Which specifier indicates bipolar episodes with anxious distress?

• A. With anxious distress
• B. In partial remission, manic
• C. In full remission, depressed
• D. With psychotic features, manic

Answer: (A)

In bipolar disorders, an anxious distress label is used when anxiety symptoms are present during a mood episode. The specifier "with anxious distress" means the person experiences clinically significant anxiety alongside the mood symptoms, such as feeling keyed up or tense, restlessness, difficulty concentrating due to worry, fear that something awful might happen, or fear of losing control. This designation matters because it signals a higher overall burden and can influence treatment planning, prompting attention to anxiety symptoms alongside mood stabilization. The other options describe remission status or the presence of psychotic features, which are different aspects of the illness and do not indicate anxious distress.