Overview
Introduction
Five days of markedly reduced sleep, pressured speech, grandiosity, and spending is not automatically mania.
Five days of markedly reduced sleep, pressured speech, grandiosity, and spending is not automatically mania. If the change is clear from baseline, includes increased energy, and causes no marked impairment, psychosis, or hospitalization, it may meet criteria for hypomania; a manic episode requires at least 1 week or hospitalization at any duration. That distinction can change the lifetime diagnosis from bipolar II to bipolar I. The NP’s task is to establish the episode on a reliable timeline, corroborate the patient’s account, exclude medication, substance, and medical causes, and then match the urgency of treatment to the patient’s risk. Duration is the diagnostic hinge, but severity and functional consequences determine whether the syndrome is manic.