Bipolar Disorders Forming the Diagnostic Impression

This chapter will introduce the reader to the signs and symptoms of mood episodes and to the most common types of bipolar disorder. The four primary diagnostic categories in the DSM-IV that will be the focus of this chapter include bipolar I disorder, bipolar II disorder, cyclothymic 

Before discussing the different types of bipolar disorders, it is important to introduce the reader to what is commonly meant by a mood episode. These mood episodes are generally not diagnosed separately they are considered building blocks for the disorders that follow. The types of mood episodes that clients who suffer from the bipolar disorders may manifest are manic, hypomanic, major depressive, or mixed episodes (American Psychiatric Association, 1994). 

In the first type of mood episode, referred to formally as the manic episode, the client s mood is persistently elevated. Along with elevated mood, the client must also exhibit at least three of the following symptoms increased psychomotor agitation, distractibility, flight of ideas, decreased need for sleep, and grandiosity. These symptoms should last for at least a week, or the symptoms can last less than a week if symptoms are severe enough to require hospitalization (American Psychiatric Association, 

In a hypomanic episode the symptoms may initially appear similar to the manic episode of persistently elevated, expansive, or irritable mood. The time frame for this mood episode is approximately four days, and it should be clear that the individual exhibits signs that are uncharacteristic 

Bipolar I disorder One or more manic episodes, usually with a histoiy of depressive episodes 

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