Why Is Bipolar an "Axis II" Disorder?

Sharon Dominick/E+/Getty Images


Why is Borderline Personality Disorder Called an "Axis II" Disorder? What does "Axis II" mean?


Up until the publication of the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5), the official guidebook for diagnosing psychological disorders published by the American Psychiatric Association, information about a person’s mental, social, emotional and physical health were provided on five different levels.

  Each level was called an "axis."

On the first level or axis, major mental disorders that were considered to be "clinical disorders" were listed.

These are the disorders that most people think of when they think of psychiatric conditions (e.g., major depressive disorder, schizophrenia, bipolar disorder).

The second axis was reserved for personality disorders, such as borderline personality disorder as well as developmental disorders. These disorders were considered to be longstanding and relatively fixed in nature.

The last three axes were used to diagnose general medical conditions that impact mental health, social or environmental problems the person is experiencing, and overall functioning.

Hearing about the different axes of mental health disorders will be occurring less and less, as the DSM-5 was released in 2013 and discarded the multiaxial format of diagnosis. 


American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.

American Psychiatric Association: Diagnostic and statistical manual of mental disorders, 4th Edition Text  Revision. Washington, DC, American Psychiatric Association, 2000.

Bernstein, DP, Iscan, C, Maser, J, Board of Directors, Association for Research in Personality Disorder, & Board of Directors, International Society for the Study of Personality Disorders. "Opinions of personality disorder experts regarding the DSM-IV Personality Disorders classification system." Journal of Personality Disorders, 21:536-551, 2007.

Edited by Jenev Caddell, PsyD

Continue Reading