Diagnosing a Manic Episode

DSM Criteria

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

Mania is one of the emotional extremes associated with bipolar disorder (manic depression). It is a hallmark symptom of bipolar disorder, specifically bipolar I disorder. But to be more precise, mania is a cluster of symptoms that are associated with one aspect of bipolar disorder. To determine if you are currently having a manic 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 manic episode, which is at least one week of continuous problems. If your symptoms are severe enough that you’ve had to go to the hospital, the duration doesn’t matter.
2. You have at least three or more of the following symptoms during this timeframe. If your abnormal mood is only irritable (not elevated or expansive), then you will need have four of these symptoms for your doctor to consider this a manic episode(see Warning Signs of Mania for additional information):
   • Inflated self-esteem or grandiosity
   • Decreased need for sleep
   • More talkative than usual or pressure to keep talking
   • Flight of ideas or subjective experience that thoughts are racing
   • Distractibility
   • Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
   • Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

3. You are experiencing a mixed episode or have in the past.
4. You’re everyday functioning is disrupted (can’t make it to work, no food in the house, cancelled social engagements, etc.), if you require hospitalization or if you have psychotic features.
5. Your symptoms are caused by a drug (legal or otherwise) or another medical problem (see Ruling Out Other Physical Conditions).

If your doctor, with your input, determines that points one, two and four are yes while points three 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).}