Bipolar disorder is classified into Bipolar I, Bipolar II, and Cyclothymic Disorder, each with distinct features:

1. Manic Episodes (Bipolar I):
   • Elevated or irritable mood lasting ≥1 week.
   • Grandiosity, reduced need for sleep, rapid speech.
   • Risky behaviors (e.g., excessive spending, impulsivity).
2. Hypomanic Episodes (Bipolar II):
   • Similar to mania but less severe and shorter (≥4 days).
   • No significant functional impairment.
3. Depressive Episodes:
   • Persistent sadness, loss of interest, fatigue.
   • Suicidal thoughts, guilt, or hopelessness.
4. Mixed Episodes:
   • Co-occurring manic and depressive symptoms (e.g., agitation with sadness).

Red Flags:

• Psychosis (delusions/hallucinations) or suicidal intent requires urgent intervention (Lippincott Review of Pathology).

BD arises from a complex interplay of genetic, neurochemical, and environmental factors:

1. Genetic Predisposition:
   • Family history increases risk; mutations in CACNA1C, ANK3, and BDNF genes.
2. Neurochemical Imbalances:
   • Dysregulation of dopamine, serotonin, and glutamate signaling.
3. Environmental Triggers:
   • Stress, trauma, substance abuse, or sleep disturbances.
4. Brain Structure Abnormalities:
   • Reduced gray matter in prefrontal cortex and hippocampus (WHO).

While BD cannot be fully prevented, these steps may reduce episode frequency/severity:

1. Early Intervention:
   • Recognize prodromal signs (e.g., sleep changes, irritability).
2. Stress Management:
   • Mindfulness, yoga, or structured routines.
3. Avoid Triggers:
   • Limit alcohol, stimulants (e.g., caffeine), and illicit drugs.
4. Regular Sleep:
   • Maintain consistent sleep-wake cycles (Mayo Clinic).

1. Pharmacological Therapy:

• Mood Stabilizers:
  • Lithium: First-line for mania and suicide prevention (monitor serum levels: 0.6–1.2 mEq/L).
  • Anticonvulsants: Valproate, lamotrigine, or carbamazepine.
• Antipsychotics:
  • Atypical: Quetiapine, olanzapine, or lurasidone (for acute mania/depression).
• Antidepressants:
  • Use cautiously (e.g., with mood stabilizers) to avoid manic switches (BNF).

2. Psychotherapy:

• Cognitive Behavioral Therapy (CBT):
  • Challenges negative thought patterns and improves coping.
• Family-Focused Therapy (FFT):
  • Enhances communication and reduces relapse risk.

3. Lifestyle Modifications:

• Exercise: Reduces depressive symptoms and stabilizes mood.
• Diet: Omega-3 fatty acids (e.g., fish oil) may support brain health.

4. Advanced Interventions:

• Electroconvulsive Therapy (ECT):
  • For severe, treatment-resistant depression or mania.
• Transcranial Magnetic Stimulation (TMS):
  • Non-invasive option for depressive episodes (Lippincott Textbook of Pharmacology).

• Suicide: 15–20% lifetime risk.
• Substance Abuse: Self-medication with alcohol or drugs.

Social/Occupational Decline: Strained relationships, job loss (WHO

Bipolar disorder requires lifelong, multidisciplinary management combining medication, therapy, and lifestyle adjustments. Early diagnosis and personalized treatment plans are critical to stabilizing mood and improving quality of life. Patients and caregivers should collaborate closely with psychiatrists and therapists to navigate challenges and prevent relapse