Yes. A person can have a mix of manic, hypomanic, or depressive symptoms that do not fit a specific bipolar diagnosis. For example, hypomanic episodes may last just 2-3 days and may not be followed by major depressive episodes. Or a person may experience cyclothymia (lesser symptoms of hypomania and depression) for less than 2 years.
If the symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning, a diagnosis of a specified or unspecified bipolar disorder may be given.
Following are examples of symptoms that may fall into the diagnostic category of “other specified bipolar and related disorder” and “unspecified bipolar and related disorder.”
Other Specified Bipolar and Related Disorder
Examples of patient symptoms that would fall under the diagnostic category of “other specified bipolar and related disorder” include:
- Short-duration hypomanic episodes of 2-3 days and a lifetime history of one or more major depressive episodes.
- A lifetime history of one or more major depressive episodes who have experienced one or more episodes of hypomania.
- One or more hypomanic episodes without a prior major depressive episode.
- Short-duration cyclothymia (less than 24 months).
Unspecified Bipolar and Related Disorder
Examples of conditions that would fall under the diagnostic category of “other specified bipolar and related disorder” include:
- Bipolar with “anxious distress” during the most recent or current episode of mania, hypomania or depression.
- Manic or hypomanic episode with mixed features of depression.
- Depressive episode with mixed features of manic/hypomanic symptoms.
- Bipolar “with melancholic features” that may include depression that is regularly worse in the morning, excessive guilt, significant anorexia or weight loss, or marked psychomotor agitation or retardation.
- Bipolar with “atypical features” that include mood reactivity (i.e., mood brightens in response to actual or potential positive events) and other possible symptoms, including significant weight gain or increase in appetite, leaden paralysis, and a long-standing pattern of interpersonal rejection sensitivity.
- Bipolar with psychotic features or catatonia.
- Bipolar with peripartum onset if first mood symptoms occur during pregnancy or in the 4 weeks following delivery.
- Bipolar with a seasonal pattern of lifetime mood episodes, such as during the fall or winter months.