Bipolar I Disorder: Current or Most Recent Episode Depressed Diagnosis – General Information
In order to have a Bipolar I Disorder: Current or Most Recent Episode Depressed diagnosis you must have at least one manic episode previous to the current or most recent episode of depression. Nearly every person with bipolar I disorder will have or can have the diagnosis of “current or most recent episode depressed” at some point in time in their mental health history.
A diagnosis of Bipolar I Disorder: Current or Most Recent Episode Depressed obviously requires a depressive episode which includes (as previously mentioned) a manic episode followed by a depressive episode. The depressive episode requires either a depressed mood for at least two weeks or a loss of interest or pleasure in normally pleasurable activities, and at least five of the depression symptoms listed in 1-9 below.
Bipolar I Disorder: Important Information
Bipolar I Disorder: Current or Most Recent Episode Depressed and bipolar I disorder in general, is a very serious mental health condition. Bipolar I disorder has a lifetime prevalence of 0.8%. Obviously, a significant percentage of people suffer from these severe mood episodes. In actuality, contrary to popular belief, bipolar I disorder is not always indicated by rapid mood swings, with some mood episodes going on for weeks or months at a time. They may resolve and then resume with a later mood episode.
Bipolar I disorder in addition to major depressive disorder can be lethal. Some researchers have found that between 25% and 50% of individuals suffering from this disorder may attempt suicide. In addition, individuals experiencing a manic episode may engage in very risky behaviors resulting in severe consequences. The healthcare costs associated with bipolar I disorder are very high because of the frequency of hospitalizations, doctor visits and the usage of expensive medications.
Bipolar I disorders occur just as frequently among women as in men, although women tend to experience more rapid cycling and more frequent depressive episodes than men. Also, in addition to the bipolar I symptoms, women seem to experience higher rates of comorbid eating disorders and substance use disorders. Unfortunately, individuals who are diagnosed with bipolar I disorders often have a lower socioeconomic status, have much higher rates of disability and a lowered life expectancy.
Bipolar I Disorder: Current or Most Recent Episode Depressed Treatments
Bipolar I Disorder: Current or Most Recent Episode Depressed is most often treated with mood stabilizing medications and antidepressants, along with psychological interventions. These disorders require lifelong management. Many researchers and clinicians agree that the combination of psychotherapy and medications is the most effective treatment for this disorder.
The most effective interventions according to research literature seem to include medications combined with psychoeducation, cognitive behavioral therapy, family-focused therapy, and other types of interpersonal and social rhythm therapy.
The specific symptoms associated with Bipolar I Disorder: Current or Most Recent Episode Depressed follow below.
Basic Bipolar I Disorder Diagnosis Criteria
A. Criteria have been met for at least one manic episode.
B. The occurrence of the manic and major depressive episode or episodes is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other schizophrenia spectrum and other psychotic disorders.
Major Depressive Episode:
A. At least five of the following symptoms have been present during the same two week period and represent a significant change from previous functioning; At least one of the symptoms must be either (1) depressed mood or (2) loss of interest or pleasure in normal activities.
Note: Never include symptoms that are clearly attributable to another medical condition.
1. Depressed mood most of the day, nearly every day, as indicated by either an individual’s subjective report, such as feelings of sadness, emptiness or hopelessness, or observation by others such as that they appear tearful or sad. (Note: In children and adolescents it can be an irritable mood.)
2. A significantly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day as indicated by either an individual’s subjective account or observation by others.
3. A significant weight loss when not dieting or a weight gain such as a change of more than 5% of body weight in a month, or a decrease or an increase in appetite nearly every day. (Note: in children, consider a significant failure to make expected weight gain.)
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor retardation or agitation nearly every day which may be observable by others and cannot be merely subjective feelings of restlessness or being slowed down.
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or inappropriate or excessive guilt (which may be delusional) nearly every day.
8. Diminished ability to concentrate, to think or be decisive, nearly every day, either by subjective account or be observable by others.
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a plan or suicide attempt or a specific plan for committing suicide.
B. The symptoms above cause significant distress or impairment in an individual’s social, occupational, educational or other important areas of functioning.
C. The episode above is not attributable to the physiological effects of a medication, substance, or to another medical condition.
Note: Criteria A-C, see above to indicate a major depressive episode. Major depressive episodes are common in individuals with Bipolar I disorder but are not absolutely required for the diagnosis of the disorder.
Note: Responses to a significant loss such as bereavement, financial ruin, losses from a natural disaster, serious medical illness or disability may include the feelings of intense sadness, ruminating about the loss, insomnia, poor appetite, and weight loss noted in criterion A above, which may resemble a depressive episode. Although such symptoms may be understandable or even appropriate to the loss, the presence of a major depressive episode in addition to the normal response to a significant loss should also be considered very carefully. This decision obviously requires the exercise of clinical judgment based upon the individual’s history and cultural norms for the expression of the distress in the context of the loss.
Coding for Bipolar I Disorder: Current or Most Recent Episode Depressed and other bipolar one disorders:
The diagnostic code for bipolar I disorder is 296._ _ (F31._ _). The actual specific coding defines either the current or most recent episode only. Also, psychologists, psychiatrists and other mental health clinicians need to specify the severity, whether psychotic features are present and finally if the patient is in partial or full remission.
Some information adapted by Paul Susic Ph.D. Licensed Psychologist from the Diagnostic And Statistical Manual of Mental Disorders Fifth Edition DSM-5