4. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. 5. The disturbance is not attributable to the physiological effects of a substance (examples: a drug of abuse, a medication) or another medical condition (example: hyperthyroidism). 6. The disturbance is not better explained by another mental disorder (examples: anxiety or worry about having panic attacks in panic disorder, negative evaluation in social anxiety disorder [social phobia], contamination or other obsessions in obsessive-compulsive disorder, separation from attachment figures in separation anxiety disorder, reminders of traumatic events in posttraumatic stress disorder, having a serious illness in illness anxiety disorder, or the content of delusional beliefs in schizophrenia or delusional disorder). Mood disorders The DSM-5 describes bipolar I disorder and bipolar II disorder as diagnoses that are composed of varying combinations of mania or hypomania along with major depressive episodes. If a person has experienced any number of major depressive episodes in their life and have also experienced at least one manic or hypomanic episode, a diagnosis of either bipolar I disorder (having experienced mania) or bipolar II disorder (having experienced hypomania but never mania) is considered warranted. Outlined below are the varying criteria associated with manic episodes and hypomanic episodes as described in the DSM-5. Manic episode 1. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least one week and present most of the day, nearly every day (or any duration if hospitalization is necessary). 2. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior: • Inflated self-esteem or grandiosity. • Decreased need for sleep (example: feels rested after only three hours of sleep). • More talkative than usual or pressure to keep talking. • Flight of ideas or subjective experience that thoughts are racing. • Distractibility (attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
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