1. Bipolar Disorder An Overview of the Diagnosis including Symptoms and Diagnostic Criteria

2. Bipolar Disorders Like other psychiatric diagnoses, this category is complex and has several subsets. Like other psychiatric diagnoses, this category is complex and has several subsets. We will not specifically address all of the subsets, but I will list them for you here. We will not specifically address all of the subsets, but I will list them for you here. Bipolar I Disorder Bipolar I Disorder Single Manic Episode Single Manic Episode Most Recent Episode Hypomanic Most Recent Episode Hypomanic Most Recent Episode Manic Most Recent Episode Manic Most Recent Episode Mixed Most Recent Episode Mixed Most Recent Episode Depressed Most Recent Episode Depressed Most Recent Episode Unspecified Most Recent Episode Unspecified Bipolar II Disorder Bipolar II Disorder Cyclothymia Cyclothymia Bipolar Disorder NOS (not otherwise specified) Bipolar Disorder NOS (not otherwise specified)

3. Associated Features Mortality rate due to suicide of 10%-15% Mortality rate due to suicide of 10%-15% Child abuse, spouse abuse, or other violent behavior may occur during severe Manic Episodes Child abuse, spouse abuse, or other violent behavior may occur during severe Manic Episodes School truancy, school failure, occupational failure, divorce, or episodic antisocial behavior. School truancy, school failure, occupational failure, divorce, or episodic antisocial behavior. Rapid and/or persistent speech (hyper-verbal; rumination) Rapid and/or persistent speech (hyper-verbal; rumination) No racial differentiation No racial differentiation No significant gender differences (unlike Maj. Dep. Dis.) No significant gender differences (unlike Maj. Dep. Dis.) Male first episode is likely to be a Manic Episode Male first episode is likely to be a Manic Episode Female first episode likely to be a Maj. Dep. Epi. Female first episode likely to be a Maj. Dep. Epi.

4. Criteria for a Manic Episode A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary) A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary) During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:

5. Criteria cont’d Inflated self-esteem or grandiosity Inflated self-esteem or grandiosity Decreased need for sleep (e.g., feels rested after only 3 hours of sleep) Decreased need for sleep (e.g., feels rested after only 3 hours of sleep) More talkative than usual or pressure to keep talking More talkative than usual or pressure to keep talking Flight of ideas or subjective experience that thoughts are racing Flight of ideas or subjective experience that thoughts are racing Distractibility (i.e., attention too easily drawn to unimportant or irrelevant stimuli. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant stimuli. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments) Mood disturbance is sufficiently severe to cause marked impairments in life.

6. Course Recurrent disorder ~ more than 90% of individuals who have a single Manic Episode go on to have future episodes. Recurrent disorder ~ more than 90% of individuals who have a single Manic Episode go on to have future episodes. 60% - 70% of Manic Episodes occur immediately before or after a Major Depressive Episode. 60% - 70% of Manic Episodes occur immediately before or after a Major Depressive Episode. Majority of individuals return to fully functional state between episodes, 20%-30% continue to display mood lability. Majority of individuals return to fully functional state between episodes, 20%-30% continue to display mood lability. Medically treated primarily with Lithium. Medically treated primarily with Lithium.