
Bipolar, or manic-depressive, disorder is a frequent, severe, mostly recurrent
mood disorder associated with great morbidity. The lifetime prevalence of
bipolar disorder is 1.3 to 1.6%. The mortality rate of the disease is two to
three times higher than that of the general population.

About 10–20% of individuals with bipolar disorder take their own life, and
nearly one third of patients admit to at least one suicide attempt. They range
from mild hypomania or mild depression to severe forms of mania or
depression accompanied by psychosis. Bipolar disorder is equally prevalent
across genders, with the exception of rapid cycling, a severe and difficult to
treat variant of the disorder, which arises mostly in women.
Features of Mania:
Features of Depression:

Euphoria or irritable mood
• Reduced interest in activities

Decreased need for sleep
• Behavior and demeanor different from usual

Talkativeness
• Reduced appetite and weight

Racing thoughts
• Insomnia ad fatigue

Increased aggressive activity;
• Suicidal thoughts
If symptoms become too severe the person may need to be hospitalized

About 50 percent of patients with bipolar illness have a family history of the
disorder.

The lifetime risk of bipolar disorder in first-degree relatives of a bipolar
patient is 40–70% for a monozygotic twin and 5–10% for all other first-degree
relatives.

Many genes with small effect sizes are considered to contribute to the group
of disorders. For example, a study in 2019 identified 30 significant loci, of
which 20 had not previously been recognized (polygenic inheritance).

Research is still ongoing on the exact genes that affect and cause bipolar disorder as
well as how the brain is affected by these genetic variations.
Bipolar disorder could be triggered by:

Having a first-degree relative with bipolar disorder

Periods of high stress

Drugs or alcohol
Although bipolar disorder may seem like a psychological disorder, it is believed to
be caused by chemical imbalances in the brain that do not occur in the normal
human. A series of many chemical process usually caused genetically may cause
the person do have manic episodes, which can become severe and the patient
diagnosed with bipolar disorder.
Total: 123000

Research studies have shown that lithium, valproate, and carbamazepine
have established efficiency in the treatment of acute mania and are effective
in clinical practice as monotherapy for occasional episodes of mild mania.

Bipolar depression (depressive episodes in a patient with bipolar illness)
generally responds to tricyclic antidepressants. However, treatment for
bipolar depression must be carried out in the knowledge that antidepressant
drugs may induce a switch from depression to mania.

Lithium is the classic mood stabilizer. It has been used for over 50 years as a
treatment for bipolar disorder. However, the blood levels in patients taking
lithium must be monitored as too much lithium can cause severe toxic effects
and sometimes death.

Bipolar, or manic-depressive, disorder is a frequent, severe, mostly recurrent
mood disorder associated with great morbidity. The lifetime prevalence of
bipolar disorder is 1.3 to 1.6%. The mortality rate of the disease is two to
three times higher than that of the general population. About 10–20% of
individuals with bipolar disorder take their own life, and nearly one third of
patients admit to at least one suicide attempt. The clinical manifestations of
the disease are exceptionally diverse. They range from mild hypomania or
mild depression to severe forms of mania or depression.

Lithium salts are the first choice long-term preventive treatment for bipolar
disorder. They also possess well documented ant suicidal effects. Second
choice prophylactic treatments are carbamazepine and valproate, although
evidence of their effectiveness is weaker.

Müller-Oerlinghausen, B., Berghöfer, A., & Bauer, M. (2002). Bipolar disorder.
The Lancet, 359(9302), 241–247.
https://www.sciencedirect.com/science/article/abs/pii/S0140673602074500

Belmaker, R. H. (2020). Bipolar Disorder. New England Journal of Medicine,
351(5), 476–486.
https://www.nejm.org/doi/full/10.1056/NEJMra035354
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