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DSM Reference Home
DSM-IV and DSM-IV-TR:
Manic Episode
When an individual experiences a discrete period of persistent and pervasive manic (elated, irritable or euphoric) mood, this term may be applied. The individual may be diagnosed with one of the bipolar disorders.
Criteria for Manic Episode
(Warning!)
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary).
B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
(1) inflated self-esteem or grandiosity
(2) decreased need for sleep (e.g. feels rested after only 3 hours of sleep)
(3) more talkative than usual or pressure to keep talking
(4) flight of ideas or subjective experience that thoughts are racing
(5) distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
(6) increase in goal-directed activity (either socially, at work or school, or sexually) orpsychomotor agitation
(7) excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g. engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
C. The symptoms do not meet criteria for a Mixed Episode.
D. 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.
E. 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: Manic-like episodes that are clearly caused by somatic anti-depressant treatment (e.g. medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder.
Criteria for Severity/Psychotic/Remission Specifiers for current (or most recent) Manic Episode
Note: Code in fifth digit. Can be applied to a Manic Episode in Bipolar I Disorder only if it is the most recent type of mood episode.
.x1--Mild: Minimum symptom criteria are met for a Manic Episode.
.x2--Moderate: Extreme increase in activity or impairment in judgment.
.x3--Severe Without Psychotic Features: Almost continual supervision required to prevent physical harm to self or others.
.x4--Severe With Psychotic Features: Delusions or hallucinations. If possible, specify whether the psychotic features are mood-congruent or mood-incongruent:
Mood-Congruent Psychotic Features: Delusions or hallucinations whose content is entirely consistent with the typical manic themes of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person.
Mood-Incongruent Psychotic Features: Delusions or hallucinations whose content does not involve typical manic themes of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person. Included are such symptoms as persecutory delusions (not directly related to grandiose ideas or themes), thought insertion, and delusions of being controlled.
.x5--In Partial Remission: Symptoms of a Manic Episode are present but full criteria are not met, or there is a period without any significant symptoms of a Manic Episode lasting less than 2 months following the end of the Manic Episode.
.x6--In Full Remission: During the past 2 months no significant signs or symptoms of the disturbance were present.
.x0--Unspecified.
Based on the Diagnostic & Statistical Manual of Mental Disorders, 4th edition APA
The online Diagnostic & Statistical Manual of Mental Disorders lists most of the major psychological disorders and illnesses and lists the criteria that must be fulfilled in order for a diagnosis to be made. This resource is not a substitute for proper professional psychiatric diagnosis.
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Last Updated
07 January 2026
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Bill Frost - Clinical Hypnotherapist 2025