Diagnosing a Depressive Episode

DSM Criteria

There are a number of check-points your doctor will review with you to determine if you are having a depressive episode as defined by the guidelines in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

Depression is considered one of the primary symptoms of bipolar disorder. However, it is actually a set of symptoms characteristic of one aspect of bipolar disorder. An episode of depression, as it relates to bipolar disorder, is the downswing in a mood cycle. To determine if you are currently having a depressive episode or if you’ve had one in the past, your doctor will determine if:

1. Your current symptoms have lasted long enough to meet the duration requirement of a depressive episode, which is at least two weeks of continuous problems. During this two-week period, you’ve had five or more of these symptoms and these are a change from your normal behavior or emotions (See Warning Signs of Depression for additional information). One of the five symptoms must be either of the first two listed below:
   • You or those close to you have noted that you are experiencing a depressed mood most of the day.
   • You’ve lost interest or pleasure in most activities pretty much all day.
   • You’ve had a significant change in your weight or appetite. This can be either an increase or a decrease.
   • You are having trouble with insomnia or hypersomnia.
   • You are experiencing psychomotor agitation or psychomotor retardation.
   • You are fatigued.
   • You feel like you are worthlessness or you have excessive guilt.
   • You find it difficult to think or concentrate.
   • You think a lot about death or suicide; You have attempted suicide.

2. You are experiencing a mixed episode or have in the past.
3. You’re everyday functioning is disrupted -- can’t make it to work, no food in the house, cancelled social engagements, etc.
4. Your symptoms are caused by a drug (legal or otherwise) or another medical problem (see Ruling Out Other Physical Conditions).
5. Your symptoms are caused by bereavement; someone important in your life has died and you are still mourning their loss.

If your doctor, with your input, determines that points one and three are yes while points two, four and five are no, your symptoms will most likely be considered a manic episode.

As noted above, these criteria have been established through the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. It is the primary system used to classify and diagnose all mental disorders.

As per this formal classification system, bipolar disorder is a clinical disorder within the category of mood disorders. The manual recognizes four types of bipolar disorder. Each specific type of bipolar disorder is distinguished by the others through the nature of episodes experienced.

• Bipolar Disorders
  • Criteria for Bipolar I Disorder
  • Criteria for Bipolar II Disorder
  • Criteria for Cyclothymic Disorder
  • Criteria for Bipolar Disorder Not Otherwise Specified
• Episodes
  • Criteria for a Manic Episode
  • Criteria for a Hypomanic Episode
  • Criteria for a Depressive Episode
  • Criteria for a Mixed Episode

_Source:

_{American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IV-TR).}