BIPOLAR DISORDER (MANIC-DEPRESSIVE ILLNESS)
Bipolar disorder is a chronic and severe mental illness, characterized by recurrent manic and depressive episodes. In about 10% of patients, the episodes are exclusively manic; however, the condition is still classified as bipolar disorder.
It most commonly appears towards the end of the second decade of life, though onset can occur at any age.
After the resolution of the first episode, the patient typically remains euthymic for a long period. However, after the second episode, these periods of stability usually become shorter. As the illness progresses and with increasing age, residual symptoms often persist between episodes.
It most commonly appears towards the end of the second decade of life, though onset can occur at any age.
After the resolution of the first episode, the patient typically remains euthymic for a long period. However, after the second episode, these periods of stability usually become shorter. As the illness progresses and with increasing age, residual symptoms often persist between episodes.
Manic Episode
According to the DSM-5 criteria, a manic episode is defined as a distinct period of abnormally elevated or irritable mood, lasting at least one week (or less if hospitalization is required).
Key features include:
These symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Hypomanic Episode
Hypomania refers to a milder elevation of mood, often accompanied by irritability and increased activity or energy.
It is typically shorter in duration (at least 4 consecutive days) and less disruptive than a manic episode.
Depressive Episode
The depressive episode presents symptoms similar to major depressive disorder, including:
These symptoms also cause clinically significant distress or functional impairment.
Treatment
Management of bipolar disorder includes:
At the Agia Irini Psychiatric Clinic in Drama, treatment focuses on evidence-based pharmacological interventions combined with psychosocial support, helping patients and their families navigate the challenges of this complex disorder.
According to the DSM-5 criteria, a manic episode is defined as a distinct period of abnormally elevated or irritable mood, lasting at least one week (or less if hospitalization is required).
Key features include:
- Grandiosity or inflated self-esteem
- Decreased need for sleep (feels rested after only 3–4 hours of sleep)
- Increased talkativeness or pressure to keep talking
- Flight of ideas or racing thoughts
- Distractibility (attention easily drawn to irrelevant stimuli)
- Increase in goal-directed activity or psychomotor agitation
- Excessive involvement in high-risk activities (e.g., reckless spending, risky sexual behavior, impulsive investments)
These symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Hypomanic Episode
Hypomania refers to a milder elevation of mood, often accompanied by irritability and increased activity or energy.
It is typically shorter in duration (at least 4 consecutive days) and less disruptive than a manic episode.
Depressive Episode
The depressive episode presents symptoms similar to major depressive disorder, including:
- Persistent depressed mood (feeling sad, empty, or hopeless)
- Loss of interest or pleasure (anhedonia) in almost all activities
- Changes in appetite or weight (loss or gain)
- Sleep disturbances (insomnia or hypersomnia)
- Psychomotor agitation or retardation observable by others
- Fatigue or loss of energy
- Feelings of worthlessness or excessive guilt
- Diminished ability to think, concentrate, or make decisions
- Recurrent thoughts of death, suicidal ideation, attempt, or plan
These symptoms also cause clinically significant distress or functional impairment.
Treatment
Management of bipolar disorder includes:
- Pharmacotherapy: mood stabilizers (e.g., lithium, anticonvulsants), antipsychotics, benzodiazepines, or combination therapies
- Psychoeducation: for patients and families to enhance understanding and adherence
- Supportive psychotherapy
- Group therapy
At the Agia Irini Psychiatric Clinic in Drama, treatment focuses on evidence-based pharmacological interventions combined with psychosocial support, helping patients and their families navigate the challenges of this complex disorder.
