Diagnostic Criteria for Hypomanic Episode
| • A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood. |
| • During the period of mood disturbance, 3 or more of the following symptoms have persisted (4 if the mood is only irritable) and have been present to a significant degree: |
| 1. Inflated self-esteem or grandiosity. |
| 2. Decreased need for sleep (eg, feels rested after only 3 hours of sleep). |
| 3. More talkative than usual or pressure to keep talking. |
| 4. Flight of ideas or subjective experience that thoughts are racing. |
| 5. Distractibility (ie, attention too easily drawn to unimportant or irrelevant external stimuli). |
| 6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation. |
| 7. Excessive involvement in pleasurable activities that have a high potential for painful consequences (eg, engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments). |
| • The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic. |
| • The disturbance in mood and the change in functioning are observable by others. |
| • The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features. |
| • The symptoms are not due to the direct physiological effects of a substance (eg, a drug of abuse, a medication, or other treatment) or a general medical condition (eg, hyperthyroidism). |
| Note: Hypomanic-like episodes that are clearly caused by somatic antidepressant treatment (eg, medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of bipolar II disorder. |
Reprinted from American Psychiatric Association: Diagnostic and statistical manual of mental disorders, 4th ed, text rev. Washington DC: American Psychiatric Publishing, Inc; 2000. p. 368. Copyright © 2000 American Psychiatric Association. Used with permission.