is clinically useful to specify accurately the presence and severity levels of anxious
distress for treatment planning and monitoring of response to treatment.
With mixed features:  The mixed features specifier can apply to the current manic, hy-
pomanic, or depressive episode in bi polar I or bipolar II disorder:
Manic or hypomanic episode, with mixed features:
A. Full criteria are met for a manic episode or hypomanic episode, and at least
three of the following symptoms are present during the majority of days of the
current or most recent episode of mania or hypomania:
1. Prominent dysphoria or depressed mood as indicated by either subjective
report (e.g., feels sad or empty) or observation made by others (e.g., ap-
pears tearful).
2. Diminished interest or pleasure in all, or almost all, activities (as indicated by
either subjective account or observation made by others).
3. Psychomotor retardation nearly every day (observable by others; not merely
subjective feelings of being slowed down).