Bipolar I Disorder

Bipolar I Disorder is not a complete diagnosis in and of itself. When someone is diagnosed with Bipolar I Disorder, the doctor uses what are called specifiers to give more information about the patient’s current condition. Specifiers describe the mood episode and severity of the illness that the patient is experiencing.

If the person most recently experienced a hypomanic episode, often no further specifiers are given. Hypomania is by definition, a mild manic episode with no psychotic features. Therefore, it would be redundant to specify the severity of the symptoms and the presence of psychotic features. This diagnosis can be further specified to give describe if the person is experiencing rapid cycling, if there is a seasonal pattern to their condition, or if there is an absence of symptoms between episodes.

The first specification tells what kind of episode is the person’s most recent episode. The diagnoses with episode specifiers used to describe the person’s most recent mood episode are:

• Bipolar I Disorder, Single Manic Episode
• Bipolar I Disorder, Most Recent Episode Hypomanic
• Bipolar I Disorder, Most Recent Episode Manic
• Bipolar I Disorder, Most Recent Episode Mixed
• Bipolar I Disorder, Most Recent Episode Depressed
• Bipolar I Disorder, Most Recent Episode Unspecified

If the diagnosis is "Bipolar I Disorder, Single Manic Episode," that means that the person has experienced a manic episode, and they have never had any other manic or depressive episodes. For "Bipolar I Disorder, Most Recent Episode Unspecified," the person meets the criteria for the symptoms of either a manic, mixed, hypomanic, or depressed episode with the exception of the duration of the symptoms.

If the person’s diagnosis is "Bipolar I Disorder, Single Manic Episode," the doctor may further specify the patient’s condition according to whether or not the symptoms meet the criteria for a mixed episode. The doctor may specify if the manic episode began postpartum, meaning after the patient gave birth. The specifiers can also describe the severity of the symptoms and whether or not there are psychotic or catatonic features. The doctor can also use a diagnosis specifier to indicate if the patient is in partial remission or full remission.

With the other diagnoses, they are further specified by severity, presence of psychotic features, presence of catatonic features, whether the symptoms began postpartum, whether there is rapid cycling, if there is an absence of symptoms between episodes, or if there is a seasonal pattern. The diagnosis may also specify if the most recent episode meets the criteria for a mixed episode. These diagnoses can also be specified as being in partial remission or full remission.

Taking a look at all the possible specifiers can give you an idea of how varied each patient’s experience with Bipolar I Disorder can be. You need only compare two possible diagnoses to get an impression of how vast the continuum of bipolar disorder can be. Bipolar I Disorder, Most Recent Episode Depressed, Severe with Psychotic Features looks very different from Bipolar I Disorder, Single Manic Episode In Full Remission. Patients with those diagnoses both suffer from the same medical condition of bipolar disorder, but according to the specifiers, their symptoms and experiences with the disorder are extremely different. Without specifiers, the diagnosis of "Bipolar I Disorder" fails to convey the exact nature of the patient’s condition.

Next article: Bipolar II Disorder - Characteristics