Clinical Symptoms of Manic Depression (Bipolar Disorder)

The formal diagnosis of manic depression, or Bipolar Disorder, rests on these symptoms, which can be evaluated by psychiatrists and other mental health professionals.

Symptoms of Manic Depression

The DSM distinguishes two different forms of Bipolar Disorder: “The essential feature of Bipolar I Disorder is a clinical course that is characterized by the occurrence of one or more Manic Episodes or Mixed Episodes” (p. 382), while “The essential feature of Bipolar II Disorder is a clinical course that is characterized by the occurrence of one or more Major Depressive Episodes accompanied by at least one Hypomanic Episode” (p. 392). Variants of Bipolar I Disorder are further distinguished by their recent history. The following specific diagnostic criteria are reproduced verbatim (except for codings and page references) from the DSM-IV TR (where ‘IV TR’ indicates fourth edition, text revision), pages 388-392 for Bipolar I Disorder and page 397 for Bipolar II Disorder.

Diagnostic criteria for Bipolar I Disorder, Single Manic Episode

A. Presence of only one Manic Episode and no past Major Depressive Episodes.

Note: Recurrence is defined as either a change in polarity from depression or an interval of at least 2 months without manic symptoms.

B. The Manic Episode is not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.

Diagnostic criteria for Bipolar I Disorder, Most Recent Episode Hypomanic

A. Currently (or most recently) in a Hypomanic Episode.

B. There has previously been at least one Manic Episode or Mixed Episode.

C. The mood symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.

Diagnostic criteria for Bipolar I Disorder, Most Recent Episode Manic

A. Currently (or most recently) in a Manic Episode.

B. There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed Episode.

C. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.

Diagnostic criteria for Bipolar I Disorder, Most Recent Episode Mixed

A. Currently (or most recently) in a Mixed Episode.

B. There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed Episode.

C. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.

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Diagnostic criteria for Bipolar I Disorder, Most Recent Episode Depressed

A. Currently (or most recently) in a Major Depressive Episode.

B. There has previously been at least one Manic Episode or Mixed Episode.

C. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.

Diagnostic criteria for Bipolar I Disorder, Most Recent Episode Unspecified

A. Criteria, except for duration, are currently (or most recently) met for a Manic, a Hypomanic, a Mixed, or a Major Depressive Episode.

B. There has previously been at least one Manic Episode or Mixed Episode.

C. The mood symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.

E. The mood symptoms in Criteria A and B are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

Diagnostic criteria for Bipolar II Disorder

A. Presence (or history) of one or more Major Depressive Episodes.

B. Presence (or history) of at least one Hypomanic Episode.

C. There has never been a Manic Episode or a Mixed Episode.

C. The mood symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.

E. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

All clinical material on this site is peer reviewed by one or more qualified mental health professionals. This specific article was originally published by on and was last reviewed or updated by Dr Greg Mulhauser, Managing Editor on .

Our material is not intended as a substitute for direct consultation with a qualified mental health professional. Please seek professional advice if you are experiencing any mental health concern.

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