pulse-control, or conduct disorder (e.g., intermittent explosive disorder, oppositional
defiant disorder, conduct disorder), and any su bstance use disorder (e.g., alcohol use dis-
order) occur in over half of individuals with bipolar I disorder. Adults with bipolar I dis-
order have high rates of serious and/or untreated co-occurring medical conditions.
Metabolic syndrome and migraine are more common among individuals with bipolar dis-
order than in the general population. More than half of individuals whose symptoms meet
criteria for bipolar disorder have an alcoho l use disorder, and those with both disorders
are at greater risk for suicide attempt.
Bipolar II Disorder
Diagnostic Criteria 296.89 (F31.81)
For a diagnosis of bipolar II disorder, it is necessary to meet the following criteria for a cur-
rent or past hypomanic episode and the following criteria for a current or past major de-
pressive episode:
Hypomanic Episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood
and abnormally and persistently increased activity or energy, lasting at least 4 consec-
utive days and present most of the day, nearly every day.
B. During the period of mood disturbance and in creased energy and activity, three (or more)
of the following symptoms have persisted (four if the mood is only irritable), represent a no-
ticeable change from usual behavior, and have been present to a significant degree:
1. Inflated self-esteem or grandiosity.
2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).
3. More talkative than usual or pressure to keep talking.