Criteria for a Mixed Episode

A.    The criteria are met both for a Manic Episode and for a Major Depressive Episode 
       (except for duration) nearly every day for at least a 1-week period.

B.    The mood disturbance is sufficiently severe to cause marked impairment in occupational 
        functioning or in usual social activities or relationships with others, or to necessitate  
        hospitalization to prevent harm to self or others, or there are psychotic features.

C.    The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, 
        a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism). 

Dysthymic Disorder

People with this disorder have had persistent depression for at least 2 years, have not had a Major Depressive Episode during the first 2 years of the disorder, and have never had a Manic Episode, Mixed Episode, or Hypmanic Episode, or met the criteria for Cyclothymic Disorder.  During the depression the patient has experienced at least two of the following:

1. Poor appetite or overeating

2. Insomnia or hypersomnia

3. Low energy or fatigue

4. Low self-esteem

5. Poor concentration or difficulty making decisions

6. Feelings of hopelessness

Cyclothymic Disorder

Patients with this disorder have had many periods of  hypomanic symptoms and many periods of depressive symptoms for at least 2 years but have not met the criteria for a Major Depressive Episode, Manic Episode, or Mixed Episode in the first 2 years of the disturbance.

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