DSM-5 and Bipolar Disorder/ Bipolar Symptoms

"The "Diagnostic and Statistical Manual of Mental Disorders" (DSM) is published by the American Psychiatric Association and contains the formal requirements for classifying and diagnosing mental illnesses. You will often find references to both the fourth and fifth editions of the DSM. The DSM-IV was published in 1994 and the DSM-5 replaced it in 2013.

"The importance of the DSM is that it contains diagnostic codes for mental illnesses, similar to those for physical illnesses. For example, if a doctor orders blood tests and gives you a paper to take to the lab, the lab may insist that there be a diagnostic code on the order because they have to provide it to your insurance company. It's the same with mental illnesses: a psychiatrist can't simply tell your insurance, "This patient has bipolar disorder." He has to give them a specific code for the type of bipolar disorder."

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• "Axis I - Clinical Disorders (including bipolar disorder)
• Axis II - Personality Disorders and Mental Retardation
• Axis III - General Medical Conditions
• Axis IV - Psychosocial and Environmental Problems (stressors)
• Axis V - Global Assessment of Functioning"

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"For adult bipolar disorder, there are now five possible diagnoses:

• C 00 Bipolar I Disorder
• C 01 Bipolar II Disorder
• C 02 Cyclothymic Disorder
• C 03 Substance-Induced Bipolar Disorder
• C 04 Bipolar Disorder Associated with Another Medical Condition
• C 05 Bipolar Disorder Not Elsewhere Classified

Changes include:

• Elimination of "Mixed Episode." Instead, a manic, hypomanic or depressive episode can be specified as "With Mixed Features," a specifier with its own definition in the manual.
• The Bipolar II diagnosis in the DSM-IV excluded a history of mixed episodes. This exclusion has been removed, an important change.
• In addition, a subtle change is that the word "abnormally" was not included in Criterion A for a hypomanic episode, while it was in Criterion A for a manic episode. This brings the full criteria for the two distinct types of episodes much closer together."

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"Current Diagnostic Criteria for Bipolar Disorders and Episodes

Until the DSM-5 is actually published, the official diagnostic criteria are:

1. For Bipolar Disorder:

• Bipolar I Disorder
• Bipolar II Disorder
• Cyclothymic Disorder (Cyclothymia)
• Bipolar Not Otherwise Specified

2. Episodes:

• Manic
• Hypomanic
• Depressive
• Mixed (eliminated in the DSM-5)"

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Verywell Mind

Bipolar disorder isn't just about having mood swings. It's a serious mental health condition that used to be referred to as manic depression.

According to the DSM-5, the guide used to diagnose mental illnesses, there are two main types of bipolar disorder that can be diagnosed based on the severity and nature of their symptoms:

• Bipolar I – Individuals with bipolar I experience at least one manic episode in their lives. Although not required for the formal diagnosis, the vast majority will also experience major depressive episodes during the course of their lives.
• Bipolar II – Individuals with bipolar II have at least one hypomanic episode (a less serious form of mania) and at least one major depressive episodes.

Bipolar Mania Symptoms

Manic episodes last at least seven days. Hypomanic episodes involve the same symptoms, but the individual's functioning isn't markedly impaired and psychotic symptoms cannot be present.

Symptoms of a manic or hypomanic episode include:

• Decreased need for sleep
• Talking excessively
• Racing thoughts
• Being easily distracted
• Physical agitation and relentless movement
• Increased sexual desire
• Impulsive risk behaviors (including gambling and lavish spending)
• Grandiosity or inappropriate behavior
• Irritability, hostility, or aggression
• Delusions or hallucinations

Bipolar Depression Symptoms

During a depressive episode, an individual may experience the following symptoms: 

• Crying for no reason or prolonged periods of sadness
• Feelings of guilt or hopelessness
• Loss of interest in activities that usually give you pleasure
• Extreme fatigue, including the inability to get out of bed
• Loss of interest in your health, nutrition, or physical appearance
• Difficulty concentrating or remembering things
• Sleeping excessively or difficulty sleeping
• Suicidal thoughts or an impulse to self-harm

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From: https://www.verywellmind.com/what-is-the-dsm-5-379955

And: https://www.verywellmind.com/bipolar-disorder-symptoms-and-diagnosis-379962