Editing Bipolar I disorder

{{short description|Bipolar disorder that is characterized by at least one manic or mixed episode}}
{{Use dmy dates|date=September 2020}}
{{Infobox medical condition (new)
| name            = Bipolar disorder
| image           = 
| caption         = Graphical representation of Bipolar I, [[Bipolar II]] and [[cyclothymia]]
| symptoms        = mood instability, [[psychosis]] in some cases
| complications   = [[self harm]], 
 [[suicide]]
| onset           = 25 years of age
| duration        = 
| types           = 
| causes          = Complex
| risks           = 
| diagnosis       = 
| differential    = [[Bipolar disorder|Other bipolar disorders]], [[borderline personality disorder]], [[antisocial personality disorder]]
| prevention      = 
| treatment       = Therapy, mood stabilizing medication such as lithium
| medication      = [[Lithium (medication)|Lithium]], [[anticonvulsant]]s, [[antipsychotic]]s
| prognosis       = 
| frequency       = 
| deaths          = 15-20% die by suicide {{Citation needed|date=July 2024}}
}}

''' Bipolar I disorder''' (BD-I; pronounced "type one bipolar disorder") is a type of [[bipolar spectrum disorder]] characterized by the occurrence of at least one [[manic episode]], with or without mixed or psychotic features.<ref>{{cite web|url=http://psychcentral.com/lib/the-two-types-of-bipolar-disorder/000612|title=The Two Types of Bipolar Disorder|work=Psych Central.com|access-date=25 November 2015|archive-date=6 August 2013|archive-url=https://web.archive.org/web/20130806115733/http://psychcentral.com/lib/the-two-types-of-bipolar-disorder/000612|url-status=dead}}</ref> Most people also, at other times, have one or more [[depression (mood)|depressive]] episodes.<ref name="Bipolar Disorder: Who's at Risk?">{{cite web|title=Bipolar Disorder: Who's at Risk?|url=http://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-whos-at-risk|access-date=22 November 2011}}</ref> Typically, these 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.<ref>{{Cite web |title=Bipolar Disorder - National Institute of Mental Health (NIMH) |url=https://www.nimh.nih.gov/health/topics/bipolar-disorder |access-date=2024-03-16 |website=www.nimh.nih.gov |language=en}}</ref>

It is a type of bipolar disorder and conforms to the classic concept of manic-depressive illness, which can include [[psychosis]] during mood episodes.<ref name="What are the types of bipolar disorder?">{{cite web|title=What are the types of bipolar disorder? |url=http://www.medicinenet.com/bipolar_disorder/page2.htm#types |access-date=22 November 2011}}</ref>

==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.<ref>{{Cite journal|last1=Phillips|first1=Mary L|last2=Kupfer|first2=David J|date=2013-05-11|title=Bipolar disorder diagnosis: challenges and future directions|journal=Lancet|volume=381|issue=9878|pages=1663–1671|doi=10.1016/S0140-6736(13)60989-7|issn=0140-6736|pmc=5858935|pmid=23663952}}</ref> Often, individuals have had one or more [[major depressive episode]]s.<ref name="DepressionD">{{cite web|url=http://depressiond.org/bipolar-test/|title=Online Bipolar Tests: How Much Can You Trust Them?|publisher=DepressionD|access-date=7 January 2012}}</ref> One episode of mania is sufficient to make the diagnosis of bipolar disorder; the person may or may not have a history of [[major depressive disorder]].<ref name="DepressionD"/> Episodes of substance-induced mood disorder due to the direct effects of a [[medication]], or other [[somatic psychology|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.<ref name=":2">{{Cite book|title=Diagnostic and statistical manual of mental disorders : DSM-5.|others=American Psychiatric Association., American Psychiatric Association. DSM-5 Task Force.|isbn=978-0-89042-559-6|edition=Fifth|location=Arlington, VA|oclc=847226928|year = 2013}}</ref> 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.<ref name=":2" /> 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.<ref>{{Cite journal|last1=Khalsa|first1=Hari-Mandir K.|last2=Baldessarini|first2=Ross J.|last3=Tohen|first3=Mauricio|last4=Salvatore|first4=Paola|date=2018-08-11|title=Aggression among 216 patients with a first-psychotic episode of bipolar I disorder|journal=International Journal of Bipolar Disorders|volume=6|issue=1|pages=18|doi=10.1186/s40345-018-0126-8|issn=2194-7511|pmc=6161985|pmid=30097737 |doi-access=free }}</ref>

Bipolar I disorder often coexists with other disorders including [[Post-traumatic stress disorder|PTSD]], substance use disorders, and a variety of mood disorders.<ref name=":02">{{Cite journal|last1=Cerimele|first1=Joseph M.|last2=Bauer|first2=Amy M.|last3=Fortney|first3=John C.|last4=Bauer|first4=Mark S.|date=May 2017|title=Patients With Co-Occurring Bipolar Disorder and Posttraumatic Stress Disorder: A Rapid Review of the Literature|journal=The Journal of Clinical Psychiatry|volume=78|issue=5|pages=e506–e514|doi=10.4088/JCP.16r10897|issn=1555-2101|pmid=28570791}}</ref><ref>{{Cite journal|last1=Hunt|first1=Glenn E.|last2=Malhi|first2=Gin S.|last3=Cleary|first3=Michelle|last4=Lai|first4=Harry Man Xiong|last5=Sitharthan|first5=Thiagarajan|date=December 2016|title=Prevalence of comorbid bipolar and substance use disorders in clinical settings, 1990–2015: Systematic review and meta-analysis|journal=Journal of Affective Disorders|volume=206|pages=331–349|doi=10.1016/j.jad.2016.07.011|issn=1573-2517|pmid=27476137}}</ref>  Studies suggest that psychiatric comorbidities correlate with further impairment of day-to-day life.<ref>{{Cite journal |last1=Léda-Rêgo |first1=Gabriela |last2=Studart-Bottó |first2=Paula |last3=Sarmento |first3=Stella |last4=Cerqueira-Silva |first4=Thiago |last5=Bezerra-Filho |first5=Severino |last6=Miranda-Scippa |first6=Ângela |date=2023-02-01 |title=Psychiatric comorbidity in individuals with bipolar disorder: relation with clinical outcomes and functioning |url=http://dx.doi.org/10.1007/s00406-023-01562-5 |journal=European Archives of Psychiatry and Clinical Neuroscience |volume=273 |issue=5 |pages=1175–1181 |doi=10.1007/s00406-023-01562-5 |pmid=36725737 |s2cid=256501014 |issn=0940-1334}}</ref> Up to 40% of people with bipolar disorder also present with PTSD, with higher rates occurring in women and individuals with bipolar I disorder.<ref name=":02" /> 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.<ref>{{cite web|url=http://www.pchtreatment.com/bipolar-treatment-center/|title=Bipolar Disorder Residential Treatment Center Los Angeles|work=PCH Treatment|access-date=25 November 2015}}</ref>

===Medical assessment===
Regular medical assessments are performed to rule-out secondary causes of mania and depression.<ref name=":3" /> These tests include [[complete blood count]], [[Glucose test|glucose]], serum chemistry/electrolyte panel, [[Thyroid function tests|thyroid function test]], [[Liver function tests|liver function test]], [[Renal function|renal function test]], [[urinalysis]], [[vitamin B12]] and [[folate]] levels, [[Diagnosis of HIV/AIDS|HIV screening]], [[Syphilis serodiagnosis|syphilis screening]], and [[pregnancy test]], and when clinically indicated, an [[Electrocardiography|electrocardiogram]] (ECG), an [[Electroencephalography|electroencephalogram]] (EEG), a [[CT scan|computed tomography]] (CT scan), and/or a [[Magnetic resonance imaging|magnetic resonance imagining]] (MRI) may be ordered.<ref name=":3">{{Cite journal|last=Bobo|first=William V.|date=October 2017|title=The Diagnosis and Management of Bipolar I and II Disorders: Clinical Practice Update|journal=Mayo Clinic Proceedings|volume=92|issue=10|pages=1532–1551|doi=10.1016/j.mayocp.2017.06.022|pmid=28888714|issn=0025-6196|doi-access=free}}</ref> Drug screening includes [[recreational drug]]s, particularly [[synthetic cannabinoid]]s, and exposure to toxins.

===Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV-TR)===
{| class="wikitable"
|-
! 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 [[Psychosis|psychotic]] features, with [[Mixed affective state|mixed]] features, with [[Catatonia|catatonic]] features, with rapid cycling, with [[Anxiety disorder|anxiety]] (mild to severe), with [[Suicide risk assessment|suicide risk severity]], with [[Seasonal affective disorder|seasonal pattern]], and with [[Postpartum period|postpartum]] onset.<ref name=":03">{{Cite book|title=Diagnostic and Statistical Manual of Mental Disorders|last=American Psychiatric Association|date=2013-05-22|publisher=American Psychiatric Association|isbn=978-0-89042-555-8|doi=10.1176/appi.books.9780890425596|url-access=registration|url=https://archive.org/details/diagnosticstatis0005unse}}</ref> Bipolar I Disorder 296.5x (most recent episode depressed) will include all of the above specifiers plus the following: with [[Melancholia|melancholic]] features and with atypical features.<ref name=":03" /> The categories for specifiers will be removed in DSM-5 and criterion A will add or there are at least 3 symptoms of major [[Major depressive disorder|depression]] of which one of the symptoms is [[Depression (mood)|depressed]] mood or [[anhedonia]].<ref name=":03" /> For Bipolar I Disorder 296.7 (most recent episode unspecified), the listed specifiers will be removed.''<ref name=":03" />''

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.<ref name="ReferenceA">{{cite book|title=Issues pertinent to a developmental approach to bipolar disorder in DSM-5|publisher=American Psychiatric Association|year=2010}}</ref><ref>{{cite book|title=Diagnostic and Statistical Manual of Mental Disorders (4th ed. text revision)|year=2000|publisher=American Psychiatric Association|location=Washington, DC|pages=345–392}}</ref>

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).<ref name="ReferenceA"/>

===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

== Treatment ==

===Medication===
[[Mood stabilizer]]s are often used as part of the treatment process.<ref>{{Cite news|url=https://health.usnews.com/health-care/for-better/articles/2017-07-20/can-people-recover-from-bipolar-disorder|title=Can People Recover From Bipolar Disorder?|last=Schwartz|first=Jeremy|date=2017-07-20|work=U.S. News & World Report}}</ref>
# [[Lithium (medication)|Lithium]] is the mainstay in the management of bipolar disorder but it has a narrow [[therapeutic range]] and typically requires monitoring<ref>{{Cite journal|url=http://www.cochrane.org/CD003013/DEPRESSN_lithium-for-maintenance-treatment-of-mood-disorders|title=Lithium for maintenance treatment of mood disorders {{!}} Cochrane|journal=Cochrane Database of Systematic Reviews|doi=10.1002/14651858.CD003013|year=2001|last1=Burgess|first1=Sally SA|last2=Geddes|first2=John|last3=Hawton|first3=Keith KE|last4=Taylor|first4=Matthew J.|last5=Townsend|first5=Ellen|last6=Jamison|first6=K.|last7=Goodwin|first7=Guy|volume=2001|issue=3|pages=CD003013|pmc=7005360}}</ref>
# [[Anticonvulsant]]s, such as [[valproate]],<ref>{{Cite journal|url=http://www.cochrane.org/CD004052/DEPRESSN_valproate-for-acutre-mood-episodes-in-bipolar-disorder|title=Valproate for acutre mood episodes in bipolar disorder {{!}} Cochrane|journal=Cochrane Database of Systematic Reviews|issue=1|pages=CD004052|doi=10.1002/14651858.CD004052|pmid=12535506|year=2003|last1=MacRitchie|first1=Karine|last2=Geddes|first2=John|last3=Scott|first3=Jan|last4=Haslam|first4=D. R.|last5=Silva De Lima|first5=Mauricio|last6=Goodwin|first6=Guy}}</ref> [[carbamazepine]], or [[lamotrigine]]
# [[Atypical antipsychotic]]s, such as [[quetiapine]],<ref>{{cite journal|last1=Datto|first1=Catherine|title=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 |journal=Annals of General Psychiatry|date=11 March 2016|volume=15|pages=9 |doi=10.1186/s12991-016-0096-0 |pmid=26973704 |pmc=4788818 |doi-access=free }}</ref><ref>{{cite journal |last1=Young |first1=Allan |title=A Randomised, Placebo-Controlled 52-Week Trial of Continued Quetiapine Treatment in Recently Depressed Patients With Bipolar I And Bipolar II Disorder|journal=World Journal of Biological Psychiatry |date=February 2014 |volume=15|issue=2|pages=96–112 |doi=10.3109/15622975.2012.665177 |pmid=22404704|s2cid=2224996 }}</ref> [[risperidone]], [[olanzapine]], or [[aripiprazole]]
# [[Electroconvulsive therapy]], a psychiatric treatment in which [[seizure]]s are [[electrically]] induced in [[general anaesthesia|anesthetized]] patients for [[therapeutic effect]]

[[Antidepressant]]-induced mania occurs in 20–40% of people with bipolar disorder. Mood stabilizers, especially lithium, may protect against this effect, but some research contradicts this.<ref>{{Cite journal|last1=Goldberg|first1=Joseph F|last2=Truman|first2=Christine J|date=2003-12-01|title=Antidepressant-induced mania: an overview of current controversies|journal=Bipolar Disorders|volume=5|issue=6|pages=407–420|doi=10.1046/j.1399-5618.2003.00067.x|pmid=14636364|issn=1399-5618}}</ref>

A frequent problem in these individuals is non-adherence to pharmacological treatment; long-acting injectable antipsychotics may contribute to solving this issue in some patients.<ref>{{Cite journal|last1=Tohen|first1=Mauricio|last2=Goldberg|first2=Joseph F.|last3=Hassoun|first3=Youssef|last4=Sureddi|first4=Suresh|date=2020-06-16|title=Identifying Profiles of Patients With Bipolar I Disorder Who Would Benefit From Maintenance Therapy With a Long-Acting Injectable Antipsychotic|journal=The Journal of Clinical Psychiatry|volume=81|issue=4|doi=10.4088/JCP.OT19046AH1|issn=1555-2101|pmid=32558403|s2cid=219923839|doi-access=free}}</ref>

A review of validated treatment guidelines for bipolar disorder by international bodies was published in 2020.<ref>{{Cite journal|last1=Verdolini|first1=Norma|last2=Hidalgo-Mazzei|first2=Diego|last3=Del Matto|first3=Laura|last4=Muscas|first4=Michele|last5=Pacchiarotti|first5=Isabella|last6=Murru|first6=Andrea|last7=Samalin|first7=Ludovic|last8=Aedo|first8=Alberto|last9=Tohen|first9=Mauricio|last10=Grunze|first10=Heinz|last11=Young|first11=Allan H.|date=2020-12-22|title=Long-term treatment of bipolar disorder type I: A systematic and critical review of clinical guidelines with derived practice algorithms|url=https://pubmed.ncbi.nlm.nih.gov/33354842|journal=Bipolar Disorders|volume=23|issue=4|pages=324–340|doi=10.1111/bdi.13040|issn=1399-5618|pmid=33354842|s2cid=229693238}}</ref>

==Prognosis==
Bipolar I usually has a poor prognosis, which is associated with substance abuse, psychotic features, depressive symptoms, and inter-episode depression.<ref>{{cite web | url=https://www.ncbi.nlm.nih.gov/books/NBK558998/#article-18332.s11 | pmid=32644424 | year=2023 | last1=Jain | first1=A. | last2=Mitra | first2=P. | title=Bipolar Disorder | publisher=StatPearls }}</ref> A manic episode can be so severe that it requires hospitalization. An estimated 63% of all BP-I related mania results in hospitalization.<ref>{{cite journal | url=https://pubmed.ncbi.nlm.nih.gov/14596627/ | pmid=14596627 | year=2003 | last1=De Zelicourt | first1=M. | last2=Dardennes | first2=R. | last3=Verdoux | first3=H. | last4=Gandhi | first4=G. | last5=Khoshnood | first5=B. | last6=Chomette | first6=E. | last7=Papatheodorou | first7=M. L. | last8=Edgell | first8=E. T. | last9=Even | first9=C. | last10=Fagnani | first10=F. | title=Frequency of hospitalisations and inpatient care costs of manic episodes: In patients with bipolar I disorder in France | journal=Pharmacoeconomics | volume=21 | issue=15 | pages=1081–1090 | doi=10.2165/00019053-200321150-00002 | s2cid=41439636 }}</ref> The natural course of BP-I, if left untreated, leads to episodes becoming more frequent or severe over time.<ref>{{cite web | url=https://www.treatmentadvocacycenter.org/evidence-and-research/learn-more-about/463-bipolar-disorder-fact-sheet | title=Bipolar Disorder – Fact Sheet }}</ref> The absolute risk of suicide is highest for BP-I, than any other mood and mental disorders. <ref>{{cite web | url=https://www.nature.com/articles/s41380-025-02887-4 | title=Risk of suicide and all-cause death in patients with mental disorders: a nationwide cohort study }}</ref> Up to a quarter of individuals with BP-I die by suicide. <ref>{{cite web | url=https://pmc.ncbi.nlm.nih.gov/articles/PMC6723289/#B2-medicina-55-00403 | title=Suicide Risk in Bipolar Disorder: A Brief Review }}</ref> With proper treatment, individuals with BP-I can, however, lead a healthy lifestyle.<ref>{{cite web | url=https://www.samhsa.gov/serious-mental-illness/bi-polar | title=Living Well with Bipolar Disorder | date=7 May 2019 }}</ref>

===Education===
Psychosocial interventions can be used for managing acute depressive episodes and for maintenance treatment to aid in relapse prevention.<ref name=":0" /> This includes [[psychoeducation]], [[Cognitive behavioral therapy|cognitive behavioural therapy]] (CBT), family-focused therapy (FFT), [[interpersonal and social rhythm therapy]] (IPSRT), and [[peer support]].<ref name=":0">{{Cite journal|last1=Yatham|first1=Lakshmi N.|last2=Kennedy|first2=Sidney H.|last3=Parikh|first3=Sagar V.|last4=Schaffer|first4=Ayal|last5=Bond|first5=David J.|last6=Frey|first6=Benicio N.|last7=Sharma|first7=Verinder|last8=Goldstein|first8=Benjamin I.|last9=Rej|first9=Soham|last10=Beaulieu|first10=Serge|last11=Alda|first11=Martin|date=2018|title=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|journal=Bipolar Disorders|volume=20|issue=2|pages=97–170|doi=10.1111/bdi.12609|issn=1399-5618|pmc=5947163|pmid=29536616}}</ref>

Information on the condition, importance of regular sleep patterns, routines and eating habits and the importance of [[medication compliance|compliance with medication]] as [[medical prescription|prescribed]]. [[Behavior modification]] through [[mental health counselor|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%.<ref>{{Cite journal|last1=Merikangas|first1=Kathleen R.|author-link=Kathleen Merikangas|last2=Akiskal|first2=Hagop S.|last3=Angst|first3=Jules|last4=Greenberg|first4=Paul E.|last5=Hirschfeld|first5=Robert M.A.|last6=Petukhova|first6=Maria|last7=Kessler|first7=Ronald C.|date=1 May 2007|title=Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication|journal=Archives of General Psychiatry|volume=64|issue=5|pages=543–552|doi=10.1001/archpsyc.64.5.543|issn=0003-990X|pmc=1931566|pmid=17485606}}</ref>

== See also ==
{{Portal|Psychiatry|Psychology|Medicine}}
<!-- Please keep entries in alphabetical order & add a short description [[WP:SEEALSO]] -->
{{div col|colwidth=20em|small=yes}}
* [[List of people with bipolar disorder]]
* [[Outline of bipolar disorder]]
* [[Bipolar disorder]]
* [[Bipolar disorders research]]
* [[Bipolar II disorder]]
* [[Cyclothymia]]
* [[Bipolar NOS]]
* [[Borderline personality disorder]]
* [[Creativity and bipolar disorder]]
* [[DSM-IV codes#Bipolar disorders|Detailed listing of DSM-IV-TR bipolar disorder diagnostics codes]]
* [[Emotional dysregulation]]
* [[International Society for Bipolar Disorders]]
* [[Kleine–Levin syndrome]]
* [[Major depressive disorder]]
* [[Racing thoughts]]
* [[Seasonal affective disorder]]
{{div col end}}
<!-- please keep entries in alphabetical order -->

==References==
{{reflist}}

{{Medical resources
|  DiseasesDB = 
|  ICD11 = {{ICD11|6A60}}
|  ICD10 = {{ICD10|F31.9}}
|  ICD9 = {{ICD9|296.7}} 
|  ICDO = 
|  OMIM = 
|  MedlinePlus = 
|  eMedicineSubj = 
|  eMedicineTopic = 
|  MeshID =
}}

{{Bipolar disorder}}

[[Category:Bipolar spectrum]]
[[Category:Depression (mood)]]
[[Category:Mood disorders]]
[[Category:Psychotherapy]]
[[Category:Psychiatry]]