The DSM is the standard diagnosis manual created by psychiatrists. While bipolar disorder cannot be clinically tested, persons with bipolar suffer from similar characteristics which the DSM-IV catalogues under Mood Disorders.
Bipolar I
A diagnosis of bipolar I means having at least one manic or mixed episode in one’s lifetime as long as it lasts a week. Only mania is needed to diagnose manic depression, although almost all bipolar individuals have depressive episodes.
Bipolar II
A diagnosis of Bipolar II involves at least one depressive and one hypomanic episode over a lifetime. Mania classifies a person as Bipolar I, and if someone’s bipolar is left untreated, it could result in a reclassification from bipolar II to bipolar I, as bipolar disorder worsens with time if left untreated.
Cyclothymic Disorder
A diagnosis of cyclothymic disorder involves the experience of hypomanic symptoms over a period of two years, as well as minor depression episodes. Of those two years at least half of the days need to be higher or lower than normal, with no period of normal lasting more than two months.
Cyclothymia is best described as bipolar lite, and most persons suffering from it usually receive a diagnosis of bipolar II later in life.
Hypomanic vs. Manic
The distinction between hypomania and mania is important to differentiate between Bipolar I and Bipolar II. Hypomania is a period of elevated mood lasting at least four days and is not severe enough to cause severe impairment in social functioning and does not require hospitalization. A manic episode is a persistent elevated mood that lasts over a week, and hinders social functioning and may require hospitalization if not treated.
Mixed Episode
A mixed state occurs when symptoms of depression and mania occur at the same time. This is a frustrating bipolar state as one may feel like a failure while simultaneously having many ideas. By far mixed states are the most dangerous of bipolar experiences, as they typically involve shifting from radical extremes of depression and mania.
Mixed states are typically caused by drug use or stressful situations in a bipolar individuals’ life.
Drugs like lithium and other mood stabilizers prevent mixed state by controlling mania, which in turn balances the depression. Of the current pharmaceuticals on the market, Lamictal is the only one with antidepressant properties that work for bipolar.
The DSM defines a mixed state as a major depressive episode and a manic episode almost every day for over a week. Any bipolar undergoing a mixed episode is at EXTREME risk of suicide.
Schizoaffective Bipolar Disorder
Schizoaffective bipolar disorder is a hybrid between bipolar and schizophrenia and it is debatable whether this disorder actually exists. It is possible that schizophrenia and bipolar are closely genetically linked and this is the reason for the overlap. Most individuals suffering from schizoaffective bipolar disorder are either misdiagnosed as bipolar or schizophrenia.
Typically an individual must have delusions and hallucinations for over two weeks during a period of normality to be classified as schizoaffective.
Treatment for schizoaffective bipolar disorder involves using mood stabilizers in addition to anti-psychotics. Since many drugs for mental illness overlap, the two diagnoses of bipolar I and schizoaffective bipolar disorder may share the same treatment regimen.
Due to the more extreme side effects such as hallucinations, schizoaffective bipolar disorder has a high risk of suicide. The percentage of people with schizophrenia and bipolar disorder who threaten or attempt suicide is significant.