In order to be diagnosed with bipolar disorder, a person must meet the following criteria:
-
A history of one or more major depressive episodes.
-
A history of at least one hypomanic episode (See the hypomania criteria listed below)
-
There has never been a “mixed episode” in which a person experiences both mania and major depression nearly every day over a 1-week period.
-
The person’s behavior cannot be explained by schizophrenia, a delusional disorder, or an NOS (not otherwise specified) psychotic disorder.
-
The symptoms are causing “significant distress or impairment in social, occupational, or other important areas of functioning.”
Criteria for hypomania
A) “A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual non-depressed mood.”
B) The presence of 3 or more of the following symptoms (or 4 if the mood is only irritable), expressed to a significant degree during this period:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- Rapid speech or more talkative than normal
- Racing thoughts or many ideas swirling in the mind
- Easily distractible
- An “increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation.”
- Seeks pleasurable activities in risky ways that have a high likelihood of adverse consequences (i.e., casual sex, spending sprees, gambling, etc.)
C) This behavior marks an “unequivocal change in functioning that is not characteristic of the person” when not in a manic state.
D) These behavioral changes are observable by others.
E) Episodes are not severe enough to result in psychosis or require hospitalization (for type 2; the opposite for type 1).
F) These symptoms cannot be explained by substance use (whether drugs or medication) or a medical condition such as hyperthyroidism.