Bipolar Disorder: Defining the Terms

As you work to find the right help for your child, you may come across other terms that are used to differentiate forms of Bipolar Disorder.

• Bipolar I: This term is used when a person experiences one or more manic episodes or mixed episodes. Often, individuals labeled as Bipolar I also have a history of one or more episodes of Major Depression. In other words, Bipolar I is defined as mania with or without a depression.
• Bipolar II: If an individual experiences one or more major depressive episodes and has at least one hypomanic episode, he is said to suffer from Bipolar II. Put another way, Bipolar II is Major Depressive Disorder with at least one episode of hypomania.
• Bipolar Disorder Not Otherwise Specified (BPD NOS): According to DSM IV-TR (Diagnostic and Statistical Manual of Mental Disorders), this classification includes disorders with bipolar features that do not meet the full criteria for mania, depression, or mixed states. A person diagnosed with BPD NOS might experience intermittent mood shifts that last no more than two days and therefore do not meet minimal duration criteria for a manic episode or a major depressive episode or a mixed state and are not frequent enough to be called cyclothymia.
• Rapid cycling: This is the name given to the pattern of Bipolar Disorder in which an individual has had at least four mood episodes (which can be manic, mixed, hypomanic, or Major Depressive Episodes) in the preceding twelve months. If cycling occurs within a span of weeks to several days, the pattern is called ultra-rapid cycling, whereas distinct, abrupt mood shifts of less than twenty-four hours' duration are referred to as ultra-ultra rapid, or ultradian, cycling. This ultra-ultra rapid cycling is the pattern most frequently seen in bipolar children. One of my nine-year-olds calls it "instant moods."

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