Bipolar disorder, also known as manic-depressive illness, is a mental health condition characterized by extreme mood swings that range from periods of elevated and energized behavior (known as mania) to episodes of depression. People with bipolar disorder experience intense shifts in mood, energy levels, and activity levels, which can significantly impact their daily lives and relationships. The disorder is classified into different types, including bipolar I disorder, bipolar II disorder, cyclothymic disorder, and other specified and unspecified bipolar and related disorders. Bipolar I disorder involves severe manic episodes that can last for days or weeks, while bipolar II disorder involves hypomanic episodes (less severe than full mania) and depressive episodes. Cyclothymic disorder is a milder form of bipolar disorder with chronic fluctuations between hypomanic and depressive symptoms. During manic episodes, individuals may exhibit symptoms such as euphoria, increased energy and impulsivity, racing thoughts, decreased need for sleep, excessive talking, and engaging in risky behaviors. Depressive episodes are characterized by feelings of sadness, hopelessness, loss of interest, fatigue, changes in appetite, sleep disturbances, and sometimes thoughts of self-harm or suicide. The exact cause of bipolar disorder is not fully understood, but it is believed to result from a combination of genetic, biological, and environmental factors. It often first manifests in late adolescence or early adulthood and can be a lifelong condition. Bipolar disorder is typically managed through a combination of medication, therapy, lifestyle adjustments, and support from healthcare professionals and loved ones. It's important to note that this is just a brief introduction to bipolar disorder, and it's a complex condition that varies in its presentation and impact on individuals. If you or someone you know is experiencing symptoms or concerns related to bipolar disorder, it is recommended to seek professional help for an accurate diagnosis and appropriate treatment.

1. BIPOLAR
AND
RELATED
DISORDERS

2. BIPOLAR AND
RELATED DISORDERS
Introduction
Bipolar Can Be Define as
Mania or depressive illness
or a manic depression, it is
a mental illness that causes
unusual shifts in a persons
mood, energy, activity level
and concentration.

3. ETIOLOGY
Genetics
Biological Factors
Chemical Imbalances
Environmental Factors
Stressful Circumstances or Situation

4. TYPES OF BIPOLAR
Bipolar 1
Bipolar 2
Cyclothymic
Substance/Medicine Induced Bipolar
Bipolar Related To Other Medical Conditions
Other Specified Bipolar And Related Disorders.
Unspecified Bipolar And Related Disorders.

5. Bipolar-I Bipolar-II
 At least one Manic
episode.
 Preceded/followed
by Hypomanic or
Major Depressive
episode.
 Never had a Manic
episode.
 At least one
Hypomanic, and
one Major
Depressive episode.

8. MANIC EPISODE
Distinct period of
abnormally and
persistently elevated,
expensive, or irritable
mood.
At least for 1 week,
present most of the day.

9. SYMPTOMS
Inflated self-esteem or grandiosity
Decreased need for sleep
More talkative than usual
Racing thoughts or flight of ideas
Distractibility
Increase in goal-directed activity
Note: 3 symptoms must present, 4 symptoms if mood is only irritable.

10. COMPLICATIONS AND
PROGNOSIS
Impact on Daily Life:
Challenges faced by individuals experiencing manic episodes in work,
relationships, and overall functioning.
Suicide Risk:
Increased risk of suicide during manic episodes
Long-Term Outlook:
Proper treatment and management, individuals with manic episodes can achieve
stability and lead fulfilling lives.

11. DIFFERENTIAL DIAGNOSIS
Bipolar disorder Schizophrenia
Substance-induced
mood disorder
Attention-
deficit/hyperactivity
disorder
Personality disorders
Hyperthyroidism
Other psychiatric
disorders

12. HYPOMANIC EPISODE

14. DSM-5
C.The episode is associated with an unequivocal change in functioning that is
uncharacteristic of the individual when not symptomatic.
D.The disturbance in mood and the change in functioning are observable by others.
E.The episode is not severe enough to cause marked impairment in social or
occupational functioning or to necessitate hospitalization. If there are psychotic
features, the
episode is, by definition, manic.
F.The episode is not attributable to the physiological effects of a substance (e.g., a
drug abuse, a medication or other treatment).

17. MAJOR DEPRESSIVE
EPISODE
Pervasive and persistent
low mood or loss of
interest or pleasure in
almost all activities.
At least for 2 weeks.

18. SYMPTOMS
 (1) Depressed mood or (2) loss of interest or pleasure
 Insomnia, Hypersomnia
 Psychomotor agitation or
 Retardation
 Fatigue, Loss of energy
 Feelings of worthlessness
 Diminished ability to think or
 Concentrate
 Recurrent thoughts of death

19. Duration: Five Symptoms
(2 weeks)
Etiology: biological, genetic,
environmental factors
Neurotransmitters (Serotonin,
dopamine, norepinephrine)

20. CYCLOTHYMIC DISORDER
 Hypomanic symptoms, Depressive
Symptoms
 Duration: 2 years (1 year for children)
 Have not been without symptoms for 2
months.
 Criteria have not been meet for any
other mental, medical condition or
Physiological effects of a substance.
 Symptoms cause Clinical significant
distress and impairment.

22.  Specify if: With Anxious Distress
 Prevalence: 0.4%-1%
15%-50% risk for bipolar-l &
bipolar –ll disorder
 More common among first degree
relatives
 Etiology: Genetic, change in
brain neurobiology, environmental
issues

23. DIFFERENTIAL DIAGNOSIS

24. DIFFERENTIAL DIAGNOSIS
Bipolar and related
disorder due to another
medical condition
Depressive disorder due
to another medical
condition
Substance/Medication
induced bipolar and
related disorder
Bipolar-II with rapid
cycling
Substance/Medication
induced depressive
disorder
Bipolar-I with rapid
cycling

25. Mood
Disturbance
Substance/
Medication
Involvement
Not Other
Bipolar
Disorder
Not
Delirium
Significant
Distress or
Impairment
Substance/
Medication
Induced
Bipolar and
Related Disorder
SUBSTANCE/MEDICATION INDUCED BIPOLAR
AND RELATED DISORDER

26. With onset
during
Intoxication
With onset during
Withdrawal
• Happy or irritable during or shortly after using
the substance
• Extremely elevated or irritable during or shortly
after stopping the use of the substance
Substance/Medication Induced Bipolar and
Related Disorder

27. DIFFERENTIAL DIAGNOSIS
Medication Side Effects
 Substance Withdrawal
 Substance Intoxication
 Other Bipolar Disorders
Substance-Induced Delirium

28. Distress or impairment
Not during delirium
Not explained by other
mental disorder
Medical condition cause
Mood disturbance
Bipolar and Related Disorder Due to Another
Medical Condition

29. Specify if:
Manic features, incomplete criteria
Manic/hypomanic-like episode, partial criteria
Mixed features, depression symptoms
Differential Diagnosis:
 Catatonia and acute anxiety
 Delirium and major or mild neurocognitive disorder
 Medication-induced depressive or manic symptoms.

30. Short duration hypomanic episode and major depressive episode
Symptoms vary and don't fit specific disorder
Insufficient hypomanic symptoms and major depressive episode
Short-duration cyclothymia
Hypomania without prior depression
Clinically significant distress/impairment
OTHER SPECIFIED BIPOLAR AND RELATED
DISORDER

31. UNSPECIFIED BIPOLAR AND RELATED DISORDER
Symptoms like bipolar and related disorders
Cause problems in their lives
Don't fit into specific disorder
Used when doctors aren't sure
Not enough information for specific diagnosis
Difficulty in school, work, relationships

32. SPECIFIERS FOR BIPOLAR
AND RELATED DISORDERS
With Anxious Distress
Feelings of restlessness, worry, difficulty concentrating, fearing the worst
outcome, and physical symptoms of anxiety.
With Mixed Features
Combination of both manic or hypomanic symptoms and depressive
symptoms, includes concurrent symptoms that are opposite in nature.

33. With Rapid Cycling
Four or more distinct mood episodes within a 12-month period. These mood
episodes can include major depressive episodes, manic episodes, hypomanic
episodes, or a combination of these.
With Melancholic Features
Subtype of depression characterized by prominent features such as
anhedonia, excessive guilt, early morning awakening, psychomotor
agitation or retardation, and significant weight loss.
With Atypical Features
Mood reactivity, significant weight gain or increased appetite, excessive
sleepiness, heavy sensation in the limbs, and extreme sensitivity to
interpersonal rejection.

34. With Catatonia
Immobility, rigidity, excessive or purposeless motor activity, posturing,
mutism, and peculiar voluntary movements.
With Peripartum Onset
Onset of bipolar symptoms during pregnancy, recognized hormonal
changes associated with pregnancy and childbirth.
With Psychotic Features
Loss of touch with reality, include hallucinations and delusions.
Individuals experience both mood disturbances and psychotic symptoms.

35. With Seasonal Pattern
Manic or depressive episodes occur during specific seasons. Change in
seasons can trigger changes in mood, energy levels, sleep patterns, and
appetite.
Specify if;
In partial remission
In full remission
Specify current severity;
Mild
Moderate
Severe

36. Treatment Options
Medication:
Pharmacological treatments commonly used to manage manic episodes, such as
mood stabilizers, antipsychotics, and antidepressants (when appropriate).
Psychotherapy:
Such as cognitive-behavioral therapy (CBT), psycho-education, and
family-focused therapy.
Lifestyle Modifications:
Maintaining a regular sleep schedule, managing stress, and avoiding triggers like
substance abuse.