Editing Seasonal affective disorder (section)

===Bipolar disorder===
''With seasonal pattern'' is a specifier for ''bipolar and related disorders'', including bipolar I disorder and bipolar II disorder.<ref name="DSM-5-Bipolar and related disorders"/>
Most people with SAD experience [[major depressive disorder]], but as many as 20% may have a [[bipolar disorder]]. Bipolar disorder is characterized by alternating episodes of depression and mania or hypomania. Depressive episodes include symptoms such as low energy, difficulty concentrating, changes in sleep and appetite, feelings of hopelessness, and suicidal thoughts. Manic episodes, which are more common in bipolar I disorder, may include elevated mood, decreased need for sleep, impulsivity, and increased activity or risky behaviors. In contrast, hypomania (seen in bipolar II disorder) presents as a milder form of mania without significant impairment in daily life. <ref>{{Cite web |title=Bipolar Disorders |url=https://www.psychiatry.org/Patients-Families/Bipolar-Disorders |access-date=2025-04-03 |website=www.psychiatry.org |language=en}}</ref> It is important to distinguish between diagnoses because there are important treatment differences.<ref>{{cite web |url= http://www.mooddisorderscanada.ca/documents/Consumer%20and%20Family%20Support/Depression.pdf |title= Depression |access-date= August 8, 2009 |publisher= Mood Disorders Society of Canada |archive-date= July 6, 2011 |archive-url= https://web.archive.org/web/20110706185913/http://www.mooddisorderscanada.ca/documents/Consumer%20and%20Family%20Support/Depression.pdf |url-status= dead }}</ref> In these cases, people who have the ''With seasonal pattern'' specifier may experience a depressive episode either due to major depressive disorder or as part of bipolar disorder during the winter and remit in the summer.<ref name="DSM-5-Bipolar and related disorders"/> Around 25% of patients with [[bipolar disorder]] may present with a depressive seasonal pattern, which is associated with bipolar II disorder, rapid cycling, eating disorders, and more depressive episodes.<ref name="Geoffroy-2013">{{cite journal | vauthors = Geoffroy PA, Bellivier F, Scott J, Boudebesse C, Lajnef M, Gard S, Kahn JP, Azorin JM, Henry C, Leboyer M, Etain B | title = Bipolar disorder with seasonal pattern: clinical characteristics and gender influences | journal = Chronobiology International | volume = 30 | issue = 9 | pages = 1101–7 | date = November 2013 | pmid = 23931033 | pmc = 5225270 | doi = 10.3109/07420528.2013.800091 }}</ref> Differences in biological sex display distinct clinical characteristics associated to seasonal pattern: males present with more Bipolar II disorder and a higher number of depressive episodes, and females with rapid cycling and eating disorders.<ref name="Geoffroy-2013"/>