In a manic episode, some people with bipolar I disorder may experience an elevated (extremely happy) mood. Others may feel very agitated and act uncooperatively and aggressively.
A diagnosis for a manic episode includes an elevated or an irritable mood lasting at least a week, plus 3 or more of the following symptoms:
An inflated feeling of power, greatness, or importance
Needing little sleep
Talking more than usual
Being easily distracted (attention shifts between many topics in just a few minutes)
Intense focus on goal-directed activity or restlessness
Risky or impulsive behavior (like excessive spending sprees)
During a mixed episode, people have symptoms of both manic and depressive episodes that last at least a week. For example, a person may feel very sad or hopeless while also feeling extremely energized. In addition, they are often agitated, have trouble sleeping, experience major changes in appetite, experience delusions or hallucinations, and have suicidal thoughts.
A diagnosis for a major depressive episode requires having a depressed mood or loss of interest or pleasure in activities a person used to enjoy. In addition, 4 of the following symptoms must also be present nearly every day for at least 2 weeks and be troublesome enough to interfere with daily functioning:
Low energy or fatigue
Irritability, restlessness, or being slowed down
Feeling worthless or guilty
Trouble sleeping or sleeping too much
Significant weight change
Thoughts about suicide or dying