Bipolar disorder, also known as manic-depressive disorder, is a mental illness characterized by extreme mood swings that include emotional highs and lows. It has 3 main types and is associated with a decreased quality of life and the highest suicide rate among mental illnesses.

Bipolar I is characterized by manic episodes, which include symptoms like increased self-esteem and decreased need for sleep, and bipolar II is characterized by hypomanic episodes, which are milder. Both types experience depressive episodes with symptoms such as sadness and fatigue, and there can also be mixed episodes or cyclothymic disorder, which involves milder symptoms of both.

Bipolar disorder is diagnosed through a thorough evaluation by a mental health provider, using diagnostic criteria from the DSM and ICD (these criteria are established by the American Psychiatric Association and the World Health Organization, respectively).

Treatment for bipolar disorder involves managing acute episodes and providing maintenance care, typically through a combination of medications like mood stabilizers, antipsychotics, and antidepressants, along with psychotherapy. Antidepressants should not be used alone, especially in individuals with a history of rapid cycling, because they can increase mood fluctuations.

Fish oil and N-acetyl-cysteine have been found to be particularly helpful for depressive episodes in bipolar disorder. Additionally, coenzyme Q10, folic acid, zinc, and probiotics show some promise for treatment.

In addition to medication, various psychotherapy modalities tailored to individual needs (such as cognitive behavioral therapy and mindfulness) can be beneficial for bipolar disorder. Other treatments include neuromodulation options like electroconvulsive therapy and repetitive transcranial magnetic stimulation, as well as bright light therapy to alleviate depressive symptoms.

People with bipolar disorder often do not adhere to a Mediterranean diet and eat less seafood, but diets that are high in essential fatty acids may improve symptoms. However, more rigorous studies are needed to better understand the relationship between diet and bipolar disorder.

The exact cause of bipolar disorder is unknown, but it seems to be influenced by a combination of psychosocial, genetic, and biological factors.