Which statement best characterizes Bipolar I Disorder?

• A. One or more manic episodes.
• B. Only recurrent depressive episodes without mania.
• C. Chronic depressive symptoms without mania.
• D. Seasonal mood fluctuations only.

Answer: (A)

Mania defines Bipolar I Disorder. A person must experience at least one manic episode, which is a distinct period of abnormally elevated, expansive, or irritable mood with unusually high energy and activity that lasts at least one week (or is severe enough to require hospitalization). This period is typically marked by impairing functioning, and often includes symptoms such as inflated self-esteem, decreased need for sleep, rapid talkativeness, racing thoughts, distractibility, increased goal-directed activity, or risky behaviors. The presence of a manic episode is what distinguishes Bipolar I from other mood disorders.

Depressive-only presentations describe major depressive episodes or persistent depressive disorder, not Bipolar I. Seasonal mood fluctuations can occur in mood disorders but do not define Bipolar I unless mania is present. The essential hallmark of Bipolar I is the occurrence of manic, not just depressive, episodes, which is why the statement about having one or more manic episodes best characterizes the disorder.