Bipolar disorder is often not recognized, or may be confused with other conditions, and people may suffer for years before they receive appropriate treatment.
According to the DSM-5, a manic episode is manifest in an excessively euphoric, expansive, or irritable mood for most of a day, every day for at least a week, and is accompanied by abnormally and persistently increased activity and energy.
The manic symptoms may be so severe that hospitalization is required.
Bipolar II refers to the presence of a current or past hypomanic episode, which is a slightly less severe form of mania lasting at least four consecutive days, as well as the presence of a current or past episode of major depression.
The more moderate form of mania, called hypomania, similarly involves an unequivocal change in functioning, albeit for four or more days, but there is typically not significant social or occupational impairment.
Indeed, the person may feel good and highly productive, making it difficult for the person or those around him or her to identify a hypomanic episode.
Children who are at risk for bipolar disorder (because a parent has the disorder) display a developmental sequence beginning with symptoms that are not specific to bipolar disorder, notably sleep problems and anxiety.
The condition progresses from minor mood disorder to major depressive disorder in adolescence, with full-blown bipolar disorder developing in the transition to adulthood, typically with an episode of mania or hypomania or a first episode of psychosis following an episode of depression.
In addition, three (or four if the dominant mood is irritability) of the following signs must be present In addition, the mood disturbance is sufficient to cause significant impairment in social or occupational functioning or to require hospitalization to prevent self-harm, or because there are psychotic features.
What's more, the episode is not explainable by ingestion of a medication, drug of abuse, or medical condition.