Bipolar Disorder

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Depressed mood and a major depressive episode may be part of bipolar disorders. However, what characterizes bipolar disorders is the occurrence of one or more manic episodes. The DSM-IV criteria for manic episode include a period of abnormally elevated, expansive, or irritable mood lasting at least 1 week, plus three or more of the following seven symptoms:

1. Inflated self-esteem or grandiosity

2. Decreased need for sleep

3. More talkative than usual or pressured to keep talking

4. Flight of ideas or racing thoughts

5. Distractibility

6. Marked increased in goal-directed activity or psy-chomotor agitation

7. Excessive involvement in pleasurable activities with a high potential for painful consequences

There are two subtypes of bipolar disorders: Bipolar I involves full-blown manic episodes, and Bipolar II involves less intense, manic-like episodes, known as hypomanic episodes. There is also a bipolar disorder that parallels dysthymia, called cyclothymia. It is a chronic disorder that is characterized by the presence of both hypomanic periods and depressive periods most of the time for at least 2 years. Both depressive and bipolar disorders include residual categories called, respectively, "depressive disorder not otherwise specified'' and "bipolar disorder not otherwise specified.'' In both cases, the disorders do not meet the full criteria for either depressive or bipolar diagnoses.

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