Reference
Guide | Reference

52  Bipolar Spectrum Episode Prototypes

52.1 Summary

  • A set of episodic patterns marked by elevated or irritable mood with increased energy, drive, or activity, often alternating with low mood periods.

52.2 Prototype Features

  • Elevated, expansive, or irritable mood with increased activity or drive.
  • Decreased need for sleep or heightened goal-directed behavior.
  • Risk-taking, impulsivity, or agitation in elevated states.

52.3 Threshold Guidance

  • Use when elevated or mixed states are distinct, recurrent, and impairing or risky.

52.4 Expected Domain Profile

  • Mood and Drive Dysregulation: high variability or mixed elevation/low.
  • Arousal, Sleep, and Circadian Regulation: notable disruption.

52.5 Time-Course and Trajectory

  • Episodic with variable duration and recovery.
  • May show cyclicity or seasonal patterns.

52.6 Differential and Red Flags

  • Substance or medication-induced elevation.
  • Sleep deprivation or circadian disruption alone.
  • Psychosis during elevated states.

52.7 Specifiers (treatment-relevant, non-prescriptive)

  • Course/time pattern (episodic, cycling).
  • Contributors (sleep loss, substances, medications).
  • Risk modifiers (impulsivity, safety risk).

52.8 Measurement Prompts

  • Mood and energy tracking.
  • Sleep/circadian log.

52.10 Documentation Snippet (1-2 lines)

  • “Episodes of elevated mood and increased drive with reduced sleep; Mood/Drive 4, Arousal 3; episodic course.”