Abnormal Psychology

Mood Disorders and Suicide 221

Table 6.8 • DSM-IV-TR Diagnostic Criteria for Bipolar II Disorder

A. Presence (or history) of one or more major depressive episodes.

B. Presence (or history) of at least one hypomanic episode.

C. There has never been a manic episode or a mixed episode.

D. The mood symptoms in Criteria A and B are not better accounted for by schizoaffective disorder

and are not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or

psychotic disorder not otherwise specifi ed [all discussed in Chapter 12].

E. The symptoms cause clinically signifi cant distress or impairment in social, occupational, or

other important areas of functioning.

Source: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition,

Text Revision, (Copyright 2002) American Psychiatric Association.

between hypomanic episodes and MDEs (see Table 6.8); bipolar II can be

thought of as less severe because of the absence of manic episodes. Table 6.9

provides additional facts about bipolar disorders.

Both types of bipolar disorder can include rapid cycling of moods, defi ned as

having four or more episodes that meet the criteria for any type of mood episode

within 1 year (American Psychiatric Association, 2000). Rapid cycling is more

common with bipolar II disorder and in women (Papadimitriou et al., 2005). Un-

fortunately, rapid cycling of either type of bipolar disorder is associated with more

diffi culty in fi nding an effective treatment (Ozcan, Shivakumar, & Suppes, 2006).

The specifi ers for MDD—features of psychosis, catatonia, melancholia, atypical,

and postpartum onset—also apply to the MDEs experienced by people diagnosed

with bipolar disorders.

Even for those who do not have rapid cycling, changes in the sleep-wake cycle

(such as sleep deprivation and moving across time zones) can trigger or intensify a

manic, mixed, or hypomanic episode (Johnson & Roberts, 1995; Leibenluft, 2008;

Leibenluft et al., 1996). Moreover, those who are most likely to relapse have mood

symptoms that do not completely clear up after a mood episode ends (although the

symptoms do diminish enough that the criteria for a mood episode are no longer

met; Judd et al., 2008).

As with depression, people of different races and ethnicities are equally

likely to be affl icted with bipolar disorders (American Psychiatric Association,

2000). Some mental health clinicians, however, tend to diagnose schizophrenia

instead of a bipolar disorder when evaluating black individuals (Neighbors

et al., 2003).

From Jamison’s descriptions, some of her experiences, such as those at the fac-

ulty garden party, appear to have been manic episodes. Because she had at least one

manic episode, Jamison would be diagnosed with bipolar I disorder. The tentative

diagnosis of MDD proposed earlier in the chapter would be changed to bipolar dis-

order in light of Jamison’s history of at least one manic episode.

Bipolar Disorder and Creativity?

Are people with bipolar disorder more creative? Jamison and her colleagues

(Goodwin & Jamison, 1990; Jamison, 1989; Jamison et al., 1980; see also

Hershman & Lieb, 1988, 1998) have argued that a “loosening” of thought

that occurs during a manic episode enhances creativity. However, studies sup-

porting this argument often have had methodological problems. For instance,

some studies have focused on historical fi gures (such as famous composers and

writers), but these “participants” with bipolar disorder were selected because

Rapid cycling (of moods)

Having four or more episodes that meet the

criteria for any type of mood episode within

1 year.