Manic Episodes

Manic Episode

  • Elevated, expansive mood for at least one week
  • Examples of symptoms:
    • Inflated self-esteem, decreased need for sleep, excessive talkativeness, flight of ideas or sense that thoughts are racing, easy distractibility, increase in goal-directed activity or psychomotor agitation, excessive involvement in pleasurable but risky behaviors
  • Impairment in normal functioning

DSM-5 Criteria for Manic Episodes

  • A distinct period of abnormal and persistent elevated/irritable mood and abnormal and persistent increased goal-directed activity/energy, lasting at least 1 week and present most of the day, nearly every day
  • During the period of mood disturbance and increased energy/activity, at least 3 of the following symptoms are present to a significant degree and represent a noticeable change from usual behavior:
    • Inflated self-esteem or grandiosity
    • Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
    • More talkative than usual or pressure to keep talking
    • Flight of ideas or subjective experience that thoughts are racing
    • Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed
    • Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (e.g., purposeless non-goal-directed activity).
    • Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
  • The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
  • The episode is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) or to another general medical condition.
    • A full manic episode that emerges during antidepressant treatment but persists beyond the physiological effect of that treatment is sufficient evidence of a manic episode and a bipolar I diagnosis.