What is bipolar disorder?

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From the Guidelines

Bipolar disorder is a mental health condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).

Key Characteristics

  • Extreme mood swings
  • Emotional highs (mania or hypomania)
  • Emotional lows (depression) According to the practice parameter for the assessment and treatment of children and adolescents with bipolar disorder 1, treatment typically involves a combination of medication and psychotherapy.

Treatment Approaches

  • Medication: mood stabilizers, antipsychotics, and sometimes antidepressants
  • Psychotherapy: cognitive behavioral therapy, interpersonal therapy, and family-focused therapy The primary medications used include mood stabilizers like lithium and valproate, and antipsychotics such as quetiapine, olanzapine, or risperidone 1.

Medication Regimens

  • Mood stabilizers: lithium, valproate
  • Antipsychotics: quetiapine, olanzapine, risperidone Lifestyle management is crucial, including regular sleep patterns, stress reduction, avoiding alcohol and recreational drugs, and maintaining a consistent daily schedule.

Lifestyle Management

  • Regular sleep patterns
  • Stress reduction
  • Avoiding alcohol and recreational drugs
  • Consistent daily schedule Bipolar disorder is believed to result from a combination of genetic factors, brain structure and function abnormalities, and environmental triggers 1.

Causes and Triggers

  • Genetic factors
  • Brain structure and function abnormalities
  • Environmental triggers The condition is chronic, requiring long-term management, but with proper treatment, many people with bipolar disorder lead fulfilling, productive lives.

From the FDA Drug Label

  1. 2 Bipolar I Disorder (Manic or Mixed Episodes) Monotherapy — Oral ZYPREXA is indicated for the acute treatment of manic or mixed episodes associated with bipolar I disorder and maintenance treatment of bipolar I disorder Efficacy was established in three clinical trials in adult patients with manic or mixed episodes of bipolar I disorder: two 3- to 4-week trials and one monotherapy maintenance trial.

Bipolar Disorder is a mental health condition characterized by manic or mixed episodes, as described in the context of Bipolar I Disorder.

  • The exact definition of bipolar disorder is not explicitly stated in the drug label.
  • However, it is mentioned that Bipolar I Disorder involves manic or mixed episodes. 2

From the Research

Definition and Characteristics of Bipolar Disorder

  • Bipolar disorder is characterized by recurrent episodes of depression and mania or hypomania 3
  • The age of onset is usually between 15 and 25 years, and depression is the most frequent initial presentation 3
  • Approximately 75% of symptomatic time consists of depressive episodes or symptoms 3
  • Bipolar depressive episodes are similar to major depressive episodes, while manic and hypomanic episodes are characterized by a distinct change in mood and behavior during discrete time periods 3

Clinical Features and Treatment

  • Although the most distinctive clinical feature of bipolar disorder is the pathologically elevated mood, it does not usually constitute the prevalent mood state of bipolar illness 4
  • The majority of patients with bipolar disorder spend much more time in depressive episodes, including subsyndromal depressive symptoms, and bipolar depression accounts for the largest part of the morbidity and mortality of the illness 4
  • Mood stabilizers, such as lithium, valproate, and lamotrigine, are commonly used in the treatment of bipolar disorder 4, 5, 3
  • Antipsychotic agents, such as quetiapine, aripiprazole, asenapine, lurasidone, and cariprazine, are also recommended, but some are associated with weight gain 3
  • Antidepressants are not recommended as monotherapy, and their use is generally not supported by evidence-based guidelines 4, 3

Diagnosis and Prognosis

  • Early diagnosis and treatment are associated with a more favorable prognosis 3
  • Diagnosis and optimal treatment are often delayed by a mean of approximately 9 years following an initial depressive episode 3
  • Life expectancy is reduced by approximately 12 to 14 years in people with bipolar disorder, with a 1.6-fold to 2-fold increase in cardiovascular mortality occurring a mean of 17 years earlier compared with the general population 3
  • The annual suicide rate is approximately 0.9% among individuals with bipolar disorder, compared with 0.014% in the general population 3

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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