Bipolar Disorder

About Bipolar Disorder

Bipolar disorder is a mood disorder characterized by episodes of mania or hypomania and, in most cases, episodes of depression. It affects a small but significant proportion of adults worldwide and usually begins in late adolescence or early adulthood. Bipolar I disorder requires at least one manic episode lasting a week or severe enough to require hospitalization, while bipolar II disorder involves hypomanic and major depressive episodes without full mania. Mania presents with elevated or irritable mood, grandiosity, decreased need for sleep, pressured speech, racing thoughts, distractibility and risky behavior such as excessive spending, and severe episodes can include psychotic features. Bipolar depression can resemble unipolar depression but is often associated with oversleeping and low energy. The condition is strongly heritable. Lithium has been used since the mid twentieth century and remains a mainstay of long term treatment, and studies associate it with reduced suicide risk. Because the margin between effective and toxic levels is narrow, monitoring of lithium blood levels and of kidney and thyroid function is part of treatment. Other options include anticonvulsant mood stabilizers such as valproate and lamotrigine, several atypical antipsychotics, and psychotherapy and psychoeducation. Antidepressants used alone can trigger mania, so they are generally combined with a mood stabilizer.