Sky-high-cheerful, saddened to death: bipolar clinical pictures.

When phases of dejection intersect with phases of euphoria, euphoria, hyperactivity, restlessness and overconfidence, a manic-depressive (so-called manic-depressive (so-called bipolar) disorder may be present.

The phasic alternation of a depressed, depressive mood and an elevated, euphoric mood is referred to as bipolar, manic-depressive disorder, or cyclothymia, depending on its severity.  

It often takes a considerable amount of time before a diagnosis of so-called bipolar disorder is made. Sometimes a patient first experiences a depressive phase three to four times and only then a manic phase, so that initially everything points to depression. Only when mania also occurs does bipolarity become apparent.1

The causes of this form of the disease are still largely unknown. A genetic component is assumed. A disturbance in brain metabolism is detectable in affected patients. The disease or a new episode can be triggered by emotional stressful experiences of a positive or negative nature. Disturbances in the sleep-wake rhythm also have a negative effect in genetically predisposed individuals and can trigger the onset of a new episode of the disease.  

If the mania is very strong, symptoms of psychosis may also occur. This can manifest itself as persecution mania, but also as megalomania. How pronounced the individual episodes are and in what sequence they occur varies from person to person.

Specialist treatment, primarily medication but also psychotherapy, is required for all forms of bipolar disorder.

Many patients also have other psychological complaints such as anxiety, obsessive-compulsive and addictive disorders or attention deficit hyperactivity disorder (ADHD).

Alternating mood swings of lesser severity are referred to as cyclothymia. The euphoric phases are not as pronounced and are referred to as hypomania. The episodes of depressed mood are similar to depressive moodiness.

In Germany, between one and three percent of the population suffers from bipolar disorder. It usually begins in adolescence or young adulthood.1