Diagnostic Criteria For Mixed Episode
Bipolar Disorder

For a diagnosis of a mixed episode of bipolar disorder, these are the signs and symptoms doctors are looking for:

A.  The criteria are met both for a Manic Episode and for a Major Depressive Episode (except for duration) nearly every day during at least a 1-week period.

B.  The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

C.  The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

Note: Mixed-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder.

Reference:  These criteria are excerpts from Diagnostic and Statistical Manual of Mental Disorders, DSM-IV, © 1994, American Psychiatric Association.

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