Diagnostic Statistical Manual, Fifth Edition (DSM v, 2013)
BIPOLAR I DISORDER
- MANIC EPISODE
(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 significant degree and represent a noticeable change from usual behavior;
(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 others, or there are psychotic features;
(D) the episode is not attributable to the physiological effects of a substance or to another medical condition.
- HYPOMANIC EPISODE
(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, represent a noticeable change from usual behavior, and have been present to a significant degree: (1) inflated self-esteem or grandiosity; (2) decreased need for sleep; (3) more talkative than usual or pressure to keep talking; (4) flight of ideas or subjective experience that thoughts are racing; (5) distractibility as reported or observed; (6) increase in goal-directed activity or psychomotor agitation; (7) excessive involvement in activities that have a high potential for painful consequences;
(C) the episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic;
(D) The disturbance in mood and the change in functioning are observable by others; (E) the episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic.
- MAJOR DEPRESSIVE DISORDER
(1) depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by others;
(2) markedly diminished interest in pleasure in all, or almost all, activities most of the day, nearly every day;
(3) significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day;
(4) insomnia or hypersomnia nearly every day;
(5) psychomotor agitation or retardation nearly every day;
(6) failure or loss of energy nearly every day;
(7) feelings of worthlessness or excessive inappropriate guilt nearly every day;
(8) diminished ability to think or concentrate, or indecisiveness, nearly every day;
(9) recurrent thoughts of death, recurrent suicidal ideation without a specific plan without a specific plan, or a suicide attempt or a specific plan for committing suicide.