Bipolar 1 Disorder
For diagnosis of bipolar 1, it is necessary to meet the criteria for a manic episode. The manic episode may have been preceded by and may
be followed by hypomanic or major depressive episode.
Depressive episode Manic episode* Hypomanic episode
A: Five or more symptoms present during A: A distinct period of abnormally and A: A distinct period of abnormally and
the same 2-week period and represent a persistently elevated, expansive, or irritable persistently elevated, expansive, or irritable
change from previous functioning; at mood and persistently increased activity or mood and persistently increased activity or
least one of these symptoms is either: energy, lasting at least 1 week. energy, lasting throughout at least 4 days,
that is clearly different from the usual non-
1. Depressed mood or
B: During the period of mood disturbance depressed mood.
2. Loss of interest or pleasure. and increased energy and activity, three of
the following symptoms have persisted and B: During the period of mood disturbance
5 of the following symptoms present with have been present to a significant degree: and increased energy and activity, three of
either (1) or (2): the following symptoms have persisted and
Inflated self-esteem or grandiosity have been present to a significant degree:
Depressed mood most of the day, Decreased need for sleep
nearly every day (subjective report or More talkative than usual or pressure to Inflated self-esteem or grandiosity
observation) keep talking. Decreased need for sleep
Markedly diminished interest or Flight of ideas or subjective experience More talkative than usual or pressure to
pleasure in almost all activities most of that thoughts are racing. keep talking.
Distractibility Flight of ideas or subjective experience
the day, nearly every day
Increase in goal-directed activity. that thoughts are racing.
Significant weight loss when not Excessive involvement in pleasurable Distractibility
dieting, weight gain or change in activities that have a high potential for Increase in goal-directed activity.
appetite nearly every day. painful consequences. Excessive involvement in pleasurable
Insomnia or hypersomnia nearly activities that have a high potential for
everyday C: The mood disturbance is sufficiently painful consequences.
Psychomotor retardation or agitation severe to cause marked impairment in
nearly every day occupational functioning or in usual social C: The episode is associated with an
Fatigue or loss of energy activities or relationships with others, or to unequivocal change in functioning that is
Feelings of worthlessness or necessitate hospitalisation to prevent harm to uncharacteristic of the person when not
excessive inappropriate guilt nearly self or others, or there are psychotic features. symptomatic.
every day
Diminished ability to think or D: The symptoms are not due to the direct D: The disturbance in mood and the change
For diagnosis of bipolar 1, it is necessary to meet the criteria for a manic episode. The manic episode may have been preceded by and may
be followed by hypomanic or major depressive episode.
Depressive episode Manic episode* Hypomanic episode
A: Five or more symptoms present during A: A distinct period of abnormally and A: A distinct period of abnormally and
the same 2-week period and represent a persistently elevated, expansive, or irritable persistently elevated, expansive, or irritable
change from previous functioning; at mood and persistently increased activity or mood and persistently increased activity or
least one of these symptoms is either: energy, lasting at least 1 week. energy, lasting throughout at least 4 days,
that is clearly different from the usual non-
1. Depressed mood or
B: During the period of mood disturbance depressed mood.
2. Loss of interest or pleasure. and increased energy and activity, three of
the following symptoms have persisted and B: During the period of mood disturbance
5 of the following symptoms present with have been present to a significant degree: and increased energy and activity, three of
either (1) or (2): the following symptoms have persisted and
Inflated self-esteem or grandiosity have been present to a significant degree:
Depressed mood most of the day, Decreased need for sleep
nearly every day (subjective report or More talkative than usual or pressure to Inflated self-esteem or grandiosity
observation) keep talking. Decreased need for sleep
Markedly diminished interest or Flight of ideas or subjective experience More talkative than usual or pressure to
pleasure in almost all activities most of that thoughts are racing. keep talking.
Distractibility Flight of ideas or subjective experience
the day, nearly every day
Increase in goal-directed activity. that thoughts are racing.
Significant weight loss when not Excessive involvement in pleasurable Distractibility
dieting, weight gain or change in activities that have a high potential for Increase in goal-directed activity.
appetite nearly every day. painful consequences. Excessive involvement in pleasurable
Insomnia or hypersomnia nearly activities that have a high potential for
everyday C: The mood disturbance is sufficiently painful consequences.
Psychomotor retardation or agitation severe to cause marked impairment in
nearly every day occupational functioning or in usual social C: The episode is associated with an
Fatigue or loss of energy activities or relationships with others, or to unequivocal change in functioning that is
Feelings of worthlessness or necessitate hospitalisation to prevent harm to uncharacteristic of the person when not
excessive inappropriate guilt nearly self or others, or there are psychotic features. symptomatic.
every day
Diminished ability to think or D: The symptoms are not due to the direct D: The disturbance in mood and the change
