Part Three of Bipolar and Related Disorders details Cyclothymic Disorder, Substance/Medication-Induced Bipolar and Related Disorder, and Bipolar and Related Disorder Due to Another Medical Condition.
Diagnosis with one of these disorders requires that their respective symptoms cause “significant distress or impairment in social, occupational, or other important areas of functioning” (Diagnostic and Statistical Manual of Mental Disorders, 2013).
Cyclothymic Disorder
Cyclothymic Disorder is related to Bipolar Disorders because it is characterized by periods of hypomanic and depressive symptoms. An individual cannot be diagnosed with Cyclothymic Disorder if they have met the full requirements for a manic, hypomanic, or depressive episode within their lifetime. These mood episodes require that an individual experience a minimum number of symptoms within a specific time frame. Click HERE for information on classifying mood episodes.
What exactly classifies Cyclothymic Disorder? Adults must experience numerous periods of hypomanic and depressive symptoms within two years, the periods must be “present for at least of half the time”, and the symptoms must not subside “for more than 2 months at a time” (Diagnostic and Statistical Manual of Mental Disorders, 2013). The same criterions are needed to diagnose children and adolescents, but the symptoms only need to be present for one year.
Diagnosis also requires that the hypomanic and depressive symptoms are not better explained by any of the Schizophrenia Spectrum and Other Psychotic Disorders; and, that the symptoms are not attributable to the physiological effects of medication, substance abuse, or another medical condition such as hyperthyroidism. It is important to mention issues with the thyroid gland because the effect of its imbalance mimics the characteristics of Cyclothymic and other Depressive Disorders.
Substance/Medication-Induced Bipolar and Related Disorder
Substance/Medication-Induced Bipolar and Related Disorder is characterized by noticeable and continuous disturbance in mood. These moods can be “elevated, expansive, irritable, with or without depressive [symptoms, and/or] markedly diminished interest or pleasure in all, or almost all, activities” (Diagnostic and Statistical Manual of Mental Disorders, 2013).
Diagnosis with Substance/Medication-Induced Bipolar and Related Disorder requires that there is evidence of two things: one, the individual’s “symptoms develop during or soon after substance intoxication or withdrawal or after exposure to a medication”; and two, that “the involved substance/medication is capable of producing the symptoms” (Diagnostic and Statistical Manual of Mental Disorders, 2013). Evidence can be acquired through medically reported client history, the results of a physical examination, or the conclusions of laboratory tests.
The symptoms of Substance/Medication-Induced Bipolar and Related Disorder should be better explained by the criterion for another Bipolar or Related Disorder. Determining whether or not the symptoms are due to a substance or medication requires the diagnosing professional to inquire about the presence of mood episodes prior to the use of the substance or medication.
Finally, symptoms must not “occur exclusively during the course of a delirium,” which is characterized by incoherence of thought and speech and restlessness. (Diagnostic and Statistical Manual of Mental Disorders, 2013).
Bipolar and Related Disorder Due to Another Medical Condition
Bipolar and Related Disorders Due to Another Medical Condition is characterized by noticeable and continuous periods of “abnormally elevated, expansive, or irritable mood and abnormally increased activity or energy” (Diagnostic and Statistical Manual of Mental Disorders, 2013). Diagnosis with this disorder means that the disturbance supersedes the symptoms of the medical condition.
Diagnosis also requires that “there is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition”. The symptoms of Bipolar and Related Disorders Due to Another Medical Condition should not be better explained by the criterion for another mental disorder and the “disturbance does not occur exclusively during the course of a delirium” (Diagnostic and Statistical Manual of Mental Disorders, 2013).
Stay Tuned for Part Four!
Part Four of Bipolar and Related Disorders describes Other Specified Bipolar and Related Disorder, and Unspecified Bipolar and Related Disorder.
References
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013. Web. [access date: 13 April 2018]. dsm.psychiatryonline.org
Collaborative Means 
Medical doctors, especially family practioners, should be better trained or more sensitive to the impact of medications on their patients. My opinion is that they are too quick to prescribe meds for patient reported conditions (physical as well as mental) without appropriate due diligence. So the patient could be experiencing a mental disorder due to too many meds for which the Dr. prescribes another medication for that. It’s a vicious cycle!
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