Overview of bipolar disorder
<p>Bipolar disorder, previously known as manic-depressive illness, is a mental health condition characterised by extreme mood swings that go beyond normal fluctuations in mood. These mood swings typically involve episodes of mania or hypomania and depression. The condition affects approximately 2.6% of the adult population worldwide.</p><p>Bipolar disorder is classified into several subtypes, including bipolar I disorder, bipolar II disorder, cyclothymic disorder, substance/medication-induced bipolar and related disorder, bipolar and related condition due to another medical condition, and other specified and unspecified bipolar and related disorders. Each subtype is distinguished by the duration, frequency, and severity of the mood episodes, as well as the presence or absence of psychotic symptoms.</p>
What is bipolar disorder?
<p>The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision, (DSM-5-TR) notes that bipolar and related disorders are found between the chapters on schizophrenia spectrum and other psychotic disorders and depressive disorders in the DSM in recognition of their place as a bridge between those two diagnostic classes in terms of symptomatology, family history, and genetics.</p><p>Bipolar and related disorders are a group of mood disorders that involve manic or hypomanic episodes, with or without major depressive episodes. Manic episodes are defined as distinct periods of abnormally and persistently elevated, expansive, or irritable mood, lasting at least one week or requiring hospitalisation. Hypomanic episodes are similar but less severe than manic episodes and do not cause marked impairment in social or occupational functioning; they do not necessitate hospitalisation. Major depressive episodes involve persistent feelings of sadness, hopelessness, or loss of interest in activities for at least two weeks.</p><p>The DSM-5-TR recognises three primary subtypes of bipolar disorder: bipolar I disorder, bipolar II disorder, and cyclothymic disorder. Bipolar I disorder is characterised by one or more manic or mixed episodes, with or without major depressive episodes. Bipolar II disorder is characterised by one or more major depressive episodes and at least one hypomanic episode, but never a manic episode. Cyclothymic disorder is characterised by numerous periods of hypomanic and depressive symptoms, but these symptoms do not meet the criteria for a full manic or depressive episode.</p><p>The DSM-5-TR also recognises: substance/medication-induced bipolar and related disorder, bipolar and related disorder due to another medical condition, other specified bipolar and related disorders, and unspecified bipolar and related disorders for cases that do not meet the full criteria for any of the specific bipolar disorder subtypes above. These other specified and unspecified bipolar and related disorders are classified based on the severity, frequency, and duration of mood episodes, as well as the presence or absence of psychotic symptoms.</p>
What are the symptoms of bipolar disorder?
<p>Bipolar disorder is a mental health condition that is characterised by episodes of mania or hypomania and depression. The symptoms of bipolar disorder can vary widely between individuals and can also change over time. Here are some of the common symptoms associated with each type of episode:</p><p>Manic episode:</p><ul><li>Elevated or irritable mood</li><li>Grandiosity or inflated self-esteem</li><li>Decreased need for sleep</li><li>Increased energy and activity</li><li>Racing thoughts</li><li>Impulsivity and risk-taking behaviour</li><li>Distractibility</li><li>Poor judgment</li><li>Agitation or irritability</li><li>Psychotic symptoms such as delusions or hallucinations (in severe cases)</li></ul><p>Hypomanic episode:</p><ul><li>Similar symptoms as a manic episode, but less severe and not causing significant impairment in functioning</li></ul><p>Depressive episode:</p><ul><li>Persistent feelings of sadness, hopelessness, or emptiness</li><li>Loss of interest or pleasure in activities</li><li>Fatigue or loss of energy</li><li>Difficulty concentrating, remembering, or making decisions</li><li>Changes in appetite and weight</li><li>Changes in sleep patterns (insomnia or oversleeping)</li><li>Feelings of worthlessness, guilt, or self-blame</li><li>Suicidal thoughts or behaviours</li></ul><p>Some people with bipolar disorder may experience a mixed episode, which involves symptoms of both mania and depression. In a mixed episode, a person may feel depressed but also have symptoms such as restlessness, agitation, or racing thoughts.</p><p>Some individuals with bipolar disorder may experience periods of stable mood and functioning between episodes. However, others may have chronic or rapid cycling mood episodes, which involve four or more episodes of mania, hypomania, or depression within a 12-month period.</p><p>It is also worth mentioning that the symptoms of bipolar disorder can be similar to those of other mental health conditions, such as major depressive disorder, anxiety disorders, and schizophrenia. Therefore, those experiencing any of the above symptoms should seek a professional diagnosis and treatment.</p>
How to diagnose bipolar disorder
<p>Bipolar disorder is typically diagnosed by a mental health professional, such as a psychiatrist or psychologist, using a combination of clinical assessment, medical history, and diagnostic criteria.</p><p>The diagnostic criteria for bipolar disorder are outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision (DSM-5-TR), which is published by the American Psychiatric Association. According to the DSM-5-TR, the diagnosis of bipolar disorder requires the presence of one or more episodes of mania or hypomania, with or without major depressive episodes.</p><p>To make a diagnosis of bipolar disorder, a mental health professional will typically conduct a comprehensive evaluation, which may include:</p>
Note that bipolar disorder can be a complex condition to diagnose, as it can be confused with other mental health conditions, such as major depressive disorder, anxiety disorders, and schizophrenia. Therefore, those experiencing any symptoms of bipolar disorder should seek a professional diagnosis.
Common treatment approaches for bipolar disorders
<p>Bipolar disorder is a complex mental health condition that requires a comprehensive and individualised treatment plan. Treatment for bipolar disorder usually involves a combination of medication, psychotherapy, and lifestyle changes. Here are some common treatments:</p>
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Medication
Medication is typically the first-line treatment for bipolar disorder. Mood stabilisers such as lithium and anticonvulsants such as valproic acid or carbamazepine are commonly used to manage mood episodes. Atypical antipsychotics such as olanzapine, quetiapine, risperidone, and aripiprazole may also be prescribed to manage symptoms of mania or depression. Sometimes antidepressants may also be used, but with caution as they can trigger manic episodes in some people.
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Psychotherapy
Psychotherapy, or talk therapy, can help individuals with bipolar disorder learn coping skills and strategies for managing their symptoms. Cognitive-behavioural therapy (CBT) is a common type of therapy that can help individuals identify negative thoughts and behaviours and learn how to replace them with more positive ones. Interpersonal and social rhythm therapy (IPSRT) may also be used to help stabilise daily routines and sleep patterns.
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Lifestyle changes
Lifestyle changes can help manage symptoms of bipolar disorder. A regular sleep schedule, a healthy diet, regular exercise, and stress reduction techniques like yoga or mindfulness meditation can help stabilise mood and manage symptoms.
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Support groups
Support groups can be a valuable resource for individuals with bipolar disorder. These groups can provide a sense of community and support and help individuals learn from others who have experienced similar challenges.
Best practice treatment guides for bipolar disorder
These guidelines are regularly updated as new evidence emerges, and can provide valuable guidance for mental health professionals in the diagnosis and treatment of bipolar disorder.
There are several evidence-based treatment guidelines for bipolar disorder that mental health professionals can use to inform their practice. Here are some of the most widely recognised guidelines:
American Psychiatric Association (APA) Practice Guidelines for the Treatment of Bipolar Disorder 
This guideline provides recommendations for the pharmacological and psychosocial treatments of bipolar disorder based on the best available evidence. It includes guidance on the diagnosis and assessment of bipolar disorder, as well as the selection and management of medication and psychotherapy.
National Institute for Health and Care Excellence (NICE) Guideline for Bipolar Disorder
This guideline provides recommendations for the assessment, treatment, and management of bipolar disorder in adults, children, and young people. It includes guidance on the diagnosis, pharmacological and psychological interventions, and management of comorbidities.
Canadian Network for Mood and Anxiety Treatments (CANMAT) Guidelines for the Management of Patients with Bipolar Disorder
This guideline provides recommendations for the pharmacological and psychosocial treatment of bipolar disorder, based on the best available evidence. It includes guidance on the diagnosis and assessment of bipolar disorder, as well as the selection and management of medication and psychotherapy.
The British Association for Psychopharmacology (BAP) Consensus Statement on Evidence-Based Treatment of Bipolar Disorder
This guideline provides recommendations for the pharmacological and psychosocial treatment of bipolar disorder based on the best available evidence. It includes guidance on the management of acute manic, hypomanic, and depressive episodes, as well as the maintenance treatment of bipolar disorder.
World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders:
This guideline provides recommendations for the pharmacological treatment of bipolar disorder based on the best available evidence. It includes guidance on the management of acute and maintenance treatment of bipolar disorder, as well as the use of combination and adjunctive treatments.
Common comorbidities with bipolar disorder
Bipolar disorder is often associated with comorbidities, which can complicate diagnosis and treatment. Here are some of the common comorbidities with bipolar disorder:
These comorbidities can vary widely between individuals and may require specific treatment approaches in addition to those for bipolar disorder. Therefore, it is important for mental health professionals to be aware of the potential for comorbidity in individuals with bipolar disorder and to screen for these conditions as part of the diagnostic process.
MHA courses on bipolar disorder
<ul><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/diagnosing-bipolar-disorders'>Diagnosing Bipolar Disorders</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/the-psychopharmacology-of-bipolar-depression'>The Psychopharmacology of Bipolar Depression</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/creativity-and-suicide-prevention-a-healing-journey'>Creativity & Suicide Prevention: A Healing Journey</a></li></ul>
Frequently asked questions about bipolar disorder
What strategies can a patient use to manage their bipolar disorder in daily life?
<p>Individuals with bipolar disorder can manage their symptoms and improve their quality of life by implementing various strategies in their daily life. Here are some strategies that can help:</p><ol><li><em>Stick to a routine</em>: Maintaining a consistent daily routine, including regular sleep and wake times, can help stabilise mood and prevent mood swings.</li><li><em>Exercise regularly</em>: Regular exercise can improve mood, reduce stress, and improve overall physical health.</li><li><em>Practice stress management</em>: Stress can trigger mood episodes, so it's important to develop stress-management techniques like meditation, yoga, or deep breathing.</li><li><em>Avoid drugs and alcohol</em>: Substance use can trigger or worsen mood episodes and interfere with medication effectiveness.</li><li><em>Develop a support network</em>: Family, friends, and mental health professionals can provide support and help manage symptoms.</li><li><em>Monitor mood</em>: Tracking mood changes can help individuals identify triggers and recognise the onset of mood episodes.</li><li><em>Take medication as prescribed</em>: Medication can help manage mood symptoms and prevent relapse. It's important to take medication as prescribed and to report any side effects to the prescribing healthcare provider.</li><li><em>Seek help early</em>: If symptoms are worsening or interfering with daily life, it's important to seek help from a mental health professional as soon as possible.</li><li><em>Educating oneself and one’s loved ones</em>: Learning about bipolar disorder can help people understand their symptoms, recognise triggers, and develop coping strategies. Educating loved ones can also help them understand the condition and provide support.</li></ol><p>Note that the strategies that work for one person may not work for another, so it's necessary to find what works best in each individual case. Working with a mental health professional can help the client identify the strategies that will be most effective for them.</p>
What therapeutic approaches are most effective in treating patients with bipolar disorder?
<p>Several therapeutic approaches have been found to be effective in treating individuals with bipolar disorder. The most effective therapeutic approaches for bipolar disorder usually involve a combination of pharmacotherapy and psychotherapy. Here are some common approaches for the condition:</p><ol><li><em>Cognitive-behavioural therapy (CBT)</em>: CBT is a type of psychotherapy that focuses on changing negative patterns of thought and behaviour. CBT has been found to be effective in reducing the frequency and severity of mood episodes and improving functioning in individuals with bipolar disorder.</li><li><em>Interpersonal and social rhythm therapy (IPSRT):</em> IPSRT is a type of psychotherapy that focuses on stabilising daily routines, such as sleep, meal times, and exercise, to help regulate mood and prevent mood episodes.</li><li><em>Family-focused therapy (FFT):</em> FFT is a type of psychotherapy that involves family members in the treatment process to improve communication and problem-solving skills, and to reduce stress and conflict within the family.</li><li><em>Group therapy</em>: Group therapy can provide a supportive environment where individuals with bipolar disorder can share their experiences and learn coping skills from others who have similar challenges.</li><li><em>Mindfulness-based interventions</em>: Mindfulness-based interventions, such as mindfulness-based cognitive therapy (MBCT) or mindfulness-based stress reduction (MBSR), can help reduce stress and improve emotional regulation in individuals with bipolar disorder.</li><li><em>Psychoeducation</em>: Psychoeducation involves providing individuals with information about their condition and treatment options. This approach can help individuals understand their symptoms, develop coping skills, and become more engaged in their treatment.</li></ol><p>The choice of therapy will depend on the individual's specific needs and circumstances, as well as the severity of their symptoms. Working with a mental health professional can help identify the therapeutic approach that will be most effective for each individual. Additionally, it's worth noting that pharmacotherapy (medication) is often a critical component of bipolar disorder treatment, and therapy should always be integrated with medication management.</p>
What are the potential complications of bipolar disorder?
<p>Bipolar disorder can be a chronic and often lifelong mental health condition that requires ongoing treatment and management. If left untreated or poorly managed, bipolar disorder can lead to a number of potential complications, including:</p><ol><li><em>Suicide</em>: Individuals with bipolar disorder have a higher risk of suicide compared to the general population, particularly during depressive episodes or during the first year following a diagnosis.</li><li><em>Substance abuse</em>: Substance abuse and addiction are common complications of bipolar disorder. Substance abuse can worsen mood symptoms and interfere with treatment.</li><li><em>Financial and legal problems</em>: Impulsivity and risk-taking behaviour during manic episodes can lead to financial or legal problems, such as overspending, gambling, or criminal behaviour.</li><li><em>Relationship problems</em>: Mood swings and other symptoms of bipolar disorder can interfere with interpersonal relationships, leading to conflict, social isolation, and emotional distress.</li><li><em>Work or academic problems</em>: Mood swings and other symptoms of bipolar disorder can interfere with work or academic performance, leading to job loss, poor academic performance, or other negative consequences.</li><li><em>Physical health problems</em>: Individuals with bipolar disorder have a higher risk of physical health problems, such as cardiovascular disease, obesity, and diabetes, often due to lifestyle factors such as poor diet, lack of exercise, or substance abuse.</li></ol><p>It is crucial for individuals with bipolar disorder to seek treatment and follow a comprehensive management plan in order to minimise the risk of these complications. Early diagnosis and treatment, as well as ongoing monitoring and support, can help individuals with bipolar disorder achieve stability and improve their quality of life.</p>
How does bipolar disorder typically affect an individual's mood, energy levels, and motivation?
<p>Bipolar disorder can significantly impact an individual's mood, energy levels, and motivation. The symptoms of bipolar disorder can vary widely between individuals and can range from mild to severe. Here are some of the ways bipolar disorder can affect these areas of functionality:</p><ul><li><em>Mood</em>: Individuals with bipolar disorder experience significant changes in mood, ranging from periods of intense, elevated mood (mania or hypomania) to periods of profound sadness or hopelessness (depression). During manic or hypomanic episodes, individuals may feel euphoric, excessively confident, and may have racing thoughts. During depressive episodes, individuals may feel sad, hopeless, and have difficulty finding pleasure in activities they usually enjoy.</li><li><em>Energy levels</em>: Energy levels can also be affected by bipolar disorder. During manic or hypomanic episodes, individuals may experience an increased level of energy, restlessness, and reduced need for sleep. During depressive episodes, individuals may experience fatigue, loss of energy, and a decreased interest in activities.</li><li><em>Motivation</em>: Motivation can be significantly impacted by bipolar disorder, particularly during depressive episodes. Individuals may experience a lack of motivation, difficulty concentrating, and a decreased interest in activities that they usually enjoy.</li></ul><p>The symptoms of bipolar disorder can vary widely between individuals and may change over time. Treatment, including medication and psychotherapy, can help manage mood symptoms and improve energy levels and motivation. It is also important to work with a mental health professional to develop an individualised treatment plan and to monitor symptoms over time.</p>
What are the common physical and cognitive symptoms of bipolar disorder?
<p>Bipolar disorder can affect individuals in a variety of ways, including physical and cognitive symptoms. Here are some of the common physical and cognitive symptoms of bipolar disorder:</p><p>Physical symptoms:</p><ul><li>Changes in sleep patterns, including insomnia or excessive sleeping</li><li>Changes in appetite or weight</li><li>Fatigue or lack of energy</li><li>Headaches or other physical pain</li><li>Restlessness or agitation</li><li>Increased or decreased sex drive</li><li>Physical symptoms of anxiety, such as muscle tension, sweating, or palpitations.</li></ul><p>Cognitive symptoms:</p><ul><li>Racing thoughts</li><li>Difficulty concentrating or making decisions</li><li>Poor memory or forgetfulness</li><li>Negative or self-critical thoughts</li><li>Suicidal ideation or thoughts of self-harm</li><li>Feeling detached from reality or disconnected from the world around them</li></ul><p>As noted above, the symptoms of bipolar disorder can vary significantly between individuals and can also change over time. For example, an individual with bipolar disorder may experience more pronounced physical symptoms during manic episodes, while cognitive symptoms may be more prominent during depressive episodes. Additionally, the severity and frequency of symptoms can vary widely, which is why it's necessary to work with a mental health professional to develop a treatment plan that addresses each individual's specific needs.</p>
How does bipolar disorder typically impact sleep, appetite, and sexual functioning?
<p>Bipolar disorder can significantly impact sleep, appetite, and sexual functioning. Here is a closer look at each of these areas:</p><ul><li><em>Sleep</em>: Individuals with bipolar disorder may experience changes in sleep patterns, which can include difficulty falling asleep, waking up too early, or sleeping too much. During manic or hypomanic episodes, individuals may need less sleep than usual and may feel rested with very little sleep. During depressive episodes, individuals may experience insomnia or hypersomnia, which can affect their energy levels and mood.</li><li><em>Appetite</em>: Changes in appetite are common in individuals with bipolar disorder. During manic or hypomanic episodes, individuals may experience a reduced appetite, while during depressive episodes, they may have an increased appetite and may overeat. These changes in appetite can affect weight and overall physical health.</li><li><em>Sexual functioning</em>: bipolar disorder can also impact sexual functioning. During manic or hypomanic episodes, individuals may experience an increased sex drive and engage in more sexual behaviour. However, this behaviour can be risky and may lead to negative consequences, such as sexually transmitted infections or unwanted pregnancies. During depressive episodes, individuals may experience a decreased sex drive and may have difficulty with sexual functioning.</li></ul><p>Again, the symptoms of bipolar disorder can vary widely between individuals, and the impact on sleep, appetite, and sexual functioning can vary depending on the individual and the stage of the disorder. Proper treatment, including medication and therapy, can help manage these symptoms and improve overall quality of life. Individuals with bipolar disorder need to work with a mental health professional to develop an individualised treatment plan.</p>
Does bipolar disorder increase a patient's likelihood of suicide, and if so, how can a clinician assess suicide ideation?
<p>Individuals with bipolar disorder have a higher risk of suicide compared to the general population. The risk is particularly high during depressive episodes, but it can also be elevated during manic or mixed episodes. Suicide is a serious and potentially life-threatening complication of bipolar disorder that requires careful assessment and management.</p><p>Clinicians can assess suicide ideation by asking the patient about their thoughts and feelings related to suicide. Some questions that may be useful in assessing suicide ideation include:</p><ol><li>Have you ever had thoughts of hurting or killing yourself?</li><li>Have you made any plans to harm or kill yourself?</li><li>Do you have access to means of harming or killing yourself, such as medication or firearms?</li><li>Have you attempted suicide in the past?</li></ol><p>These questions should be asked in a non-judgmental and supportive manner to encourage the patient to be honest about their thoughts and feelings. If the patient reports suicidal ideation, it is important to assess the level of risk and take appropriate action to ensure the patient's safety.</p><p>Clinicians can also use screening tools, such as the Columbia-Suicide Severity Rating Scale (C-SSRS), to assess suicide ideation and behaviour in patients with bipolar disorder. These tools can help identify individuals at increased risk of suicide and can guide appropriate interventions.</p><p>Assessing suicide ideation is a critical part of the diagnostic process for bipolar disorder and should be performed regularly throughout treatment. In addition to assessing suicide ideation, the clinician should address other risk factors for suicide, such as substance use, access to means, and social isolation. Working with a mental health professional to develop an individualised treatment plan can greatly reduce the risk of suicide in individuals with bipolar disorder.</p>
Popular books on bipolar disorder
<ul><li><em>The Bipolar Disorder Survival Guide: What You and Your Family Need to Know </em>(2019) by David J. Miklowitz</li><li><em>The Concise Guide to Bipolar Disorder (A Johns Hopkins Press Health Book</em>) (2022) by Francis Mark Mondimore</li><li><em>Understanding Bipolar Disorder: The Essential Family Guide</em> (2020) by Aimee Daramus</li><li><em>Surviving Manic Depression: A Manual on Bipolar Disorder for Patients, Families, and Providers</em> (2005) by E Fuller Torrey & Michael B Knable</li><li><em>The Bipolar Workbook: Tools for Controlling Your Mood Swings</em> (2015) by Monica Ramirez Basco</li><li><em>The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety (A New Harbinger Self-Help Workbook)</em> (2014) by Stephanie McMurrich Roberts, Louisa Grandin Sylvia & Noreen A. Reilly-Harrington</li><li><em>DBT Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation and Distress Tolerance</em> (2007) by Matthew McKay, Jeffrey C. Wood & Jeffrey Brantley</li><li><em>Owning Bipolar: How Patients and Families Can Take Control of Bipolar Disorder </em>(2018) by Michael F. Pipich</li><li><em>Bipolar Disorder: A Guide for You and Your Loved Ones (A Johns Hopkins Press Health Book) </em>(2020) by Franis Mark Mondimore</li><li><em>New Hope for People with Bipolar Disorder: Your Friendly, Authoritative Guide to the Latest in Traditional and Complementary Solutions</em> (2007) by Jan Fawcett, Bernard Golden & Nancy Rosenfeld</li><li><em>Positive Parenting for Bipolar Kids: How to Identify, Treat, Manage, and Rise to the Challenge </em>(2009) by Mary Ann McDonnell, Janet Wozniak & Judy Fort Brenneman</li><li><em>Welcome to the Jungle: Everything You Wanted to Know About Bipolar But Were Too Freaked Out To Ask</em> (2010) by Hilary T. Smith</li><li><em>Navigating Bipolar Country: Personal and Professional Perspectives on Living with Bipolar Disorder</em> (2022) by Fast, <em>et al</em>, edited by Merryl Hammond</li><li><em>Beyond Madness: The Pain and Possibilities of Serious Mental Illness</em> (2022) by Rachel A. Pruchno</li><li><em>In Search of Our Identity: Understanding Behavior in Bipolar Disorder</em> (2016) by John McManamy</li><li><em>The Mind of God: Neuroscience, Faith, and a Search for the Soul</em> (2017) by Jay Lombard</li><li><em>An Unquiet Mind: A Memoir of Moods and Madness</em> (1996) by Kay Redfield Jamison</li></ul>
Recent research on bipolar disorder
<ul><li>Nature Portfolio – <a target='_blank' href='https://www.nature.com/subjects/bipolar-disorder'>Bipolar Disorder Articles</a></li><li>Harvard Medical School – <a target='_blank' href='https://hms.harvard.edu/news/bipolar-breakthrough'>Bipolar Breakthrough</a></li><li>SpringerOpen – <a target='_blank' href='https://journalbipolardisorders.springeropen.com/articles'>International Journal of Bipolar Disorders</a></li><li>Psychiatric Times – <a target='_blank' href='https://www.psychiatrictimes.com/view/8-new-findings-bipolar-research'>8 New Findings in Bipolar Research</a></li><li>Stanford Medicine – <a target='_blank' href='https://med.stanford.edu/bipolarresearch/research/currentstudies.html'>Bipolar Research: Current Studies</a></li><li>Keck School of Medicine of USC – <a target='_blank' href='https://keck.usc.edu/promising-new-bipolar-disorder-study-reveals-structural-brain-changes-over-time/'>Promising New Bipolar Disorder Study Reveals Structural Brain Changes Over Time</a></li><li>Australian Genetics of Bipolar Study – <a target='_blank' href='https://www.geneticsofbipolar.org.au/'>Information Page</a></li><li>Science Daily – <a target='_blank' href='https://www.sciencedaily.com/news/mind_brain/bipolar_disorder/'>Bipolar Disorder News </a></li></ul>
References
<ul><li>American Psychiatric Association. (2022). <em>Diagnostic and statistical manual of mental disorders: Fifth edition, text revision</em>. Washington, D.C.: American Psychiatric Association Publishing.</li><li>Health Direct. (2022). Bipolar disorder. <em>Health Direct</em>. Retrieved on 5 April, 2023, from: <a target='_blank' href='https://www.healthdirect.gov.au/bipolar-disorder'>Bipolar disorder - complications, treatments and diagnosis | healthdirect</a></li><li>Mayo Clinic staff. (2022). Bipolar disorder: Symptoms and causes. <em>Mayo Clinic</em>. Retrieved on 5 April, 2023, from: <a target='_blank' href='https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955'>Bipolar disorder - Symptoms and causes - Mayo Clinic</a></li><li>(2023). Bipolar disorder. <em>National Institute of Mental Health</em>. Retrieved on 5 April, 2023, from: <a target='_blank' href='https://www.nimh.nih.gov/health/topics/bipolar-disorder'>NIMH » Bipolar Disorder (nih.gov)</a></li><li>Toler, L. (2022). Are there different types of bipolar disorder? <em>Very Well Mind</em>. Retrieved on 5 April, 2023, from: <a target='_blank' href='https://www.verywellmind.com/are-there-different-types-of-bipolar-disorder-5194673'>The 5 Types of Bipolar Disorder (verywellmind.com)</a></li></ul>
