True or False: Bipolar I diagnosis requires the occurrence of a manic episode.

• A. False
• B. Only with psychotic features
• C. True
• D. Only if depressed

Answer: (C)

A manic episode is the defining feature that distinguishes Bipolar I from other mood disorders. To meet Bipolar I diagnosis, a person must have at least one manic episode—defined as a period of abnormally and persistently elevated, expansive, or irritable mood with increased energy or activity lasting at least seven days (or any duration if hospitalization is required) plus several accompanying symptoms such as inflated self-esteem, decreased need for sleep, pressured speech, racing thoughts, distractibility, or risky behavior. Depressive episodes may occur, but they are not required for the diagnosis. Bipolar II involves hypomanic episodes and a major depressive episode, with no full-blown manic episode. Thus, the statement is true.