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DSM-IV-TR Criteria for Bipolar Disorder

Bipolar Disorder means more than wild mood swings. It doesn't necessarily describe someone who is "hot" one day and "cold" the next. Psychiatrists and other mental health professionals have it classified as an actual disorder in the Diagnostic and Statistical Manual for Mental Disorders IV, or DSM-IV TR. By understanding the technical aspects of Bipolar Disorder, one may be able to recognize the signs and symptoms of something other than a fickle mood.

  1. Definition

    • The DSM-IV TR characterizes Bipolar Disorder as a condition in which the patient has significant mood changes that last from weeks to months at a time. Patients will experience at least one manic episode where the mood is an elevated one; followed by a period of normalcy or balance for at least two months before an onset of a major depressive episode. These mood changes cannot be due to schizophrenia, schizoaffective disorder, psychotic disorder or delusion disorder. The mood changes also cannot be a direct result of substances taken, such as sleeping pills or prescribed amphetamines.

    Manic and Depressed Episodes

    • During the manic episode, patients may feel a more-than-normal elevated mood. They could have high energy, difficulty focusing on one project, and require lots of physical or sexual activity. Some manic episodes may require hospitalization to protect the patient from harm to self or others. When the depressed mood sets in, patients will have little to no energy to complete even the most basic of daily tasks. Patients could be filled with feelings of guilt, self-doubt and even thoughts of death. The DSM-IV reports that 10 to 15 percent of bipolar patients complete suicide. Whereas the manic and depressed phases typically last for at least 3 weeks, a Mixed episode involves these episodes lasting a week or less at a time before transition. Mixed episodes are often attributed to Rapid Cycling Bipolar Disorder.

    Subtypes

    • There are subtypes to Bipolar Disorder. Bipolar 2 disorder tends to have patients that never reach a full-on manic stage. Instead, they have a hypomanic episode where the mood is elevated and energy is higher than normal, but more easily controlled. Bipolar 2 patients also experience longer and more chronic depressed episodes. Rapid Cycling Bipolar Disorder patients will experience at least 4 episodic changes within a year. Mood swings that happen within a day are referred to as ultra-ultra rapid cycling episodes.

    Associated Disorders

    • Other disorders are commonly associated with Bipolar Disorder patients. It isn't uncommon to find people with panic disorder or social phobias to also have bipolar disorder. Physical ailments such as anorexia, bulimia and nervosa are also associated. Although substances cannot directly contribute to a manic episode, substance abuse as a whole can contribute to Bipolar disorder.

    Significant Statistics

    • Approximately 90 percent of diagnosed patients who have manic episodes will have a recurring episode, while 10 to 15 percent of teenagers that experience a depressive episode will develop Bipolar 1 Disorder. Men and women are equally diagnosed with Bipolar 1 Disorder. Men tend to have manic episodes before the depressed episodes. During postpartum, women will more likely develop psychotic-related episodes. Premenstrual periods can worsen all episodes.

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