Bipolar disorder is diagnosed with a good anamnesis. Family history is questioned in diagnosis. Some patients may have tests for additional diseases, such as thyroid tests.

Bipolar disorder, manic-depressive illness, or bipolar disorder 

Diagnosis of bipolar disorder: 

Bipolar disorder is diagnosed with a good anamnesis. Family history is questioned in diagnosis. Some patients may have tests for additional diseases, such as thyroid tests.

Illness is the area of interest of the psychiatry specialty.

Diagnostic criteria for manic episode: 

  • Mood change lasting at least one week (excitement, irritability, elevation)
    • At least three of the following (four if the mood is irritable);
    • Sense of grandeur, increased self-esteem,
    • Decreased need for sleep,
    • Don’t talk too much, babble,
    • Flight of ideas,
    • Distractibility,
    • Increase in purposeful efficiency,
    • Excessive interest in activities that give pleasure, participation, risk taking,
  • There should not be a mixed period.
  • The functionality must be impaired.
  • Symptoms should not be due to a substance abuse or other illness.

Diagnostic criteria for the hypomanic episode: 

  • Mood changes lasting at least four days (excitement, irritability, elevation)
  • At least three of the following (four if the mood is irritable);
    • Sense of grandeur, increased self-esteem,
    • Decreased need for sleep,
    • Do not talk too much,
    • Flight of ideas,
    • Distractibility,
    • Increase in purposeful efficiency,
    • Excessive interest in activities that give pleasure, participation, risk taking,
  • There is no significant impairment in functionality, no need for hospitalization, and no psychotic symptoms inconsistent with the patient’s character.
  • Mood and function changes are observable by others.
  • Symptoms should not be due to a substance abuse or other illness.

Diagnostic criteria for the depression episode: 

  • Presence of at least five of the following for at least two weeks;
    • Depressive temperament,
    • Decreased interest-desire,
    • Decreased or increased appetite
    • Decreased or increased sleep
    • Psychomotor retardation or agitation
    • Decreased energy, fatigue,
    • Guilt, feelings of worthlessness,
    • Difficulty concentrating,
    • Suicidal tendency,
  • There should not be a mixed period.
  • The functionality must be impaired.
  • Symptoms should not be due to a substance abuse or other illness.
  • The symptoms cannot be explained by a bereavement situation.

Diagnostic criteria for the mixed period: 

  • Diagnostic criteria for manic and depressive episodes for at least one week have been met
  • The functionality must be impaired.
  • Symptoms should not be due to a substance abuse or other illness.

Bipolar disorder treatment: 

Bipolar disease is a disease that requires careful follow-up and treatment because of the problems it causes in family, work, school, social life, economic losses, and more importantly, the risk of suicide.



In the manic phase of the illness, the patient may not seek treatment or may discontinue ongoing treatment because he or she feels very good and full of energy. This is a significant risk for the treatment of the disease. It should be ensured that the patients continue the treatment in this period in terms of the effectiveness of the treatment.

The depression period of the disease can sometimes be confused with Major Depression Disease. Depression treatment processes in both diseases differ. Differential diagnosis should be done well.

Early diagnosis of the disease and early initiation of treatment are beneficial in terms of treatment options.

In acute manic attacks, taking safety precautions for the patient is as important as drug treatment. Risky behaviors should be controlled and environmental safety should be ensured.

Basic principles of treatment: 

  • The definitive diagnosis of the disease should be made and the treatment should be planned accordingly.
  • Depending on the severity, type and type of attacks, inpatient or outpatient treatment options are decided.
  • The patient’s safety or suicide risks are evaluated, and if necessary, information is obtained from family, relatives, classmates and colleagues.
  • The patient’s treatment should be followed and compliance should be evaluated.
  • Education should be given to the patient and his family.
  • In addition to the treatment of acute attacks, it should be ensured that preventive treatment is continued between attacks.
  • During the treatment process, the functionality of the patient is evaluated and aimed to be corrected.

Treatment options: 

  • Medication: Mood stabilizers (lithium) are used in attacks. In addition, benzodiazepines and antipsychotics can be added to the treatment. The choice of drug depends on the type of attack of the patient. Valproate can be given in mixed and psychotic episodes.
  • ECT (Electro-convulsive therapy): It can be used especially in drug-resistant cases and pregnant women.
  • Psychotherapy: Under the supervision of an experienced and expert psychiatrist and psychologist, psychotherapy can be applied in addition to drug therapy. It helps to reduce the negative effects of past traumas, if any. It helps to improve relations with family members, friends, colleagues and schoolmates.
  • Regulation of education and living habits : The patient and his family are informed about the disease, attacks and triggers. Regular exercise, doing pleasant activities, rearranging the diet and sleep patterns are provided. Alcohol and drugs should be avoided.



Tags: