Bipolar Disorders are more complex in nature than a major depressive
disorder and can fall under several categories depending on the symptoms
that are present:
1) Bipolar Disorder I
2) Bipolar Disorder II
3) Cyclothymia
Three phrases need to be defined first in order to better understand
what type of bipolar disorder is present:
1) Manic episode
2) Hypomanic episode
3) Mixed episode
Manic Episode
A manic episode is defined in the following
ways:
-
a period in which the individual experiences a
persistent and abnormally elevated, expansive and irritable mood lasting
for a minimum of 1 week
Furthermore, some of the following symptoms also
need to be present:
-
a sense of grandiosity or elevated self-esteem
-
no specific need for sleep (person feels refreshed
after only a couple hours of sleep)
-
more verbose than usual. Also feels pressure to
continue to talk
-
experiencing of many ideas in a short time span.
Also perception that thoughts are racing
-
easily distracted
-
activities that are goal directed increase
-
involvement in pleasurable activities that are
risky and may cause painful consequences (shopping sprees or excessive
sexual activities). This involvement is excessive.
This disturbance of mood is so severe that it
causes marked impairments in occupational and social functioning.
Hospitalization may sometimes be necessary as a way of protecting the individual
from harming himself/herself.
It is worth noting that these symptoms are
not experienced because of physiological effects of drug use or medical
conditions.
Hypomanic Episode
It is worth noting that the symptoms of manic
and hypomanic episodes mimic one another closely except for a few subtle
differences. A hypomanic episode is defined in the following ways:
-
a period in which the individual experiences a
persistent and abnormally elevated, expansive and irritable mood lasting
for a minimum of 4 days and that is visibly different from the non depressed
mood.
Furthermore, some of the following symptoms also
need to be present:
-
a sense of grandiosity or elevated self-esteem
-
no specific need for sleep (person feels refreshed
after only a couple hours of sleep)
-
more verbose than usual. Also feels pressure to
continue to talk
-
experiencing of many ideas in a short time span.
Also perception that thoughts are racing
-
easily distracted
-
activities that are goal directed increase
-
involvement in pleasurable activities that are
risky and may cause painful consequences (shopping sprees or excessive
sexual activities). This involvement is excessive.
This hypomanic episode shows a marked change in
the individual's functioning that is not characteristic of that individual
when he/she does not exhibit the symptoms listed above. Other people notice
this change in functioning as well.
Unlike the manic episode, this disturbance
of mood is not so severe that it causes marked impairments in occupational
and social functioning. Hospitalization will usually not be necessary
when one experiences a hypomanic episode.
It is worth noting that these symptoms are
not experienced because of physiological effects of drug use or medical
conditions.
Mixed Episode
The mixed episode criteria is met when the
individual experiences both a manic episode and a major depressive episode
(refer to the depressive
disorder section) almost everyday for a period of 1 week.
Similar to the manic episode, this episode
causes severe impairments in social and occupational functioning, in addition
to relationship with others. Furthermore, hospitalization may be necessary
to prevent the individual from harming himself/herself or others.
Finally, these symptoms are not experienced
because of physiological effects of drug use or medical conditions.
Bipolar I Disorder
There are several types of Bipolar I disorder:
-
bipolar disorder with manic episode
-
bipolar disorder with hypomanic episode
-
bipolar disorder with mixed episode
-
bipolar disorder with depressed episode
It is rather important to note that the following
disorders can also be identified as a "single" episode or "most recent"
episode.
Bipolar Disorder with a manic episode is identified
when an individual experiences at least one manic episode and no history
of a major depressive disorder (depression).
It is important to note that this manic episode is not as a result of another
disorder such as schizoaffective, etc...
A bipolar disorder with a hypomanic episode
is defined when an individual experiences a hypomanic episode. There also
needs to be at least one manic episode. These symptoms tend to cause
significant distress or functional impairments socially, occupationally
or other important areas. Once again, these episodes are not as a
result of other disorders such as schizoaffective, etc....
Bipolar disorder with a mixed episode is best
identified when an individual experiences a mixed episode. It is worth
noting that there needs to exist at least one major depressive episode,
manic episode or mixed episode. Once again these episodes are not
as a result of another disorder such as schizoaffective, etc...
Finally, a bipolar disorder with a depressed
episode is when the individual is currently in a depressive episode. In
addition, there has previously been at least one mixed or manic episode
as well. Same as with other bipolar disorders, these episodes are
not caused by other disorders such as schizoaffective or others.
Bipolar II Disorder
The criteria necessary to be identified as
a Bipolar II Disorder is as follows:
-
individual needs to currently experience (or has
in the past) at least one major depressive disorder
-
a current or history of a minimum of one hypomanic
episode
-
a manic or mixed episode has never existed
-
the symptoms identified in the above criteria
are not caused by other disorders
-
these symptoms cause considerable functional impairments
in important areas such as socially, occupationally and others
It is once again important to note whether or
not the bipolar II disorder is current or most recent episode in regards
to hypomania or depressed.
Cyclothymia
Cyclothymia is similar to dysthymia
in that it is a more chronic version of bipolar disorder as its counterpart
is to depression. It can best be identified by the following symptoms:
-
for a minimum of 2 years, there needs to exist
several periods with both hypomanic and depressive symptoms that are not
indicative of a major depressive disorder
-
while in this 2 year period (1 year for children),
the individual has not been without the symptoms for more than 2 months
at one time
-
during the first 2 years of the disorder, the
individual has not experienced a major depressive disorder, a manic episode,
or a mixed episode.
-
these symptoms are not caused by other disorders
-
these symptoms are not caused by substance
use or a general medical condition
-
these symptoms cause considerable impairments
in areas including socially , occupationally and others.