This diagnosis does not need to have a period of depression, just a manic episode.

• A. Major Depressive Disorder
• B. Bipolar I
• C. Cyclothymic Disorder
• D. Bipolar II

Answer: (B)

In Bipolar I, a manic episode by itself is enough for the diagnosis. Depressive periods may occur, but they’re not required for Bipolar I to be diagnosed; the key feature is a manic episode that causes marked impairment or hospitalization (lasting at least a week or any duration if there's severe impairment). A manic episode includes a distinct period of abnormally elevated, expansive, or irritable mood plus increased energy, with symptoms such as inflated self-esteem, decreased need for sleep, pressured speech, racing thoughts, distractibility, and engaging in risky activities.

Major Depressive Disorder, by contrast, centers on depressive episodes and does not require or usually include mania. Cyclothymic Disorder involves chronic mood fluctuations that don’t meet full criteria for manic, hypomanic, or major depressive episodes, so it isn’t Bipolar I. Bipolar II requires hypomanic episodes plus major depressive episodes, but no full manic episodes.