A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goaI-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospi- talization is necessary).
B. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a sig- nificant degree and represent a noticeable change from usual behavior:
Inflated seIf-esteem or grandiosity.
Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).
More talkative than usual or pressure to keep talking.
Flight of ideas or subjective experience that thoughts are racing.
Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (i.e., purposeless non-goaI-directed activity).
7. Excessive involvement in activities that have a high potential for painful conse- quences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).
?‘PP’NT‘ .0)
C. The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or oth- ers. or there are psychotic features.
D. The episode is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) or to another medical condition.
Note: A full manic episode that emerges during antidepressant treatment (e.g., medi- cation, electroconvulsive therapy) but persists at a fully syndromal level beyond the physiological effect of that treatment is sufficient evidence for a manic episode and, therefore, a bipolar | diagnosis.
Note: Criteria A—D constitute a manic episode. At least one lifetime manic episode is re- quired for the diagnosis of bipolar l disorder.
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consec- utive days and present most of the day, nearly every day.
B. During the period of mood disturbance and increased energy and activity, three (or more) of the following symptoms (four if the mood is only irritable) have persisted. rep- resent a noticeable change from usual behavior, and have been present to a significant degree: 1. Inflated seli-esteem or grandiosity.
Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).
More talkative than usual or pressure to keep talking.
Flight of ideas or subjective experience that thoughts are racing.
Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
6. increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation.
7. Excessive involvement in activities that have a high potential for painful conse- quences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).
. The episode is associated with an unequivocal change in functioning that is uncharac- teristic of the individual when not symptomatic.
. The disturbance in mood and the change in functioning are observable by others.
. The episode is not severe enough to cause marked impairment in social or occupa- tional functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic.
The episode is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment).