can be separated by long periods of normal mood

Explanation:
Individuals with bipolar disorder may experience months or years of euthymia (normal mood) between episodes.

Which statement about mood patterns in bipolar disorder is TRUE?

A. Bipolar disorder always follows a predictable up-down cycle
B. Mania must always be followed by depression
C. Mood episodes can be separated by long periods of normal mood
D. Hypomania always progresses to mania

Correct Answer: C. Believing one has a divine mission to save the world

Explanation:
Grandiosity in mania involves inflated self-importance that may reach delusional levels.

Which example best illustrates grandiosity in mania?

A. Feeling confident before an exam
B. Planning a realistic career change
C. Believing one has a divine mission to save the world
D. Feeling proud after success

Correct Answer: B. Sleeping 2–3 hours and feeling rested

Explanation:
Mania is characterized by reduced need for sleep without fatigue, not insomnia with exhaustion.

Which symptom reflects decreased need for sleep in mania?

A. Difficulty falling asleep but feeling tired
B. Sleeping 2–3 hours and feeling rested
C. Oversleeping and fatigue
D. Frequent nightmares

Correct Answer: C. Normal emotional reactions are mistaken for pathological mood episodes

Explanation:
Normal emotional changes are often mislabeled as bipolar disorder, but true bipolar disorder involves severe, sustained, and impairing mood episodes.

Why is bipolar disorder often misused in everyday language?

A. Symptoms are subtle
B. It resembles personality disorders
C. Normal emotional reactions are mistaken for pathological mood episodes
D. It only affects older adults

Correct Answer: C. Four

Explanation:
If the mood is only irritable (not elevated or expansive), four manic symptoms are required instead of three.

In DSM-5 criteria for mania, how many additional symptoms are required if the mood is only irritable?

A. Two
B. Three
C. Four
D. Five

Correct Answer: C. Cocaine and other illicit stimulants

Explanation:
Illicit substances—especially stimulants like cocaine—can produce manic-like symptoms and must be ruled out.

Which substance must be ruled out as a direct cause of manic symptoms before diagnosing Bipolar I disorder?

A. SSRIs only
B. Alcohol withdrawal only
C. Cocaine and other illicit stimulants
D. Caffeine

Correct Answer: B. They may better explain the mood symptoms

Explanation:
Manic symptoms must not be better explained by another mental illness, such as schizoaffective disorder.

Why must other psychiatric disorders be ruled out before diagnosing Bipolar I disorder?

A. They have similar treatments
B. They may better explain the mood symptoms
C. Bipolar disorder is a diagnosis of exclusion
D. Psychiatric disorders cannot coexist

Correct Answer: C. A normal, stable mood state

Explanation:
Euthymia describes periods of normal mood between mood episodes, which can last months or years.

What does the term euthymia refer to in bipolar disorder?

A. A mild depressive state
B. A mixed mood episode
C. A normal, stable mood state
D. A prodromal manic phase

Correct Answer: C. A manic episode excludes the diagnosis

Explanation:
If a patient has ever had a manic episode, the diagnosis becomes Bipolar I, not Bipolar II.

Which statement is TRUE regarding Bipolar II disorder?

A. Patients experience full manic episodes
B. Psychosis may occur during hypomania
C. A manic episode excludes the diagnosis
D. Hypomania alone is sufficient for diagnosis

Correct Answer: B. Anhedonia

Explanation:
A major depressive episode requires symptoms such as anhedonia, depressed mood, sleep/appetite changes, and suicidality for ≥2 weeks.

Which symptom is core to a major depressive episode in Bipolar II disorder?

A. Elevated self-esteem
B. Anhedonia
C. Pressured speech
D. Decreased need for sleep