Bipolar disorder is classically described as a psychiatric condition defined by extreme mood swings.  These mood swings can range from severe, debilitating depression to severe, uncontrollable mania.  The symptoms associated with bipolar disorder have a tendency, over time, to worsen with or without treatment.  Many subclassifications of bipolar have been defined; subclassifications are categorized based upon the duration of the different phases and both the intensity and duration of the accompanied mood swings.  Additionally, other types of bipolar behavior are found in several other disorders.

Bipolar disorder was formerly known as Manic-Depressive disorder.  Manic-Depressive disorder is a more accurate term, but, in recent times, has become a politically incorrect term.  The term bipolar disorder sounds like it refers to less severe and more acceptable disorder than does Manic-Depressive disorder.  The connotation of being either manic or depressed sounds almost as if the patient is ready to be admitted to a mental health facility.  Often unwilling to be diagnosed or labeled with such a condition, the patient is less likely to seek medical care.  The newer term, bipolar disorder, does not sound as severe, and, for that reason, is a more acceptable diagnosis for the patient.  With a more acceptable term for the condition, the patient is often more willing to accept the diagnosis, and begin taking medication for the disorder.  In many cases, however, what is diagnosed to be bipolar disorder is nothing more than a normal response to everyday life.  By changing the name of the disorder, the diagnosis rate of the disorder has increased, subsequently resulting more people supposedly needing treatment.

Whereas bipolar disorders have an energetic or euphoric stage and a separate and distinct depressive stage, depression is characterized by only a depressive stage, and is sometimes called unipolar depression.  It has been postulated that bipolar disorder and unipolar depression are different expressions of the same disorder.  Since neurotransmission and mood are involved in both depression and bipolar disorder, this would lead us to believe that both disorders, at least to some degree, have some common basis.  However, the depressive phase of bipolar disorder, when examined closely, has no true resemblance to classical depression.  The drugs used in the treatment of depression are often used in the depressive stage of bipolar disorder, and have little long term benefit in correcting the bipolar condition.

Many theories suggest various causes of bipolar disorder.  Both physiological and social causes are often cited.  No specific laboratory tests lead to the diagnosis of bipolar disorder.  Laboratory tests, however, are often performed specifically to identify or rule out any potential illnesses or disorder that may have the same symptoms of bipolar disorder.  When no other satisfactory cause can be found, the diagnosis of bipolar disorder is assigned.  The diagnosis of bipolar disorder is a diagnosis of exclusion, based purely on patient history and current subjective complaints.  A diagnosis of exclusion is often suggestive of another undiagnosed underlying cause.

Bipolar disorder appears to have, to some degree, a genetic basis.  Psychological factors also have been shown to play a role.  Bipolar disorder is classified based upon the severity of the alternating manic and depressive phases, and the time between episodes.  Certain criteria must be present for each classification, and when the criteria are met, a more refined diagnosis is assigned by the physician.  In cases when the diagnostic criteria cannot be met, Bipolar Disorder NOS (Not Otherwise Specified) is put forth as the diagnosis.  Bipolar Disorder NOS is technically a second level of an exclusionary diagnosis, which is effectively the equivalent of telling the patient that no one has any idea what is wrong.

Treatment from a traditional psychological approach involves recognizing triggers and alleviating acute symptoms through counseling.  Traditional allopathic treatment of bipolar disorder involves long term treatment using mood stabilization drugs.  Lithium is the most commonly used drug for this purpose.  Although Lithium has been used in bipolar disorder for many years, its exact mechanism of action is unknown.  Antipsychotic medications have been used for acute, uncontrollable manic phases.  Antidepressants have been used during acute depressive stages, including monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants.  A significant known problem with the use of medications for bipolar disorder is that the dosage needs to be adjusted quite often.  Rarely will the same dosage be effective for any extended period.  More common is that additional medications must be added periodically to maintain stability of the patient.

A question arises of why the same neurons located in the same brain of the same person with bipolar disorder are sometimes in a hyperactive state, yet at other times appear to be in a depressed state.  Since neurons are not dynamically created and destroyed on an as needed basis, the answer must lie outside the actual physical neuronal connections of the brain.  Since the same neuronal structure is present in both phases of the disorder, the answer will be found in how these neurons communicate to each other.  We can conclude that, since neurons communicate with each other through neurotransmitters, some aberration of neurotransmission or imbalance in neurotransmitters must be responsible for the disorder.