Bipolar Spectrum Disorders: What is a Manic Episode?

A manic episode is a distinct period of abnormally and persistently elevated, expansive or irritable mood and abnormally and persistently increased goal-directed activity or energy—lasting at least one-week and present most of the day, nearly every day.

During the period of mood disturbance and increased energy or activity, three of the following symptoms are present:

  • Inflated self-esteem
  • Little need for sleep
  • Increased rate of speech
  • Flight ideas
  • Distractibility
  • Increased interest in goals and activities or psychomotor agitation

What is a Hypomanic Episode?

A hypomanic episode is a distinct period of abnormally and persistently elevated, expansive or irritable mood and abnormally and persistently increased activity or energy lasting at least four consecutive days and present most of the day, nearly every day. During the period of mood disturbance and increased energy and activity, three of the following symptoms are present:

  • Inflated self-esteem
  • Decreased need for sleep
  • More talkative than usual or pressure to keep talking
  • Flight of ideas or subjective experience that thoughts are racing
  • Distractibility
  • Increase in goal-directive activity or psychomotor agitation
  • Excessive involvement in activities that have a high potential for painful consequences

The hypomanic episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual 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. The episode is not attributable to the physiological effects of a substance.

What is a Major Depressive Episode?

A major depressive episode is when five or more of the following symptoms have been present during the same two-week period and represent a change from previous functioning (at least one of the symptoms is either depressed mood or loss of interest):

  • Depressed mood most of the day, nearly every day
  • Markedly diminished interest or pleasure in all or almost all activities most of the day, nearly every day
  • Significant weight loss when not dieting or weigh gain
  • Insomnia or hypersomnia nearly every day
  • Psychomotor agitation or retardation nearly every day
  • Fatigue or loss of energy nearly every day
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Diminished ability to think or concentrate or indecisiveness, nearly every day
  • Recurrent thoughts of death, recurrent suicidal ideation without a specific plan or a suicide attempt

The major depressive episode symptoms cause clinically significant distress or impairment in overall functioning. The episode is not attributable to the physiological effects of a substance or other medical condition.