Mixed Episode

DSM IV Criteria

(Note: this is often referred to as "rapidly cycling bipolar" - but technically Rapid Cycling refers to at least 4 episodes in the previous 12 months that meet criteria for a Major Depressive, Manic, Mixed or Hypomanic Episode, and the Episodes are demarcated either by partial or full remission for at least 2 months or a switch to an episode of opposite polarity - e.g., Major Depressive Episode to Manic Episode)

A. The criteria are met both for a Manic Episode and for a Major Depressive Episode (except for duration) nearly every day during at least a 1-week period.

B. 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.

C. 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: Mixed-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication,, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder