Mood swings, impulsivity, instability, sadness, elation, irritation, anger, depression.. our moods are a part of everyday life that can control us if we don't control them first. How do you know if you're "moody" or if you have a mood "disorder"?
Bipolar I Disorder F31
Onset – 18yrs old
Duration – manic episode must last at least 1 week
Manic Episode:
Symptoms: Distinct period of abnormally and persistently elevated, expansive, or irritable mood and three or more of the following:
Inflated self-esteem/grandiosity
Decreased need for sleep
Talkative/pressured talking
Flight of ideas/racing thoughts
Distractibility
Increased goal-directed activity/psychomotor agitation
Excessive involvement in pleasurable activity that have high potential for painful consequences
*Note that additionally, the mood is evident of a marked impairment of occupational or social functioning or necessitates hospitalization to prevent harm to self or others or due to the presence of psychotic features.
Symptoms: Presence of at least one manic episode. A major depressive or hypomanic episode may precede or follow a manic episode, but neither is required.
Diagnostic Codes:
Mild (Most current episode: depressed – F31.31, manic - F31.11)
Moderate (Most current episode: depressed – F31.32, manic - F31.12)
Severe (Most current episode: depressed – F31.4, manic - F31.13)
With Psychotic features (Most current episode: depressed – F31.5, manic - F31.2)
In partial remission (Most current episode: depressed– F31.75, manic - F31.73)
In full remission (Most current episode: depressed – F31.76, manic - F31.74)
Unspecified F31.9
Differential:
Major Depressive Disorder – (absence of manic episode)
Other Bipolar Disorders – (B2 = mania? Other = cause?)
Attention-Deficit/Hyperactivity Disorder – (manic episode)
Generalized Anxiety Disorder – (cause is anxiety/manic episode)
Psychotic Disorders (psychosis is not caused specifically by the manic/depress episodes)
Panic Disorder – (panic attacks not mania)
Post-Tramatic Stress Disorder – (cause is trauma/manic episode)
Personality Disorders – (not episodes, steady mood issues for a long time)
Bipolar II Disorder F31.81
Onset – average mid-20s
Duration – hypomanic episode at least 4 days and Major Depressive episode at least 2 weeks
Symptoms:
Presence of hypomanic episode and presence of major depressive episode. A manic episode has NEVER occurred.
Differential:
Other Bipolar Disorders – (mania vs hypomania)
Cyclothymic Disorder – (duration of episodes)
Major Depressive Disorder – (duration of episodes)
Schizophrenia Spectrum and Other Related Psychotic Disorders – (presence of mood symptoms)
Panic Disorder or Other Anxiety Disorders – (panic attacks)
Attention-Deficit/Hyperactivity Disorder – (attention/hyperactivity – depressive episodes)
Borderline Personality Disorder – (episodes and duration)
Cyclothymic Disorder F34.0
Onset – adolescence or early adulthood
Children/adolescents – at least 1 yr
Adults – at least 2 yrs
Symptoms: N2N2
Numerous Symptomatic Period
2yrs of hypomanic and depressive symptoms
Never more than 2 months w/o symptoms
Differential:
Borderline Personality Disorder – (can coincide)
Bipolar I and II Disorders with Rapid Cycling – (criteria for episodes for Bipolar are not met w cyclothymic)
Disruptive Mood Dysregulation Disorder F34.8
Duration: 12 months
Onset: Prior to age 10
Symptoms:
Chronically irritable, acting out in ways that are extremely out of line with the circumstance, over-reacting or inability to move on from the situation long after it would be appropriate to do so.
Symptoms are present in more than one setting.
*Note that first diagnosis cannot be made prior to age 6 or after age 18.
Differential:
Oppositional Defiant Disorder – (mood is rare)
ADHD/Autism/Anxiety – (can be comorbid)
Bipolar Disorders – (episodes/duration/onset)
Intermittent Explosive Disorder – (disruption in mood between outbursts)
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