Bipolar Disorder

Bipolar Disorder is a major depressive episode that oscillate with episodes of mania

Manic Episode

Manic episodes are abnormally and persistently elevated, expansive or irritable moods lasting at least one week.

  • Grandiosity
  • Talkativeness
  • Low need for sleep
  • Distractibility
  • Flight of ideas
  • Excessive involvement in pleasurable activities
    • e.g. unrestrained buying sprees
    • e.g. sexual indiscretions

++ Example


Bipolar I Disorder

  • Alternations between MDEs and Manic Episodes.
  • Psychotic symptoms are not uncommon
  • Lifetime Prevalence = ~1%
  • Equal gender ratio
  • Average onset age = ~18 years

Bipolar II Disorder

  • Alternations between MDEs and Hypomanic (milder mania) Episodes.
  • Deficits/Suffering stems primarily from the MDE (higher rates of suicide than bipolar 1)
  • Often more rapid cycling than type I
  • Only ~10% of cases progress to bipolar type I


  • Biological
    • Mood Stabilisers for Mania
    • Antipsychotics for Mania
    • Antidepressants for MDD
  • CBT
    • Identify and modify automatic thoughts
    • Control triggers
    • Manage behavioural symptoms

CBT is contested though:




Cyclothymia is a milder but more chronic version of bipolar disorder, involving alternations between hypomanic and dysthymic episodes, with patterns lasting at least 2 years.


  • Associated with increased risk of developing Bipolar Disorder
  • Average age of onset is 12-14 years
  • Tends to be chronic and lifelong