Table 1.

Diagnostic criteria for BD diagnoses: Overview of DSM‐5

Episode	Description
Manic episode ▪At least one lifetime manic episode is required for a diagnosis of BD I	▪Period of abnormally and persistently elevated, expansive, or irritable mood and increased energy and activity lasting at least 1 week ▪Three or more of following symptoms (four symptoms if the mood is irritable): •Low self‐esteem •Decreased sleep •Pressured speech •Racing thoughts •Activity at heightened levels •Goal agitation •Risk‐taking behaviors ▪Symptoms severe enough to cause marked impairment
Hypomanic episode ▪At least one past or current hypomanic episode and a past or current major depressive episode are required for diagnosis of BD II	▪Period of abnormally and persistently elevated, expansive, or irritable mood and increased energy and activity lasting at least 4 days ▪Same symptoms as for a manic episode ▪Mood disturbance observable by others ▪Symptoms not severe enough to cause marked impairment
Major depressive episode ▪At least one past or current hypomanic episode and a past or current major depressive episode are required for diagnosis of BD II ▪ Criteria are same for MDD and for depressive episodes of BD	▪Five or more of the following symptoms over a 2‐week period (depressed mood or loss of interest or pleasure present, nearly every day) •Depressed mood •Loss of interest or pleasure •Weight loss/gain •Insomnia/hypersomnia •Agitation •Fatigue •Worthlessness •Lack of focus •Suicidal ideation ▪Significant distress or impairment
Specifiers	Description
Rapid cycling	Four or more episodes of manic, hypomanic, or major depressive episodes
	during a 12‐month period
Anxious distress	At least two of the following symptoms (on most days during the most recent mood episode): ▪Keyed up or tense ▪Unusually restless ▪Difficulty concentrating ▪Fear something awful may happen ▪Feeling individual might lose control
Mixed features ▪Manic or hypomanic episode, with mixed features ▪Depressive episode, with mixed features	Criteria for a manic or hypomanic episode, with at least three depressive symptoms Criteria for a depressive episode, with at least three manic/hypomanic symptoms

Adapted from DSM‐5 (American Psychiatric Association, 2013). Readers are referred to the full DSM‐5 criteria published by the American Psychiatric Association (2013) for establishing a bipolar diagnosis.