Bipolar

MANIC EPISODE: (NOTE: Criteria A through D constitute a manic episode. At least one lifetime manic episode is required for the diagnosis of bipolar I disorder.)
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary).
Yes No

B. During the period of mood disturbance and increased energy or activity, 3 (or more) of the following symptoms (4 if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:
1) Inflated self-esteem or grandiosity. Yes No
2) Decreased need for sleep (eg, feels rested after only 3 hours of sleep). Yes No
3) More talkative than usual or pressure to keep talking. Yes No
4) Flight of ideas or subjective experience that thoughts are racing. Yes No
5) Distractibility (ie, attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed. Yes No
6) Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (ie, purposeless non-goal-directed activity). Yes No
7) Excessive involvement in activities that have a high potential for painful consequences (eg, engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments). Yes No

C. 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. Yes No

D. The episode is not attributable to the physiological effects of a substance (eg, a drug of abuse, a medication, other treatment) or to another medical condition. Yes No

HYPOMANIC EPISODE: (Criteria A through F constitute a hypomanic episode. Hypomanic episodes are common in bipolar I disorder but are not required for the diagnosis of bipolar I disorder.)
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day. Yes No

B. During the period of mood disturbance and increased energy and activity, 3 (or more) of the following symptoms (4 if the mood is only irritable) have persisted, represent a noticeable change from usual behavior, and have been present to a significant degree:
1) Inflated self-esteem or grandiosity. Yes No
2) Decreased need for sleep (eg, feels rested after only 3 hours of sleep). Yes No
3) More talkative than usual or pressure to keep talking. Yes No
4) Flight of ideas or subjective experience that thoughts are racing. Yes No
5) Distractibility (ie, attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed. Yes No
6) Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation. Yes No
7) Excessive involvement in activities that have a high potential for painful consequences (eg, engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments). Yes No

C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic. Yes No

D. The disturbance in mood and the change in functioning are observable by others. Yes No

E. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic. Yes No

F. The episode is not attributable to the physiological effects of a substance (eg, a drug of abuse, a medication, or other treatment). Yes No

BIPOLAR MAJOR DEPRESSION:
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least 1 of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
NOTE: Do not include symptoms that are clearly attributable to another medical condition.
1) Depressed mood most of the day, nearly every day, as indicated by either subjective report (eg, feels sad, empty, hopeless) or observations made by others (eg, appears tearful). (NOTE: In children and adolescents can be irritable mood.) Yes No
2) Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation). Yes No
3) Significant weight loss when not dieting or weight gain (eg, a change of more than 5 percent of body weight in a month), or decrease or increase in appetite nearly every day. (NOTE: In children, consider failure to make expected weight gain.) Yes No
4) Insomnia or hypersomnia nearly every day. Yes No
5) Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down). Yes No
6) Fatigue or loss of energy nearly every day. Yes No
7) Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick). Yes No
8) Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by their subjective account or as observed by others). Yes No
9) 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. Yes No

B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Yes No

C. The episode is not attributable to the direct physiological effects of a substance or to another medical condition. Yes No

D. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders. Yes No

Bipolar

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