For a diagnosis of Bipolar I disorder, there must be a manic or mixed episode, but a depressive episdoe is not required for diagnosis. Though it is not required, a depressive episode frequently occurs. Meanwhile, Bipolar II, which occurs more frequently is usually characterized by at least one episode of hypomania and at least one depression episode.
A diagnosis of Cyclothymic Disorder requires the presence of numerous hypomanic episodes, intermingled with depressive episodes that aren’t up to the full criteria that characterizes a full depressive episode. The main point of Cyclothymia is that there is a low grade cycling of moods which seems to be a personality trait to a casual observer, but is really a form of bipolar that interferes with normal functioning.
For those individuals who seem to be suffering from some type of bipolar disorder as characterized by mood swings with highs and lows, but the patient doesn’t meet the criteria for one of the subtypes outlined above, he or she may have Bipolar Disorder Not Otherwise Specified.
Most bipolar patients will be depressed when they first seek help, and it is easy for these patients to be misdiagnosed as having just clinical depression. It is important for practicioners to investigate with the patient, and his or her family and friends to determine if a manic or hypomanic episode has ever occurred.
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