nia every day during at least a 1 week period. For an episode to be categorized as manic, the patients mood has been irritable or abnormally elevated for at least 1 week. A person must also exhibit at least 3 of the following symptoms (4 if the mood is only irritable): extreme feelings of personal greatness; a decreased need for sleep, marked talkativeness; distractibility; extreme focus on a goal-directed activity; reports of racing thoughts or a flight of ideas; or excessive involvement in pleasurable activities that have a high potential for painful consequences (i.e. sexual indiscretions or unintelligent business investments). As in the criteria for a depressed episode, the DSM-IV specifies that these symptoms should not be better explained as being a side effect of a drug or illness to qualify as a manic episode. These symptoms must interfere with the persons normal functioning and must not meet the criteria for a mixed episode. As with adults, childhood-onset bipolar disorder has many faces. Children with Bipolar I Disorder have episodes of mania and episodes of depression, sometimes there are long periods of normal moods between episodes. Adults usually tend to have more depressed episodes than manic episodes. However, some children will have chronic mania (symptoms of mania lasting for long periods of time or marked by frequent recurrence) and seldom experience a depressed episode. Bipolar II Disorder causes depressive episodes, sometimes lasting for long periods of time. It can also cause hypomanic episodes, but manic episodes are not present. Unlike Bipolar I Disorder, for persons with Bipolar II Disorder, periods of normal moods are virtually nonexistent. Cyclothymia is characterized by frequent hypomanic episodes and occasional episodes of mild depression only. Some children have repeated hypomanic episodes a year. Persons showing signs of depression and mania at the same time is referred to as being in a mixed state. Bipola...
