A recurrent and sometimes chronic mental illness marked by alternating periods of abnormal mood elevation and depression associated with a change or impairment in functioning.
The long-term course of illness is characterized by a predominance of depression, although a history of at least one manic, hypomanic, or mixed episode is required to make the diagnosis of a bipolar disorder.
Diagnosis is based on interviews with the patient and family, using diagnostic criteria for bipolar disorder.
Misdiagnosis of bipolar disorder is common, with unipolar major depressive disorder the most frequent diagnostic error made.
The management of acute mania requires the use of mood stabilizers or atypical antipsychotics, as monotherapy or in combination. There are fewer approved treatment options for acute bipolar depression; traditional antidepressants are not indicated.
Bipolar disorder requires individualizing a long-term management plan that includes maintenance medication(s), adjunctive psychosocial therapies, and careful monitoring for any treatment-emergent complications.