​Pathology - Bipolar Disorder

​Pathology - Bipolar Disorder 
Pathophysiology 
In order to be diagnosed with major depressive disorder, a patient must have experienced at least one manic episode, typically accompanied by a history suggestive of one or more such episodes. A manic episode is defined as having three symptoms and requiring hospitalization, or as having an excessively high, expansive, or irritated mood for at least one week. The following are some of the symptoms: grandiosity (inflated self-esteem), distraction, insomnia or decreased need for sleep, flight of ideas (racing thoughts), psychomotor agitation or increase in goal-directed activities, pressured speech, and risk-taking (activities involving pleasure with painful consequences, i.e., excessive spending, sexual indiscretion, gambling). DIG FAST is an effective mnemonic. The mood disruption for bipolar I disorder must be severe enough to interfere with social or professional functioning, necessitate hospitalization, or have psychotic symptoms. Bipolar II disorder would be the diagnosis if this were not the case and at least three symptoms accompanied by a change in mood had persisted for at least four days. This would be referred to as a hypomanic episode. Since personality disorders are classified as axis II diagnosis, it is critical to differentiate the symptoms from personality disorders.