Bipolar Disorder

Definitions
  1. Bipolar I Disorder:
    • Characterized by at least one manic episode that lasts for at least one week and may require hospitalization. Depressive episodes are common but not required for diagnosis.
  2. Bipolar II Disorder:
    • Defined by at least one hypomanic episode (a milder form of mania) lasting at least four days and one major depressive episode lasting at least two weeks. Full-blown manic episodes do not occur.
Sources: DSM-5-TR, Mayo Clinic, NIMH.
SymptomsManic Episodes (Bipolar I):
  • Elevated, expansive, or irritable mood.
  • Increased energy or activity.
  • Inflated self-esteem or grandiosity.
  • Decreased need for sleep.
  • Rapid speech or racing thoughts.
  • Risk-taking behavior (e.g., impulsive spending or unsafe sexual activity).
Hypomanic Episodes (Bipolar II):
  • Similar symptoms to mania but less severe and do not cause significant functional impairment.
Major Depressive Episodes (Both Types):
  • Persistent sadness or hopelessness.
  • Loss of interest in activities.
  • Fatigue or low energy.
  • Changes in appetite or sleep patterns.
  • Difficulty concentrating or making decisions.
  • Thoughts of death or suicide.
Sources: APA Guidelines, National Alliance on Mental Illness (NAMI).

Onset
  • Typical Onset: Late adolescence to early adulthood (ages 18–25).
  • Risk Factors: Family history, environmental stress, and neurobiological changes.
  • Bipolar I tends to appear slightly earlier than Bipolar II.
Sources: NIH, PubMed, DSM-5-TR.

Prevalence
  • Bipolar I: Affects approximately 1% of the population worldwide.
  • Bipolar II: Slightly more common, affecting around 1.1–1.5%.
Sources: WHO, NIMH, Epidemiological Studies.

Gender Differences
  1. Bipolar I:
    • Equally prevalent in men and women.
    • Men are more likely to experience manic episodes.
    • Women are more prone to mixed states or rapid cycling.
  2. Bipolar II:
    • More common in women.
    • Women are at higher risk for depressive episodes.
Sources: Journal of Affective Disorders, NIMH.
Medications Mood Stabilizers:
  1. Lithium: Gold standard for mood stabilization and preventing manic and depressive episodes.
  2. Valproate (Depakote): Effective for acute mania and maintenance.
  3. Lamotrigine (Lamictal): More effective for depressive episodes in bipolar II.
Antipsychotics:
  1. Atypical Antipsychotics: Quetiapine (Seroquel), Olanzapine (Zyprexa), Aripiprazole (Abilify).
  2. Used for acute mania, mixed episodes, or maintenance.
Antidepressants:
  • Typically used cautiously in bipolar depression to avoid triggering mania or rapid cycling.
Combination Therapy:
  • Often involves a mood stabilizer with an antipsychotic or antidepressant, tailored to the patient’s symptoms.
Other Treatments:
  • Electroconvulsive Therapy (ECT) for severe or treatment-resistant episodes.
Sources: APA Practice Guidelines, Clinical Pharmacology, Drugs.com.
Summary
  • Bipolar I involves full manic episodes and possibly depressive episodes, while Bipolar II involves hypomania and significant depressive episodes.
  • Symptoms, onset, and treatments vary between individuals, and long-term management often includes medication, therapy, and lifestyle interventions.
  • Prevalence and gender differences suggest a need for tailored treatments, especially in managing depressive episodes for women and manic episodes for men.