Bipolar Disorder Episodes According to the DSM-V

Wherever you see something written about bipolar disorder, the term episode is usually encountered. An episode refers to a collection of symptoms that describe a person's overall mood and behavior.

Episodes in Bipolar Disorder

Let's take a closer look at episodes in bipolar disorder, according to the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-V).

Manic Episodes

During a manic episode, a person has a sustained and abnormally elevated, expansive, or irritable mood for at least one week, and at least three of the following symptoms:

Grandiosity or an inflated sense of self
Little need for sleep
Feeling pressured to speak, talking loudly and rapidly
Easily distracted
Engaging in multiple tasks at one time — more than can be realistically accomplished in one day
Engaging in risky behavior like gambling or unprotected sex
Racing thoughts

These symptoms are exaggerated and noted by family members and loved ones. They impair a person's ability to function at home, school, and/or work.

Hypomanic Episodes

During a hypomanic episode, the symptoms of mania only need to last four days in a row. The symptoms do not impair everyday functioning like they do in a manic episode, and they are not severe enough to necessitate hospitalization.

Major Depressive Episodes

A major depressive episode must last at least two weeks and is characterized by either a severe sadness or feeling of hopelessness and/or a loss of interest or pleasure in activities that the person once enjoyed. Other symptoms that may occur in a major depressive episode include:

Feeling guilty
Sleeping problems, like too much or too little
Feeling agitated or alternatively, feeling slowed down
Eating more or less
Fatigue and loss of energy
Difficulty concentrating
Thinking of death or suicide

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Mixed Episodes

In the DSM-5, the term mixed episode was changed to mixed features. Mixed features mean that a person may either be experiencing a manic episode with at least symptoms of depression or on the contrary, a major depressive episode with at least three symptoms of mania.

Basically, a person is having both symptoms of mania and depression at the same time.

If a person if simultaneously having both a manic and depressive episode, the diagnosis is technically categorized as "manic episode with mixed features."

People with depression and mixed features are at particularly high risk for developing substance abuse disorders.

What to Do If You Experience a Bipolar Episode

Remember a bipolar episode is a distinct period of time when specific symptoms are present that, taken together, classify a person's mood as manic, hypomanic, or depressive.

If you are concerned you are experiencing symptoms of a bipolar episode, please seek care from a mental health professional.

The 9 Best Online Therapy Programs