What is the primary requirement for diagnosing bipolar disorder?

The primary requirement for diagnosing bipolar disorder is the presence of one or more episodes of mania or hypomania, accompanied by a history of one or more major depressive episodes. This is essential because bipolar disorder is characterized by mood swings that include manic or hypomanic episodes—states of elevated mood, increased activity, or irritability. In addition, the presence of depressive episodes is crucial in distinguishing bipolar disorder from unipolar depression and establishing the full spectrum of the disorder.

Manic episodes involve symptoms such as grandiosity, decreased need for sleep, talkativeness, racing thoughts, distractibility, and risk-taking behaviors. Hypomania presents similar, but less severe, symptoms and is also a critical component of the diagnostic criteria. The combination of these elevated mood states with depressive episodes reflects the hallmark cycling of mood in bipolar disorder, making it distinctly different from other mood disorders.

The other choices do not meet the criteria for a bipolar diagnosis. A history of only major depressive episodes does not encompass the full criteria needed for bipolar disorder, as it lacks the essential manic or hypomanic component. Mild mood fluctuations do not qualify as the intense mood changes required for a diagnosis, and prolonged periods of extreme calmness do not reflect the manic or depressive states characteristic