Bipolar disorder reflects a range of moods. People suffering from bipolar disorder experience unusually intense emotional states which are known as ‘mood episodes’. In a ‘manic episode’, a person might show hyperactivity, be over-joyful, or be over-excited. The new DSM-5 also suggests increased energy/activity as a core symptom of a manic episode. On the other hand, during a ‘depressive episode,’ a person appears extremely sad or hopeless. Sometimes, a mood episode includes symptoms of both mania and depression. This is called a ‘mixed state’. This is a very difficult phase because; people in a mixed state may feel very sad or hopeless and at the same time be extremely energized. The symptoms of mood episodes can be extremely severe in some cases and the person cannot function normally at work, school, or home.
Overall, symptoms of bipolar disorder are seen ranging from severe depression to severe mania with some normal mood states in between.
The spectrum of Bipolar Disorder Symptoms
Based on the mood changes during either a depressive or manic episode, people with It show some behavioral and physical changes. The details of mood and behavior changes in either episode are described in the following table 1.
Table 1: Symptoms during mood episodes
Bipolar Disorder Specifiers
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5, a manual used by clinicians and researchers to diagnose and classify mental disorders) has mentioned some ‘specifiers’ for it. These ‘specifiers’ further clarify the severity or special features of the disorder apart from diagnosis. The two new specifiers in the DSM-5 are “with mixed features” and “with anxious distress.”
The specifier “with mixed features” signifies a mood that contains both manic/hypomanic and depressive symptoms. The specifier “with anxious distress” is intended to identify patients with anxiety symptoms that are not part of the bipolar diagnostic criteria.
