Bipolar disorder, often referred to as manic-depressive disorder strikes the young and old and is a lifelong problem. The mood swings that are seen during the disorder are  the extremes which include the highs called “manic” phase and the lows called “depressive” phase. The two different phases are two distinct moods which vary in thought, action, energy and behavior.

Bipolar disorder affects millions of people and the diagnosis involves proper recognition. Bipolar disorders are classified into four different types to make it easy for treatment. They are Bipolar I, Bipolar II, Cyclothymia and Bipolar NOS. (NOS –Not otherwise specified).

Broadly speaking, the manic phase could also have a milder version called hypomania. The depression state could be replaced with a mixed episode. Mixed episode refers to the presence of both manic and depressive moods at the same time. This is characterized by high energy levels (as seen during the manic phase) but low mood levels (as seen in a depressive phase). 

The Diagnostic and Statistical Manual of Mental Disorders (DSM) version IV is published by the American Psychiatric Association.  It provides the various criteria for diagnosing mental disorders. The criterion given by DSM is the fundamental frame work of the disorder and is used by clinicians, researchers, drug regulation companies and pharmaceutical companies.

Following is the essential feature of the Bipolar I disorder – there should be one manic or mixed episode. It is to be noted that depressive episode is not the requirement but usually it occurs. Certain substances like cocaine when consumed results in a manic phase which cannot be considered. In some cases, medication for depression could also trigger a manic phase which cannot be considered.

An occurrence of at least one manic episode, or if the most recent episode is hypomanic or if   the last episode showed manic symptoms or the latest episode shows mixed episodes or the latest episode shows depression or an unspecified episode, they should be tested if they have to be treated for Bipolar I.

Diagnostic tests are conducted also to rule out the somatic causes. Also, since these symptoms match with schizoaffective disorders, they are ruled out. Ultra sounds of  head, EEG, CAT scans, thyroid test, liver function tests and screening for drugs are some of the prescribed test for Bipolar I.

The mood disorder is treatable when diagnosed correctly through mood stabilizing drugs and therapy. Medication includes mood stabilizing drugs like Lithium Carbonate, anticonvulsants like Sodium Evaporate, antipsychotics and sometimes electroconvulsive (shock) therapy (ETC) for the extreme cases.

Along with the above, the patient is thoroughly educated about the need for regular sleep, good health habits and relaxation. Counseling tends to give a positive impact.

Bipolar I can thus be treated to yield positive results.