Bipolar Disorders

Types of Bipolar Disorder

  • Bipolar I disorder: alternations between major depressive episodes and manic episodes
  • Bipolar II disorder: alternations between major depressive episodes and hypomanic episodes
  • Cyclothymic disorder: alternations between less severe depressive and hypomanic periods

DSM-5 Criteria: Bipolar II Disorder

  • Criteria have been met for at least one hypomanic episode and at least one major depressive episode.
    • Criteria for a hypomanic episode are identical to those for a manic episode, with the following distinctions:
    • 1) Minimum duration is 4 days
    • 2) Although the episode represents a definite change in functioning, it is not severe enough to cause marked social or occupational impairment or hospitalization
    • 3) There are no psychotic features.
  • There has never been a manic episode.
  • The occurrence of the hypomanic episode(s) and major depressive episode(s) is not better explained by:
    • schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.
  • The symptoms of depression causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
    • Also caused by the unpredictability caused by frequent alternation between periods of depression and hypomania
  • Specify current or most recent episode:
    • Hypomanic: If currently (or most recently) in a hypomanic episode
    • Depressed: If currently (or most recently) in a major depressive episode
  • Specify if:
    • With anxious distress
    • With mixed features
    • With rapid cycling
    • With mood-congruent psychotic features
    • With mood-incongruent psychotic features
    • With catatonia
    • With peripartum onset
    • With seasonal pattern
  • Specify course if full criteria for a mood episode are not currently met:
    • In full remission, in partial remission
  • Specify severity if full criteria for a mood episode are currently met:
    • Mild, moderate, severe

Cyclothymic Disorder

  • Chronic version of bipolar disorder
  • Alternating between periods of mild depressive symptoms and mild hypomanic symptoms
    • Episodes do not meet criteria for full major depressive episode, full hypomanic episode, or full manic episode
  • Hypomanic or depressive mood states may persist for long periods
  • Must last for at least two years (one year for children and adolescents)

DSM-5 Criteria: Cyclothymic Disorder

  • At least 2 yrs with numerous periods w/ hypomanic symptoms that don’t meet criteria for a hypomanic episode, and periods w/ depressive symptoms that don’t meet criteria for a major depressive episode.
  • During the above 2-year period, the hypomanic and depressive periods have been present for at least half the time and the individual has not been without the symptoms for more than 2 months at a time.
  • Criteria for a major depressive, manic, or hypomanic episode have never been met.
  • The symptoms in the first criteria aren’t better explained by:
    • schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.
  • The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).
  • The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • Specify if: With anxious distress