Category · F30-F39 block
F30 — Manic episode
Terminology note: "Manic episode" here means a single, first-ever episode of abnormally and persistently elevated, expansive or irritable mood with increased activity or energy. It is reserved specifically for a first episode: a repeat episode of elevated mood, or any documented prior episode of the opposite (depressive) pole, reclassifies the presentation as bipolar affective disorder (F31), even if the current episode looks identical to a textbook single manic episode.
What is this category?
F30's single defining feature is not the symptom picture itself (which overlaps completely with F31's manic episodes) but the episode count: this code exists specifically for the first time a person has ever experienced pathological mood elevation, with no prior manic, hypomanic, or depressive episode on record. The moment a second episode of either pole occurs, the course reclassifies as bipolar. Severity (hypomania, mania without psychotic symptoms, or mania with psychotic symptoms) then determines the fourth character.
Core diagnostic concept
Before assigning F30, the decisive question is not "how severe is this episode" but "has this person ever had an episode like this, or an opposite-pole episode, before?" A textbook-perfect manic episode is F31, not F30, the instant a genuine prior episode is confirmed. Severity grading (hypomania -> mania without psychotic symptoms -> mania with psychotic symptoms) is a second, separate judgment made only after the course question is settled.
Key diagnostic features
- Elevated, expansive or irritable mood
- A distinct change from the person's usual baseline mood, sustained rather than momentary.
- Increased activity, energy, or goal-directed behaviour
- Taking on many new projects, increased sociability, or restless overactivity.
- Decreased need for sleep
- Feeling rested after only a few hours, without the fatigue that would follow genuine sleep deprivation.
- Grandiosity or inflated self-esteem
- Ranging from mild overconfidence to unrealistic beliefs about one's importance, abilities, or resources.
- Pressured speech, flight of ideas, and distractibility
- Speech that is rapid and hard to interrupt, thoughts that race and shift topic quickly, and difficulty sustaining attention.
- Impaired judgement and risk-taking
- Reckless spending, disinhibited or impulsive decisions, or risky ventures out of keeping with the person's usual character.
How to weigh evidence
These learning labels are teaching aids, not official ICD-10 terminology (see Sources and Method).
- supports A clear, sustained escalation from baseline lasting at least a week, with reduced need for sleep, grandiosity, and functional impairment (e.g. reckless spending, disrupted work performance).
- consistent not decisive Feeling unusually upbeat and energetic for a day or two after genuinely good news, without the broader symptom cluster or functional impairment.
- raises alternative Grandiose or expansive behaviour beginning only after a period of stimulant use, or a course of corticosteroids.
- contradicts or weakens A documented prior manic, hypomanic, or depressive episode — this reclassifies the presentation as bipolar (F31), whatever the current episode's severity.
- missing and necessary to ask Whether this is genuinely the person's first-ever episode of mood elevation or low mood — the single most decisive fact for choosing between F30 and F31.
Diagnostic boundary
F30 is reserved for a first-ever episode of pathological mood elevation with no prior manic, hypomanic, or depressive episode on record; any such prior episode reclassifies the course as bipolar affective disorder (F31), and severity (with or without psychotic features) determines the fourth character.
Full comparisons:
Duration and course
Minimum duration: Mania or hypomania is typically present for at least one week (any duration if hospitalisation is required); hypomania's threshold is lower severity, not necessarily shorter duration.
Course: Onset is often abrupt, developing over days, and represents a clear departure from the person's usual baseline functioning.
Included presentations
- A first-ever manic episode with clear functional impairment, no psychotic features (F30.1).
- A first-ever hypomanic episode: mild elevation without significant functional impairment (F30.0).
- A first-ever manic episode with psychotic features such as grandiose or persecutory delusions (F30.2).
Exclusions and distinguishing presentations
| If this is true instead… | Consider | Why |
|---|---|---|
| A second or later episode of mood elevation, or an elevated episode with any documented prior depressive episode | F31 | Any confirmed prior episode of either pole reclassifies the course as bipolar affective disorder. |
| Mood elevation confined to, and fully explained by, intoxication with a psychoactive substance or a medical condition/medication | organic substance mood cause capsule | A substance- or medically-caused mood elevation should be actively considered and ruled out before a primary F30 classification is made. |
| Psychotic symptoms not confined to, or explained by, the mood episode, or persisting well beyond its resolution | F20 | Psychotic symptoms outlasting or exceeding the mood episode itself raise consideration of an independent psychotic illness rather than mania with psychotic features. |
Four-character subtypes (orientation)
A learner should not classify any first elevated-mood presentation as F30 without checking episode history first — this category applies only when no prior manic, hypomanic, or depressive episode is documented. Subtypes beyond F30.0-F30.2 are taught here for orientation only.
- F30.0 — Hypomania
- Mild, sustained elevation of mood and increased activity, without significant functional impairment or psychotic features. (in_depth)
- F30.1 — Mania without psychotic symptoms
- Mood elevation severe enough to cause marked functional impairment or require hospitalisation, without delusions or hallucinations. (in_depth)
- F30.2 — Mania with psychotic symptoms
- Mania accompanied by delusions (often grandiose) or hallucinations, or mania so severe that ordinary social activities are impossible. (in_depth)
- F30.8 — Other manic episodes
- A manic presentation not matching the other listed subtypes. (taught for orientation only, not separately assessed in this pilot)
- F30.9 — Manic episode, unspecified
- A manic episode identified but without enough information to grade its severity further. (taught for orientation only, not separately assessed in this pilot)
External causes to check first
Categories in this block require that the disturbance is not better explained by another external cause listed below. These short capsules are reminders, not full teaching modules.
External cause capsule — Affective disorders with psychotic features
A reminder to check whether psychotic symptoms are confined to, and explained by, a manic or depressive episode, before applying F20 or F25.
What to check:
- Whether psychotic symptoms (e.g. mood-congruent delusions of guilt or grandiosity) appear only during a clearly established manic or depressive episode and resolve as the mood episode resolves.
- Whether mood symptoms clearly preceded the psychotic features, or vice versa.
- Whether the delusional content is mood-congruent (fitting the prevailing mood, e.g. grandiose ideas during mania) rather than the more mood-neutral or bizarre content typical of F20.
- Whether this pattern has recurred across more than one episode, which would raise consideration of F25 rather than a simple mood disorder with psychotic features.
The full F30-F39 category pages (F30, F31, F32, F33) themselves, which cover the severity-and-psychotic-features gradient for manic and depressive episodes in depth; this capsule is a focused reminder of the boundary against F20/F25, not a substitute for those pages.
External cause capsule — Organic, medical, or substance-related mood presentations
A reminder that a manic or depressive presentation can be caused by a general medical condition (e.g. thyroid disease, stroke) or by a substance or medication (e.g. corticosteroids, stimulant intoxication, sedative/alcohol withdrawal) rather than being a primary F30-F39 mood disorder, and that this should be actively considered before a primary mood-disorder classification is settled.
What to check:
- Timing: did the mood symptoms begin during or shortly after starting, stopping, intoxication with, or withdrawal from a substance or medication known to affect mood?
- Medical context: is there a known medical condition (e.g. thyroid disease, corticosteroid treatment, a neurological condition) with a recognised association with mood disturbance?
- Course after the cause is addressed: a mood presentation that substantially improves once the medical condition is treated or the substance/medication is stopped weighs toward a secondary cause rather than a primary mood disorder.
- Whether mood symptoms clearly predated the medical condition, substance use, or medication in question, which would argue against a purely secondary explanation.
A full teaching module on F10-F19 (substance-related disorders) or a general medical work-up, both of which are outside this capsule's scope.
Worked example — checking the episode-count boundary before grading severity
A 29-year-old presents for the first time with ten days of markedly elevated, expansive mood. He is sleeping only two to three hours nightly without feeling tired, speaking rapidly and difficult to interrupt, and has drawn up unrealistic plans to found a company overnight after emptying his savings into it. His family confirms he has never previously had a period of unusually low mood, nor any earlier similar episode of elevation. He describes no unusual beliefs beyond the business plans themselves, and no perceptual disturbances.
- Step 1 — Note the core presentation: elevated mood, decreased need for sleep, pressured speech, and increased goal-directed activity together meet the manic symptom cluster.
- Step 2 — Grade severity: reckless spending and an unrealistic business venture represent clear functional impairment, placing this beyond hypomania.
- Step 3 — Check for psychotic features: the business plans, while unrealistic, are not described as fixed false beliefs held with delusional conviction, and no hallucinations are reported — psychotic features are not established here.
- Step 4 — Check the decisive course question: family confirms no prior manic, hypomanic, or depressive episode — this is genuinely a first episode.
- Conclusion — F30.1 Mania without psychotic symptoms. Because no prior episode of either pole is documented, this is classified as a single manic episode (F30), not bipolar affective disorder (F31).
Interactive practice
- Type A Eight days, two maxed-out cards Recognition / application · Foundation
- Type B Chattier than usual, still at work Boundary discrimination · Foundation
Retrieval prompts
Try answering each of these from memory before revealing where to check. Nothing you think or type here is sent or saved anywhere.
-
State the one question that must be answered before classifying any elevated-mood presentation as F30 rather than F31.
Reveal answer location
Check Duration and course, Diagnostic boundary, or the rapid revision card below — the cue you need is one of those, in this category's own already-authored wording.
-
Name the feature that separates mania without psychotic symptoms from mania with psychotic symptoms.
Reveal answer location
Check Duration and course, Diagnostic boundary, or the rapid revision card below — the cue you need is one of those, in this category's own already-authored wording.
-
Explain in one sentence why unrealistic but non-delusional grandiose plans do not, by themselves, establish psychotic features.
Reveal answer location
Check Duration and course, Diagnostic boundary, or the rapid revision card below — the cue you need is one of those, in this category's own already-authored wording.
These self-checks are a personal study aid only, visible to you on this page for this visit — they are not stored and do not affect your mastery dimensions.
Rapid revision card
F30: F30 is reserved for a first-ever episode of pathological mood elevation with no prior manic, hypomanic, or depressive episode on record; any such history reclassifies the course as bipolar (F31), and severity then determines the fourth character.
Decisive boundary cues:
- No prior manic, hypomanic, or depressive episode -> weighs toward F30 (single episode).
- Any documented prior episode of either pole -> weighs toward F31 (bipolar course), regardless of how the current episode looks.
- Delusions or hallucinations present -> mania with psychotic symptoms (F30.2), not F30.1.
Duration/course: Typically present for at least one week (any duration if hospitalisation is required); hypomania's threshold is lower severity, not shorter duration.
Nearest alternatives: F31, F38
Common mistake: Grading severity first and treating that as the whole classification task, without first checking whether a prior episode of either pole has ever occurred.
Retrieval prompt: What single question would you ask about this person's episode history before finalising a code?
(or use your browser's print function) Open full-page printable revision view →
Related glossary terms
-
Mania
A state of abnormally and persistently elevated, expansive, or irritable mood accompanied by increased activity or energy, sufficient to cause marked functional impairment, require hospitalisation, or involve psychotic features. The most severe point on the elevated-mood gradient, above hypomania.
-
Hypomania
A milder, sustained elevation of mood and increased activity that is a clear change from a person's usual baseline, but without the marked functional impairment, need for hospitalisation, or psychotic features that would make it mania.
-
Mood-congruent (psychotic features)
Delusions or hallucinations whose content fits the prevailing mood — for example, grandiose delusions during mania, or delusions of guilt, nihilism, or hypochondriasis during severe depression. Contrasted with mood-incongruent features, whose content does not fit the mood and which raise consideration of an independent psychotic illness.
Source basis
WHO ICD-10 international classification structure and code/title (ICD-10 Browser, 2019 English release).
Original educational synthesis, informed by general published clinical-education understanding of ICD-10 F30-F39; no verbatim CDDG or DCR text is reproduced. See Sources and Method for the full policy.
Last reviewed: 2026-09-16. Full policy: Sources and Method.
Educational resource only. This page and its cases teach ICD-10 classification reasoning using fictional scenarios. It does not diagnose real people and should not be used to assess yourself or anyone else. If you or someone you know may be experiencing a mood episode, or is at risk of harming themselves, please seek prompt professional evaluation.