Bipolar I and Bipolar II Disorders

Bipolar Disorder is a commonly misunderstood, and misdiagnosed, mental health disorder.  According to the National Alliance on Mental Health, about 2.6% of the US population has been diagnosed with Bipolar Disorder.   It is often difficult to diagnose due to its symptoms overlapping with the effects of substance abuse, certain medications, and other mental health diagnoses (e.g. ADHD, schizophrenia).   Additionally, there are four types of BD:  Bipolar I, Bipolar II, Cyclothymia, and Bipolar Unspecified.   

This post will focus on the first two types.      

According to the DSM-V, this is the breakdown on Bipolar I and Bipolar II criteria, categorized by letter.   

Bipolar I

Bipolar I is characterized by manic symptoms of abnormally elevated/energized mood or irritability that must last at least one week nearly every day (A).  For a person experiencing elevated/hyper mood to meet full criteria for Bipolar I, they must meet three of these seven symptoms (B):  

grandiosity (unrealistic beliefs about oneself)

less need for sleep without feeling tired

an unusual level of talkativeness for the person’s personality

high distractibility

flight of ideas (random, racing thoughts)

increased goal-directed activity (e.g. excessive planning, sexual promiscuity) or purposeless agitation

impulsive behaviors (e.g. spending, high risk sexual behaviors)

If a person’s mood is more irritable than elevated/energized, four of the above criteria must be met.  

Additionally, the manic episode must cause significant social or occupational dysfunction OR psychotic symptoms are present OR hospitalization is required to prevent harm to self or others.   (C)

These symptoms must not be caused by the effects of a substance, medication, or medical condition (D).   

Although common with Bipolar I, a major depressive episode is not required to be diagnosed with Bipolar I.   

Bipolar II

Bipolar II is similar but characterized by a hypomanic episode (See below for criteria).   Also criteria for at least one major depressive episode must been met (A).   

The person has never had a manic episode (B).

The hypomanic episode and the major depressive episode are not better explained by another disorder (e.g. schizophrenia, other psychotic disorder, delusional disorder) (C).

Depression and/or alternating moods between depressed mood and hypomania cause significant distress (not severe) in the person's life socially and/or occupationally (D).  

Criteria for a hypomanic episode:  

A hypomanic episode must last at least 4 days and the person's mood must be abnormally elevated or irritable nearly all day, every day (A). 

The category B requirements are the same as listed above for manic episode (B).  

The changes must be out of character for the individual (C).  

The changes must be noticeable to others (D).  

The effect of a hypomanic episode on a person socially or occupationally is not severe and there is no psychosis or need for hospitalization (E).   

The episode is not caused by use of a substance or another medical condition (F).  

Major Depressive Episode

A major depressive episode must occur during a 2 week period of time.   Five of the following symptoms must be present during this period (A):

Depressed mood most of the day, nearly every day (this can be a feeling of emptiness or hopelessness).

Significant decrease in activities or interests 

Weight loss or gain due to appetite change

Insomnia or sleeping too much

Physical agitation or retardation

Loss of energy/fatigue

A feeling of worthlessness or excessive guilt

Decreased ability to make decisions or concentrate

Recurring thoughts of death or suicidal ideation (without a specific plan)

Additionally, these symptoms must have a significantly negative affect on a person socially, occupationally, or in any other major area of a person’s life (B).  

These symptoms must not be caused by another medical condition or by the effects of a substance (C).  

Bipolar diagnoses become more complicated when severity, various features such as onset, and other types disorders in this category are factored in, but these are the basics and I hope its helpful. 

Sources:  

NAMI. (n.d.). Retrieved November 14, 2017, from https://www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder

American Psychiatric Association. (2013). Diagnostic and 

     statistical manual of mental disorders (5th ed.). Washington, DC: 

     Author.