Bipolar disorder or Manic-Depressive Disorder is a mental disorder characterised by wide mood swings from high (manic) to low (depressed) states. When the patient becomes hyperactive, and irritable, he is in the manic extreme of this condition.

Classically, he can have delusions of grandeur and go on expensive spending sprees. He can also be uninhibited in his expressions and sexual advances.

Symptoms

The manic phase is characterised by:

• Delusions (false beliefs) or hallucinations (false perceptions)
• Hyperactivity
• Irritable mood
• Decreased need for sleep
• Exaggerated, puffed-up self esteem
• Rapid or "pressured" speech
• Rapid thoughts
• Poor attention span
• Recklessness

During a depressive period, symptoms may include:

• Appearing slow or agitated
• Fatigue and loss of energy
• Feelings of worthlessness or guilt
• Poor concentration
• Indecisiveness
• Low or irritable mood
• Loss of interest
• Increased or decreased weight and appetite
• Increased or decreased sleep
• Plans of death, suicide attempts

Treatment

A combination of medication and psychotherapy is most helpful.

The class of medications known as mood stabilizers is the primary treatment. Lithium is widely used and is very effective for the treatment of manic episodes and for the prevention of their recurrence. Blood levels of lithium must be checked regularly to prevent harmful levels of accumulation.

Psychotherapy to provide education and support is important too, and helps the patient come to terms with the illness.