People with bipolar disorder experience unusually intense emotional states that occur in distinct periods called "mood episodes." An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a depressive episode.   While it is normal for everyone to go through ups and downs, it is the severity and duration of the mood related symptoms that determine the diagnosis of bipolar disorder.

General Signs and Symptoms of Bipolar Disorder

Bi Polar Symptoms - Specific Criteria From DSM-IV

(DSM-IV is the the Diagnostic and Statistical Manual of Mental Disorders (DSM). It is published by the American Psychiatric Association and provides diagnostic criteria for mental disorders.)

• Manic episodes are characterized by the following symptoms:
  • A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary)
  • Three or more of the following symptoms are present:
  •  
    • Grandiosity or inflated self-esteem
    • Diminished need for sleep
    • Excessive talking or the feeling of pressure to keep talking
    • Racing thoughts or flight of ideas
    • Evidence of distractibility
    • Increased level of goal-focused activity at home, at work, or sexually
    • Excessive pleasurable activities, often with painful consequences
  • The mood disturbance is sufficient to cause impairment at work, unusual social activities, disrupted relatinships or a danger to the patient or others.
  • The mood is not the result of substance abuse or a medical condition.
• Hypomanic episodes are characterized by the following symptoms:
  • 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.
  • Durring the period of mood disturmbance, three or more of the following symptoms are present:
    • Grandiosity or inflated self-esteem
    • Diminished need for sleep
    • Excessive talking or the feeling of pressure to keep talking
    • Racing thoughts or flight of ideas
    • Evidence of distractibility
    • Psychomotor agitation at home, at work, or sexually
    • Engaging in activities with a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
  • The mood disturbance is observable to others.
  • The mood is not the result of substance abuse or a medical condition.
• Major depressive episodes are characterized by the following symptoms:
  • For the same 2 weeks, 5 or more of the following symptoms have been present. At least 1 of them being either a depressed mood or a loss of pleasure or interest:
    • Depressed mood as indicated by subjective report or observation by others.
    • Markedly diminished pleasure or interest in nearly all activities
    • Significant weight loss or gain or significant loss or increase in appetite
    • Hypersomnia or insomnia
    • Psychomotor retardation or agitation
    • Loss of energy or fatigue
    • Feelings of worthlessness or excessive guilt.
    • Decreased concentration ability or marked indecisiveness
    • 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
  • The symptoms cause significant impairment and distress in social, occupational, or other areas of functioning.
  • The mood is not the result of substance abuse, a medical condition, or bereavement (e.g. loss of a loved one, end of a relationship)
• Mixed episodes are characterized by the following symptoms:
  • Persons must meet both the criteria for mania and major depression; the depressive event is required to be present for 1 week only.
  • The mood disturbance results in marked disruption in social or vocation function.
  • The mood is not the result of substance abuse or a medical condition.
  • The mixed symptomology is quite common in patients presenting with bipolar symptomology. This often causes a diagnostic dilemma