Multiple distinct mood episodes occur within a year, separated by remission or a switch in polarity.
Deciding signal
Count syndromal episodes across time; do not substitute moment-to-moment emotional lability.
Ask this
Does the longitudinal timeline show repeated distinct episodes rather than rapid shifts within one episode?
Typical language
“I have had several separate episodes this year”
A mood episode begins during pregnancy or in the period soon after birth.
Deciding signal
Timing around pregnancy and birth changes safety assessment, treatment context, and family support needs.
Ask this
Did the mood episode begin in the peripartum window, and are bipolarity, psychosis, and immediate safety actively assessed?
Typical language
“This began during the pregnancy”
Episodes show a repeated temporal relationship with a particular season and a contrasting pattern at another time of year.
Deciding signal
The recurring calendar-linked course matters more than the season in which one episode happens.
Ask this
Across years, is there a consistent seasonal onset-and-remission pattern that is not explained by seasonal stressors?
Typical language
“Every winter I shut down”