Bipolar
Bipolar I Disorder
According to the definition outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), bipolar I disorder, considered the most severe form of this mental illness is “characterized by one or more Manic or Mixed Episodes, usually accompanied by Major Depressive Episodes.”
In a major manic episode the patient may become delusional and even suffer from hallucinations, which are symptoms of psychosis. If this occurs, the condition is called bio-polar 1 with psychotic features. Only bipolar I disorder, by definition, can include such psychotic features. Bipolar I can seriously impair day-to-day functioning.
Other symptoms and characteristics of mania include:
- Grandiosity
- Decreased need for sleep
- Pressured speech
- Racing thoughts
- Distractibility
- Tendency to engage in behavior that could have serious consequences, such as spending recklessly or inappropriate sexual encounters
- Excess energy
Symptoms and characteristics of major depression include:
- Decreased energy
- Severe withdrawal from normal activities
- Weight loss or gain
- Despair
- Irritability
- Uncontrollable crying
- Thoughts of or attempts at suicide
BiPolar II Disorder
According to the definition in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), bipolar II disorder is “characterized by one or more Major Depressive Episodes accompanied by at least one Hypomanic Episode.” The key difference between bipolar I and bipolar II is that bipolar II has hypomanic but not manic episodes. Also, while those with bipolar I disorder may experience additional psychotic symptoms such as delusions and hallucinations, bipolar II by definition cannot have psychotic features.
The signs which would lead to a diagnosis of bipolar II disorder are:
- One or more major depressive episodes
- At least one hypomanic episode
- There has never been a manic or mixed episode
- Another disorder is not responsible for symptoms
- Symptoms cause distress or impair functioning
Symptoms and characteristics of depression include:
- Decreased energy
- Weight loss or gain
- Despair
- Irritability
- Uncontrollable crying
Symptoms and characteristics of hypomania include:
- Grandiosity
- Decreased need for sleep
- Pressured speech
- Racing thoughts
- Distractibility
- Tendency to engage in behavior that could have serious consequences, such as spending recklessly or inappropriate sexual encounters
- Excess energy
It should be noted that the symptoms of hypomania are the same as for mania, but they are less severe. Therefore, the official diagnostic criteria separating a diagnosis of bipolar II from that of bipolar I disorder is that hypomania does not cause marked impairment of functioning or require hospitalization.
Cyclothymia
Forms of Bipolar Disorder
According to the official US definition as outlined in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, Cyclothymic Disorder – also called Cyclothymia – is “a chronic, fluctuating mood disturbance involving numerous periods of hypomanic symptoms and numerous periods of depressive symptoms.” Simply translated, this means it is a long-term condition where the person’s moods cycle between hypomania – a “high” that can be mild to fairly severe but does not include delusions, hallucinations or other psychotic features – and depression, also mild to fairly severe but not incapacitating or suicidal.
Diagnosing Cyclothymia:
- Symptoms do not qualify as Major Manic or Major Depressive Episodes;
- Symptoms never ease up for more than two months;
- There hasn’t been a Manic, Mixed or Depressive Episode in the first two years of symptoms;
- Another disorder is not responsible for symptoms; and
Symptoms are not caused by a drug or general medical condition.
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