Introduction & Types of Bipolar Disorders
Bipolar disorder is a type of mental disorder. Bipolar Affective Disorder has two different forms that present with different sets of signs, symptoms, diagnoses and treatments. These are known as Bipolar I Disorder and Bipolar II Disorder. These disorders are diagnosed using criteria developed and updated in the DSM-5.
The DSM-5 is an acronym that stands for: Diagnostic and Statistical Manual of Mental Disorders. This updated version of the DSM, provides a complete chapter on diagnosing Bipolar and Bipolar Related Disorders.
Also included in the DSM-5 manual is “manic-like” phenomena which provide a separate set of diagnostic criteria and guidelines that are unique to other outside stimuli that may contribute to this manic-like behavior. This is not considered to be true Bipolar Disorder. Drugs are an example of outside stimuli that can contribute to “manic-like” behavior. A patient cannot be diagnosed with a psychiatric illness if he or she is altered with drugs. It is only after the drugs have been eliminated from the patient’s body that a full evaluation can be performed.
In order to be diagnosed with Bipolar Disorder Type I the patient must present with mania that lasts at least one week in duration or have an episode of mania that results in the patient being hospitalized or resulting in impairment with the patient’s social or occupational functioning. This episodic mania cannot be a result from drugs, alcohol or other medical conditions. A patient must first be cleared medically before a psychiatric illness can be diagnosed. The patient must also experience signs/symptoms associated with Major Depressive Disorder for two weeks.
Bipolar II Disorder is characterized by episodes of hypomania and depression. Hypomania is defined as an elevated, expansive or irritable mood that lasts for at least four days in a row and it requires at least three symptoms of mania. The reason it is defined as hypomania, and not mania, is that in hypomania the patient will not experience these symptoms to the drastic degree that there will be consequences associated with their actions. In other words, it will not interfere with their ability to work or function socially, nor will it result in hospitalization. The patient will also experience episodes of major depression as is seen in Bipolar I as well.
Finally, if the signs/symptoms with the mania, hypomania or depressive episodes are not completely met to fit in Bipolar I or Bipolar II disorders, then it is possible that the disorder is Cyclothymic disorder. In Cyclothymic disorder there are signs and symptoms of Bipolar I or Bipolar II, but they do not fully meet the criteria for either of those disorders.