Bipolar I disorder

Short description: Bipolar disorder that is characterized by at least one manic or mixed episode

Bipolar I disorder

Other names| Manic-depressive disorder, bipolar affective disorder
Specialty| Psychiatry
Symptoms| Mood instability, behavioral changes, psychosis in some cases
Complications| Suicide, self-harm
Usual onset| 15-25 years of age
Causes| Complex
Risk factors| Family history
Diagnostic method| By psychiatric evaluation
Differential diagnosis| Other bipolar disorders, borderline personality disorder, antisocial personality disorder
Treatment| Pharmacotherapy such as mood stabilizers, antipsychotics; supplemental psychotherapy
Medication| Lithium, anticonvulsants, antipsychotics
Frequency| ~1% of the global population is affected
Deaths| 15-20% die by suicide[1]

Bipolar I disorder (also referred to as BD-I or type one bipolar disorder) is a type of bipolar spectrum disorder characterized by the occurrence of at least one manic episode.[2][3] Symptoms of bipolar I disorder typically begin at age 15-25 years of age, with depression being the most common initial symptom.[4] People may also have one or more depressive episodes.[5] Typically, manic episodes can last at least 7 days for most of each day to the extent that the individual may need medical attention, while the depressive episodes last at least 2 weeks.[6] The prevalence of bipolar disorders is about 1% worldwide.[7]

## Contents

* 1 Signs and symptoms
* 1.1 Manic episodes
* 1.2 Hypomanic episodes
* 1.3 Depressive episodes
* 1.4 Psychosis
* 2 Risk Factors
* 3 Diagnosis
* 3.1 Medical assessment
* 3.2 Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV-TR)
* 3.3 Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5)
* 3.4 ICD-10
* 3.5 Differential diagnosis
* 4 Management
* 4.1 Medication
* 5 Prognosis
* 5.1 Education
* 6 See also
* 7 References

## Signs and symptoms

Bipolar I disorder is characterized by severe, recurrent mood changes and behavioral changes.[8] A manic episode is a key feature of bipolar I disorder and is required for diagnosis of bipolar I disorder.[9] Hypomanic episodes, major depressive episodes, and psychotic features may also be present but are not necessary for diagnosis.[9]

Graph illustrating mood fluctuations in bipolar disorders

### Manic episodes

A manic episode is a distinct period of time, lasting at least one week and for most of each day, where an individual experiences persistent irritable mood and/or persistent euphoria or elation that is disproportionately out of norm.[10] These symptoms are severe, and cause either significant impairment in an individual's life or require hospitalization.[10] Furthermore, these symptoms and changes are not caused by medications, illicit substances, or another medical condition.[10]

### Hypomanic episodes

Similar to mania, hypomanic episodes involve distinct periods of time where an individual experiences persistent, increased energy, euphoria, elation, or irritable mood that is disproportionately out of norm.[9] They differ in severity of impairment and symptom duration.[9] A hypomanic episode lasts a minimum of 4 days in a row and for most of the day and does not require hospitalization or involve psychotic symptoms.[9]

### Depressive episodes

A depressive episode involves depressed mood and/or anhedonia (lack of interest or pleasure) in addition to other symptoms of depression that lasts for at least 2 weeks.[9] Other symptoms of depression include unintentional weight changes, changes in appetite, sleep disruption (lack of sleep or excessive sleep), restlessness or slowness, lack of energy, difficulty concentrating, and suicidal ideation.[9]

### Psychosis

Most people with bipolar disorder experience psychosis during their lifetime, with one half to two-thirds of people experiencing it.[11] Symptoms of psychosis include delusions, hallucinations, or both. Delusions are more common than hallucinations in bipolar disorder. Psychotic symptoms occur more frequently during manic or mixed episodes. Having psychotic episodes indicates a more severe illness. People with psychosis have poor insight and more agitation, anxiety, and hostility. Psychotic symptoms are more common in bipolar type I compared to bipolar type II.[11]

## Risk Factors

Currently, there are no single, clear causes of bipolar disorder.[12] However, there are evidence that suggest there may be a genetic component that contribute to the development of bipolar disorder.[12] Studies from identical twins suggest that there is a 5-10% lifetime risk (about seven times greater compared to the general population) of developing bipolar disorder if there is a first-degree relative diagnosed with bipolar disorder.[12] Bipolar disorder appears to be more common in high-income countries compared to low-income countries, and higher rates of bipolar I disorder are seen in individuals that are separated, divorced, or widowed compared to those who are married or never married.[9]

## Diagnosis

The essential feature of bipolar I disorder is a clinical course characterized by the occurrence of one or more manic episodes or mixed episodes.[13] One episode of mania is sufficient to make the diagnosis of bipolar disorder. Often, individuals have had one or more major depressive episodes and may or may not have a history of major depressive disorder.[14] Because depression is typically one of the first symptoms of bipolar disorders, the initial diagnosis of bipolar disorder may be delayed.[7]

Episodes of substance-induced mood disorder due to the direct effects of a medication, or other somatic treatments for depression, substance use disorder, or toxin exposure, or of mood disorder due to a general medical condition need to be excluded before a diagnosis of bipolar I disorder can be made. Bipolar I disorder requires confirmation of only 1 full manic episode for diagnosis, but may be associated with hypomanic and depressive episodes as well.[3] In contrast, diagnosis for bipolar II disorder does not include a full manic episode; instead, it requires the occurrence of both a hypomanic episode and a major depressive episode.[3] Serious aggression has been reported to occur in one out of every ten major, first-episode, BD-I patients with psychotic features, the prevalence in this group being particularly high in association with a recent suicide attempt, alcohol use disorder, learning disability, or manic polarity in the first episode.[15]

Bipolar I disorder often coexists with other disorders including PTSD, substance use disorders, and a variety of mood disorders.[16][17] Studies suggest that psychiatric comorbidities correlate with further impairment of day-to-day life.[18] Up to 40% of people with bipolar disorder also present with PTSD, with higher rates occurring in women and individuals with bipolar I disorder.[16] A diagnosis of bipolar 1 disorder is only given if bipolar episodes are not better accounted for by schizoaffective disorder or superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or a psychotic disorder not otherwise specified.[19]

### Medical assessment

Regular medical assessments are performed to rule-out secondary causes of mania and depression.[20] These tests include complete blood count, glucose, serum chemistry/electrolyte panel, thyroid function test, liver function test, renal function test, urinalysis, vitamin B12 and folate levels, HIV screening, syphilis screening, and pregnancy test, and when clinically indicated, an electrocardiogram (ECG), an electroencephalogram (EEG), a computed tomography (CT scan), and/or a magnetic resonance imagining (MRI) may be ordered.[20] Drug screening includes recreational drugs, particularly synthetic cannabinoids, and exposure to toxins.

### Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV-TR)

Dx code #  | Disorder  | Description

|
|

296.0x  | Bipolar I disorder  | Single manic episode
296.40  | Bipolar I disorder  | Most recent episode hypomanic
296.4x  | Bipolar I disorder  | Most recent episode manic
296.5x  | Bipolar I disorder  | Most recent episode depressed
296.6x  | Bipolar I disorder  | Most recent episode mixed
296.7  | Bipolar I disorder  | Most recent episode unspecified

### Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5)

In May 2013, American Psychiatric Association released the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). There are several proposed revisions to occur in the diagnostic criteria of Bipolar I Disorder and its subtypes. For Bipolar I Disorder 296.40 (most recent episode hypomanic) and 296.4x (most recent episode manic), the proposed revision includes the following specifiers: with psychotic features, with mixed features, with catatonic features, with rapid cycling, with anxiety (mild to severe), with suicide risk severity, with seasonal pattern, and with postpartum onset.[21] Bipolar I Disorder 296.5x (most recent episode depressed) will include all of the above specifiers plus the following: with melancholic features and with atypical features.[21] The categories for specifiers will be removed in DSM-5 and criterion A will add or there are at least 3 symptoms of major depression of which one of the symptoms is depressed mood or anhedonia.[21] For Bipolar I Disorder 296.7 (most recent episode unspecified), the listed specifiers will be removed.[21]

The criteria for manic and hypomanic episodes in criteria A & B will be edited. Criterion A will include "and present most of the day, nearly every day", and criterion B will include "and represent a noticeable change from usual behavior". These criteria as defined in the DSM-IV-TR have created confusion for clinicians and need to be more clearly defined.[22][23]

There have also been proposed revisions to criterion B of the diagnostic criteria for a Hypomanic Episode, which is used to diagnose For Bipolar I Disorder 296.40, Most Recent Episode Hypomanic. Criterion B lists "inflated self-esteem, flight of ideas, distractibility, and decreased need for sleep" as symptoms of a Hypomanic Episode. This has been confusing in the field of child psychiatry because these symptoms closely overlap with symptoms of attention deficit hyperactivity disorder (ADHD).[22]

### ICD-10

* F31 Bipolar Affective Disorder
* F31.6 Bipolar Affective Disorder, Current Episode Mixed
* F30 Manic Episode
* F30.0 Hypomania
* F30.1 Mania Without Psychotic Symptoms
* F30.2 Mania With Psychotic Symptoms
* F32 Depressive Episode
* F32.0 Mild Depressive Episode
* F32.1 Moderate Depressive Episode
* F32.2 Severe Depressive Episode Without Psychotic Symptoms
* F32.3 Severe Depressive Episode With Psychotic Symptoms

### Differential diagnosis

When evaluating an individual for bipolar I disorder, other psychiatric conditions that mimic or present with similar symptoms to bipolar I disorder must be considered. It is possible that some of these may be co-occurring with bipolar I disorder.[9]

* Other bipolar disorders, such as bipolar II or bipolar disorder due to another medical condition[9]
* Major depressive disorder with hypomanic or manic symptoms[9]
* Anxiety disorders including Generalized Anxiety Disorder (GAD), panic disorder, post-traumatic stress disorder (PTSD)[9]
* Attention-deficit/hyperactivity disorder (ADHD)[9]
* Substance or medication-induced bipolar disorder[9]
* Personality disorders such as borderline personality disorder[9]

## Management

### Medication

Pharmacotherapy is the primary method of managing bipolar disorder, with multiple medications and combinations available.[24] Medications used may vary depending on the side effect profile and patient preference as well as the phase of bipolar disorder being managed (acute mania, bipolar depression, mixed states, or maintenance relapse prevention).[24]

1. Lithium (has a narrow therapeutic range and typically requires monitoring).[25] It has suicide-protective effects, with an 87% reduction in suicide risk compared to placebos in mood disorders.[26]
2. Anticonvulsants, such as valproate,[27] carbamazepine, or lamotrigine
3. Atypical antipsychotics, such as quetiapine,[28][29] risperidone, olanzapine, lurasidone, or aripiprazole
4. Combination therapies such as lithium or valproate with antipsychotics[24]

A review of validated treatment guidelines for bipolar disorder by international bodies was published in 2020.[30]

Usage of antidepressants alone in the treatment of bipolar disorders is not recommended.[31] However, antidepressants may be used to supplement mood stabilizers or second-generation antipsychotics (adjuvant therapy).[32][33] There has been concerns that usage of antidepressants may cause individuals to switch to mania (sometimes referred to as antidepressant-induced mania).[33] Current studies have not shown clear differences in significant risk of switching to mania between different antidepressants when compared to placebos.[33]

For the treatment of treatment-resistant bipolar depression, the NMDA receptor antagonist ketamine and its S-enantiomer esketamine (Spravato) have emerged as rapid-acting anesthetic/sedative options with less risk of overdose than other anesthetics.[34] They act quickly to block NMDA receptors and treat depression, with effects lasting up to a week. However, it is unknown exactly why it works.

In severe cases, Electroconvulsive therapy (ECT), a type of brain stimulation therapy where seizures are electrically induced in anesthetized patients for therapeutic effect may be used for bipolar depression[35]

Patients with bipolar disorder may benefit from supplemental psychotherapy (such as cognitive behavioral therapy) in reducing recurrences and stabilizing depressive phases.[36] Interventions that target sleep regulation and mood monitoring, as well as efforts to reduce stigma, are beneficial in improving their quality of life.[24]

Patients with bipolar disorder may struggle with non-adherence to pharmacological treatment; long-acting injectable antipsychotics maybe beneficial with adherence to some patients.[37]

## Prognosis

Bipolar I usually has a poor prognosis, which is associated with substance abuse, psychotic features, depressive symptoms, and inter-episode depression.[38] A manic episode can be so severe that it requires hospitalization. An estimated 63% of all BP-I related mania results in hospitalization.[39] The natural course of BP-I, if left untreated, leads to episodes becoming more frequent or severe over time.[40] The absolute risk of suicide is highest for BP-I than all other mood and mental disorders.[41] Approximately 15-20% of people with bipolar disorder die by suicide, with 30-60% making at least one attempt.[1] The attempts use more lethal means than those among the general population.[42] Individuals with BP-I typically have a shorter life expectancy compared to the general population, with estimates suggesting a reduction of 11 to 20 years.[43] With proper treatment, individuals with BP-I can, however, lead a healthy lifestyle.[44]

### Education

Psychosocial interventions can be used for managing acute depressive episodes and for maintenance treatment to aid in relapse prevention.[45] This includes psychoeducation, cognitive behavioural therapy (CBT), family-focused therapy (FFT), interpersonal and social rhythm therapy (IPSRT), and peer support.[45]

Information on the condition, importance of regular sleep patterns, routines and eating habits and the importance of compliance with medication as prescribed. Behavior modification through counseling can have positive influence to help reduce the effects of risky behavior during the manic phase. Additionally, the lifetime prevalence for bipolar I disorder is estimated to be 1%, while bipolar spectrum disorder has been estimated to affect as much as 6% of people.[46]

## See also

* Outline of bipolar disorder
* Bipolar disorder
* Bipolar II disorder
* Bipolar NOS
* Cyclothymia
* Bipolar disorders research
* History of bipolar disorder
* Creativity and bipolar disorder
* List of people with bipolar disorder
* International Society for Bipolar Disorders
* Detailed listing of DSM-IV-TR bipolar disorder diagnostics codes
* Borderline personality disorder
* Kleine–Levin syndrome
* Major depressive disorder
* Seasonal affective disorder
* Racing thoughts
* Emotional dysregulation

## References

1. ↑ 1.0 1.1 Gergel, Tania; Adiukwu, Frances; McInnis, Melvin (2024-10-01). "Suicide and bipolar disorder: opportunities to change the agenda" (in English). The Lancet Psychiatry 11 (10): 781–784. doi:10.1016/S2215-0366(24)00172-X. ISSN 2215-0366. PMID 38885666. https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(24)00172-X/abstract.
2. ↑ "The Two Types of Bipolar Disorder". Psych Central.com. http://psychcentral.com/lib/the-two-types-of-bipolar-disorder/000612.
3. ↑ 3.0 3.1 3.2 Diagnostic and statistical manual of mental disorders: DSM-5.. American Psychiatric Association., American Psychiatric Association. DSM-5 Task Force. (Fifth ed.). Arlington, VA. 2013. ISBN 978-0-89042-559-6. OCLC 847226928.
4. ↑ Nierenberg, Andrew A.; Agustini, Bruno; Köhler-Forsberg, Ole; Cusin, Cristina; Katz, Douglas; Sylvia, Louisa G.; Peters, Amy; Berk, Michael (2023-10-10). "Diagnosis and Treatment of Bipolar Disorder" (in en). JAMA 330 (14): 1370–1380. doi:10.1001/jama.2023.18588. ISSN 0098-7484. PMID 37815563. https://jamanetwork.com/journals/jama/article-abstract/2810502. Retrieved 15 January 2026.
5. ↑ "Bipolar Disorder: Who's at Risk?". http://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-whos-at-risk.
6. ↑ "Bipolar Disorder - National Institute of Mental Health (NIMH)" (in en). https://www.nimh.nih.gov/health/topics/bipolar-disorder.
7. ↑ 7.0 7.1 Oliva, Vincenzo; Fico, Giovanna; De Prisco, Michele; Gonda, Xenia; Rosa, Adriane R.; Vieta, Eduard (Jan 2025). "Bipolar disorders: an update on critical aspects". The Lancet Regional Health. Europe 48. doi:10.1016/j.lanepe.2024.101135. ISSN 2666-7762. PMID 39811787.
8. ↑ Mari, Jair; Dieckmann, Luiz Henrique Junqueira; Prates-Baldez, Daniel; Haddad, Michel; Rodrigues da Silva, Naielly; Kapczinski, Flavio (2024-11-05). "The efficacy of valproate in acute mania, bipolar depression and maintenance therapy for bipolar disorder: an overview of systematic reviews with meta-analyses". BMJ Open 14 (11). doi:10.1136/bmjopen-2024-087999. ISSN 2044-6055. PMID 39500601.
9. ↑ 9.00 9.01 9.02 9.03 9.04 9.05 9.06 9.07 9.08 9.09 9.10 9.11 9.12 9.13 9.14 Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington: American psychiatric association. 2013. pp. 123–154. ISBN 978-0-89042-554-1.
10. ↑ 10.0 10.1 10.2 Black, Donald W. (May 4, 2020). "Chapter 6 Mood Disorders". Introductory Textbook of Psychiatry (7th ed.). USA: American Psychiatric Association Publishing (published July 28, 2020). ISBN 978-1-61537-413-7.
11. ↑ 11.0 11.1 Chakrabarti, Subho; Singh, Navdeep (2022-09-19). "Psychotic symptoms in bipolar disorder and their impact on the illness: A systematic review". World Journal of Psychiatry 12 (9): 1204–1232. doi:10.5498/wjp.v12.i9.1204. ISSN 2220-3206. PMID 36186500.
12. ↑ 12.0 12.1 12.2 Rowland, Tobias A.; Marwaha, Steven (September 2018). "Epidemiology and risk factors for bipolar disorder". Therapeutic Advances in Psychopharmacology 8 (9): 251–269. doi:10.1177/2045125318769235. ISSN 2045-1253. PMID 30181867.
13. ↑ Phillips, Mary L; Kupfer, David J (2013-05-11). "Bipolar disorder diagnosis: challenges and future directions". Lancet 381 (9878): 1663–1671. doi:10.1016/S0140-6736(13)60989-7. ISSN 0140-6736. PMID 23663952.
14. ↑ "Online Bipolar Tests: How Much Can You Trust Them?". DepressionD. http://depressiond.org/bipolar-test/.
15. ↑ Khalsa, Hari-Mandir K.; Baldessarini, Ross J.; Tohen, Mauricio; Salvatore, Paola (2018-08-11). "Aggression among 216 patients with a first-psychotic episode of bipolar I disorder". International Journal of Bipolar Disorders 6 (1): 18. doi:10.1186/s40345-018-0126-8. ISSN 2194-7511. PMID 30097737.
16. ↑ 16.0 16.1 Cerimele, Joseph M.; Bauer, Amy M.; Fortney, John C.; Bauer, Mark S. (May 2017). "Patients With Co-Occurring Bipolar Disorder and Posttraumatic Stress Disorder: A Rapid Review of the Literature". The Journal of Clinical Psychiatry 78 (5): e506–e514. doi:10.4088/JCP.16r10897. ISSN 1555-2101. PMID 28570791.
17. ↑ Hunt, Glenn E.; Malhi, Gin S.; Cleary, Michelle; Lai, Harry Man Xiong; Sitharthan, Thiagarajan (December 2016). "Prevalence of comorbid bipolar and substance use disorders in clinical settings, 1990–2015: Systematic review and meta-analysis". Journal of Affective Disorders 206: 331–349. doi:10.1016/j.jad.2016.07.011. ISSN 1573-2517. PMID 27476137.
18. ↑ Léda-Rêgo, Gabriela; Studart-Bottó, Paula; Sarmento, Stella; Cerqueira-Silva, Thiago; Bezerra-Filho, Severino; Miranda-Scippa, Ângela (2023-02-01). "Psychiatric comorbidity in individuals with bipolar disorder: relation with clinical outcomes and functioning". European Archives of Psychiatry and Clinical Neuroscience 273 (5): 1175–1181. doi:10.1007/s00406-023-01562-5. ISSN 0940-1334. PMID 36725737.
19. ↑ "Bipolar Disorder Residential Treatment Center Los Angeles". PCH Treatment. http://www.pchtreatment.com/bipolar-treatment-center/.
20. ↑ 20.0 20.1 Bobo, William V. (October 2017). "The Diagnosis and Management of Bipolar I and II Disorders: Clinical Practice Update". Mayo Clinic Proceedings 92 (10): 1532–1551. doi:10.1016/j.mayocp.2017.06.022. ISSN 0025-6196. PMID 28888714.
21. ↑ 21.0 21.1 21.2 21.3 American Psychiatric Association (2013-05-22). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association. doi:10.1176/appi.books.9780890425596. ISBN 978-0-89042-555-8. https://archive.org/details/diagnosticstatis0005unse.
22. ↑ 22.0 22.1 Issues pertinent to a developmental approach to bipolar disorder in DSM-5. American Psychiatric Association. 2010.
23. ↑ Diagnostic and Statistical Manual of Mental Disorders (4th ed. text revision). Washington, DC: American Psychiatric Association. 2000. pp. 345–392.
24. ↑ 24.0 24.1 24.2 24.3 Singh, Balwinder; Swartz, Holly A; Cuellar-Barboza, Alfredo B; Schaffer, Ayal; Kato, Tadafumi; Dols, Annemieke; Sperry, Sarah H; Vassilev, Andrea B et al. (August 2025). "Bipolar disorder". The Lancet 406 (10506): 963–978. doi:10.1016/S0140-6736(25)01140-7. ISSN 0140-6736. PMID 40712624. PMC 12340982. https://linkinghub.elsevier.com/retrieve/pii/S0140673625011407.
25. ↑ Burgess, S.; Geddes, J.; Hawton, K.; Townsend, E.; Jamison, K.; Goodwin, G. (2001). "Lithium for maintenance treatment of mood disorders". The Cochrane Database of Systematic Reviews (3). doi:10.1002/14651858.CD003013. ISSN 1469-493X. PMID 11687035.
26. ↑ Barroilhet, S. A.; Ghaemi, S. N. (2020-07-07). "When and how to use lithium" (in en). Acta Psychiatrica Scandinavica 142 (3): 161–172. doi:10.1111/acps.13202. ISSN 0001-690X. https://www.researchgate.net/profile/Sergio-Barroilhet/publication/342111738_When_and_how_to_use_Lithium/links/5ef374cba6fdcceb7b1f9576/When-and-how-to-use-Lithium.pdf. Retrieved 2 February 2026.
27. ↑ MacRitchie, Karine; Geddes, John; Scott, Jan; Haslam, D. R.; Silva De Lima, Mauricio; Goodwin, Guy (2003). "Valproate for acutre mood episodes in bipolar disorder | Cochrane". Cochrane Database of Systematic Reviews (1). doi:10.1002/14651858.CD004052. PMID 12535506. http://www.cochrane.org/CD004052/DEPRESSN_valproate-for-acutre-mood-episodes-in-bipolar-disorder. Retrieved 9 March 2016.
28. ↑ Datto, Catherine (11 March 2016). "Bipolar II compared with bipolar I disorder: baseline characteristics and treatment response to quetiapine in a pooled analysis of five placebo-controlled clinical trials of acute bipolar depression". Annals of General Psychiatry 15. doi:10.1186/s12991-016-0096-0. PMID 26973704.
29. ↑ Young, Allan (February 2014). "A Randomised, Placebo-Controlled 52-Week Trial of Continued Quetiapine Treatment in Recently Depressed Patients With Bipolar I And Bipolar II Disorder". World Journal of Biological Psychiatry 15 (2): 96–112. doi:10.3109/15622975.2012.665177. PMID 22404704.
30. ↑ Verdolini, Norma; Hidalgo-Mazzei, Diego; Del Matto, Laura; Muscas, Michele; Pacchiarotti, Isabella; Murru, Andrea; Samalin, Ludovic; Aedo, Alberto et al. (Dec 22, 2020). "Long-term treatment of bipolar disorder type I: A systematic and critical review of clinical guidelines with derived practice algorithms". Bipolar Disorders 23 (4): 324–340. doi:10.1111/bdi.13040. ISSN 1399-5618. PMID 33354842.
31. ↑ Nierenberg, Andrew A.; Agustini, Bruno; Köhler-Forsberg, Ole; Cusin, Cristina; Katz, Douglas; Sylvia, Louisa G.; Peters, Amy; Berk, Michael (2023-10-10). "Diagnosis and Treatment of Bipolar Disorder: A Review". JAMA 330 (14): 1370–1380. doi:10.1001/jama.2023.18588. ISSN 1538-3598. PMID 37815563.
32. ↑ Hirschfeld, R. M. (2014-12-01). "Differential diagnosis of bipolar disorder and major depressive disorder". Journal of Affective Disorders. Advances in the Diagnosis and Treatment of Bipolar Depression 169: S12–S16. doi:10.1016/S0165-0327(14)70004-7. ISSN 0165-0327. PMID 25533909. https://www.sciencedirect.com/science/article/pii/S0165032714700047.
33. ↑ 33.0 33.1 33.2 Oliva, Vincenzo; De Prisco, Michele; La Spina, Enrico; Paolucci, Sofia; Fico, Giovanna; Anmella, Gerard; Hidalgo-Mazzei, Diego; Murru, Andrea et al. (September 2025). "Switch to mania after acute antidepressant treatment for bipolar depression: a systematic review and network meta-analysis of randomised controlled trials" (in English). eClinicalMedicine 87. doi:10.1016/j.eclinm.2025.103413. ISSN 2589-5370. PMID 40823496. PMC 12355415. https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(25)00345-1/fulltext. Retrieved 16 January 2026.
34. ↑ Queissner, Robert; Fellendorf, Frederike; Reininghaus, Eva Z. (2026). "Ketamine as an NMDA-Modulating Therapy in Bipolar Disorder: Rationale and Evidence". Frontiers in Psychiatry. doi:10.3389/fpsyt.2026.1777402. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2026.1777402/abstract. Retrieved February 11, 2026.
35. ↑ Mutz, Julian (Feb 2023). "Brain stimulation treatment for bipolar disorder". Bipolar Disorders 25 (1): 9–24. doi:10.1111/bdi.13283. ISSN 1399-5618. PMID 36515461.
36. ↑ Miklowitz, David J.; Efthimiou, Orestis; Furukawa, Toshi A.; Scott, Jan; McLaren, Ross; Geddes, John R.; Cipriani, Andrea (2021-02-01). "Adjunctive Psychotherapy for Bipolar Disorder: A Systematic Review and Component Network Meta-analysis". JAMA Psychiatry 78 (2): 141–150. doi:10.1001/jamapsychiatry.2020.2993. ISSN 2168-6238. PMID 33052390.
37. ↑ Tohen, Mauricio; Goldberg, Joseph F.; Hassoun, Youssef; Sureddi, Suresh (2020-06-16). "Identifying Profiles of Patients With Bipolar I Disorder Who Would Benefit From Maintenance Therapy With a Long-Acting Injectable Antipsychotic". The Journal of Clinical Psychiatry 81 (4). doi:10.4088/JCP.OT19046AH1. ISSN 1555-2101. PMID 32558403.
38. ↑ Jain, A.; Mitra, P. (2023). "Bipolar Disorder". StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK558998/#article-18332.s11.
39. ↑ De Zelicourt, M.; Dardennes, R.; Verdoux, H.; Gandhi, G.; Khoshnood, B.; Chomette, E.; Papatheodorou, M. L.; Edgell, E. T. et al. (2003). "Frequency of hospitalisations and inpatient care costs of manic episodes: In patients with bipolar I disorder in France". Pharmacoeconomics 21 (15): 1081–1090. doi:10.2165/00019053-200321150-00002. PMID 14596627.
40. ↑ "Bipolar Disorder – Fact Sheet". https://www.treatmentadvocacycenter.org/evidence-and-research/learn-more-about/463-bipolar-disorder-fact-sheet.
41. ↑ Kim, Hyewon; Jung, Jin Hyung; Han, Kyungdo; Jeon, Hong Jin (2025). "Risk of suicide and all-cause death in patients with mental disorders: a nationwide cohort study". Molecular Psychiatry 30 (7): 2831–2839. doi:10.1038/s41380-025-02887-4. PMID 39843548.
42. ↑ Dome, P.; Rihmer, Z.; Gonda, X. (2019). "Suicide Risk in Bipolar Disorder: A Brief Review". Medicina 55 (8): 403. doi:10.3390/medicina55080403. PMID 31344941.
43. ↑ Kessing, L. V.; Vradi, E.; Andersen, P. K. (2015). "Life expectancy in bipolar disorder". Bipolar Disorders 17 (5): 543–548. doi:10.1111/bdi.12296. PMID 25846854.
44. ↑ "Living Well with Bipolar Disorder". 7 May 2019. https://www.samhsa.gov/serious-mental-illness/bi-polar.
45. ↑ 45.0 45.1 Yatham, Lakshmi N.; Kennedy, Sidney H.; Parikh, Sagar V.; Schaffer, Ayal; Bond, David J.; Frey, Benicio N.; Sharma, Verinder; Goldstein, Benjamin I. et al. (2018). "Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder". Bipolar Disorders 20 (2): 97–170. doi:10.1111/bdi.12609. ISSN 1399-5618. PMID 29536616.
46. ↑ Merikangas, Kathleen R.; Akiskal, Hagop S.; Angst, Jules; Greenberg, Paul E.; Hirschfeld, Robert M.A.; Petukhova, Maria; Kessler, Ronald C. (1 May 2007). "Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication". Archives of General Psychiatry 64 (5): 543–552. doi:10.1001/archpsyc.64.5.543. ISSN 0003-990X. PMID 17485606.

Classification|

* ICD-11: 6A60
* ICD-10: F31.9
* ICD-9-CM: 296.7

|

* v
* t
* e

Mood disorder (F30–F39, 296)

History|

* Emil Kraepelin
* Karl Leonhard
* John Cade
* Mogens Schou
* Frederick K. Goodwin
* Kay Redfield Jamison

Symptoms|

* Hallucination
* Delusion
* Emotional dysregulation
* Anhedonia
* Dysphoria
* Suicidal ideation
* Mood swing
* Sleep disorder
* Hypersomnia
* Insomnia
* Psychosis
* Racing thoughts
* Reduced affect display
* Depression (differential diagnoses)

Spectrum|

* Bipolar disorder
* Bipolar I
* Bipolar II
* Cyclothymia
* Bipolar NOS
* Depression
* Major depressive disorder
* Dysthymia
* Seasonal affective disorder
* Atypical depression
* Melancholic depression
* Schizoaffective disorder
* Mania
* Mixed affective state
* Hypomania
* Major depressive episode
* Rapid cycling

Treatment|

| Anticonvulsants|

* Carbamazepine
* Lamotrigine
* Oxcarbazepine
* Valproate
* Sodium valproate
* Valproate semisodium

|

Sympathomimetics,
SSRIs & similar|

* Dextroamphetamine
* Methylphenidate
* Bupropion
* Sertraline
* Fluoxetine
* Escitalopram

Other mood stabilizers|

* Antipsychotics
* Lithium
* Lithium carbonate
* Lithium citrate
* Lithium sulfate
* Lithium toxicity
* Atypical antipsychotics

Non-pharmaceutical|

* Clinical psychology
* Electroconvulsive therapy
* Involuntary commitment
* Light therapy
* Psychotherapy
* Transcranial magnetic stimulation
* Cognitive behavioral therapy
* Dialectical behavior therapy

Template:Mental disorders

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Original source: https://en.wikipedia.org/wiki/Bipolar I disorder. Read more

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