Mood Disorders Introduction to Bipolar Disorders

The common understanding of bipolar disorders comes from the swings in “mood” from depressed to manic, but the disorders involve much more. There are four major conditions that may be involved with bipolar disorders: major depression, manic episodes, hypomanic episodes, and mixed episodes.

There are two official types of bipolar disorder: Bipolar I and Bipolar II. These are distinctly different types of the Bipolar mood disorders. There is also Unspecified Bipolar Disorder, where no cause related to the other bipolar disorders can be found, but the symptoms exist.

The mood disorders are markedly different from the human being’s normal ups and downs in mood, where even bouts of depression are a biological fact of life.

The DSM-IV-TR has detailed criterion and descriptions of the conditions of Bipolar I and II disorders and indicates that a diagnosis is a complex physiological and psychological examination process which is aided by the observations of family and others who have observed the symptoms and behavior, especially when the individual cannot describe events or remember exhibiting the symptoms.

The first issue with bipolar disorders is to not confuse the complaint or claim with some other problem, for example when substance abusers claim that they have the true form of the disorder, rather than the mood changes that from being “high” or being off of drugs; or even the side effects of the drugs, themselves. There are other conditions that may cause similar or the same symptoms, such as schizophrenia, medication, somatic treatments for depression, and general medical conditions.

There are several criterion for diagnosing Bipolar I and II disorders.There are also conditions of duration of symptoms or episodes. The symptoms are clearly listed, with the presence of a certain number of listed symptoms being required for the conditions of a diagnosis to be met.  

Bipolar I disorder will involve great swings from debilitating major depression to highly risky, grandiose or excessive changes in irritability, or delusional behavior. Bipolar I disorder includes major depression, mixed, and manic episodes. Mixed episodes are a period of rapid change from major depression to manic behavior. Hospitalization can be required, and the individual undergoes great upheavals in life

Bipolar II disorder is mostly different from Bipolar I disorder because there are hypomanic episodes, rather than manic episoded.There will also be a return to normal mood after a major depression, called euthymic episode.

Hypomanic episodes: These are episodes that last for at least four days and involve behavior that is “abnormally and persistently elevated, expansive or irritable”. (DSM IV-TR) The hypomanic episodes of Bipolar II disorder are much milder than the manic episodes of Bipolar I disorder, can be described as “eccentric” rather than “over the top”, and will generally not require hospitalization.

Major Depression: Major Depression is mood depression or the loss of interest or pleasure from almost every activity lasts for at least two weeks. Children may exhibit an irritable instead of sad mood. There are times and recencies that must be met: either the symptom is new or has obviously gotten worse than it was before the depressive episode. Persistence: most of the day, almost every day, at least 2 consecutive weeks.

Manic Episode: The Manic Episode goes on for a distinct period of time, at least one week. There is elevated, expansive, or irritable mood and hospitalization can be required. If the patient is hospitalized, the one week duration criterion is lessened, since the individual is being stabilized and treated.

Mixed Episode: One or more Mixed Episodes is a major part of Bipolar I Disorder. The Mixed Episode may or may not be evolved from a Major Depressive Episode. The Mixed Episode meets the major criterion for both a Major Depressive and a Manic Episode for a week and almost every day of the week. This is a period of rapid alterations and alternating moods, from sadness and irritability to euphoria. There are appetite, insomnia, psychotic, agitation and suicidal thinking features in the Mixed Episode.

There are excellent references in the DSM-IV for learning more about bipolar mood disorders.

DSM-IV-TR, Bipolar I Disorder m/content.aspx?aID=2475&searchStr=bipolar+i+disorder#2 475

DSM-IV-TR, Bipolar I Disorder m/content.aspx?aID=2475&searchStr=bipolar+i+disorder#2 475

DSM-IV-TR, Bipolar II Disorder

DSM-IV-TR, Unspecified Bipolar Disorder

DSM-IV-TR, Mixed Episode m/content.aspx?aID=2199&searchStr=mixed+episode

DSM-IV-TR, Manic Episode m/content.aspx?aID=2149&searchStr=manic+episode

DSM-IV-TR, Major Depressive Disorder

DSM-IV-TR, Hypomanic Episode