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Bipolar disorder is a chronic mood condition characterized by alternating episodes of mania or hypomania and depression, causing significant disruption to daily life.
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Bipolar disorder is a chronic mood condition characterized by alternating episodes of mania or hypomania and depression, causing significant disruption to daily life. Dr. Ruja Shrestha (NMC 19766, Experienced clinical practice in psychiatry and mental health) evaluates bipolar disorder at Kathmandu Neurology Clinic & Cognitive Center, Durbar Marg, Opposite of Yak & Yeti Hotel, Kathmandu 44600, Nepal — evidence-based, medically reviewed.
Bipolar disorder involves recurrent episodes of elevated or irritable mood (mania or hypomania) alternating with depressive episodes. Bipolar I requires at least one manic episode; bipolar II requires at least one hypomanic episode and one major depressive episode. The disorder has strong genetic components and involves dysregulation of neurotransmitter systems, circadian rhythms, and intracellular signaling pathways. Long-term mood stabilization is the primary treatment goal.
Clinical diagnosis based on DSM-5 or ICD-11 criteria: at least one episode of mania (bipolar I) or hypomania plus depression (bipolar II). Mood charting helps establish the pattern. Screening tools include the MDQ (Mood Disorder Questionnaire) and HCL-32 (Hypomania Checklist). Medical evaluation should exclude thyroid dysfunction, substance-induced mood episodes, and neurological causes. Family history is an important diagnostic clue.
Mood stabilizers (lithium, valproate) and atypical antipsychotics (quetiapine, olanzapine, lurasidone) are first-line pharmacotherapy. Lithium has the strongest evidence for long-term maintenance and suicide risk reduction. Psychoeducation, CBT for bipolar disorder, and interpersonal and social rhythm therapy (IPSRT) support medication adherence and lifestyle stability. Antidepressant monotherapy is contraindicated due to mania risk.
Management is individualized and discussed with benefits, limitations, and follow-up.
Consistent sleep-wake patterns, avoidance of substance use, medication adherence, and early recognition of prodromal symptoms (sleep changes, increased energy, irritability) can reduce relapse. Mood charting enables early detection. Regular follow-up with a psychiatrist is important for long-term management.
Bipolar I requires at least one manic episode (elevated mood lasting 7+ days or requiring hospitalization). Bipolar II requires at least one hypomanic episode (less severe, 4+ days) plus at least one major depressive episode.
Lifestyle regularity (sleep, exercise, stress management) is important but is typically not sufficient without pharmacotherapy for established bipolar disorder. Medication is a cornerstone of management.
Lithium is effective for long-term maintenance but requires regular monitoring of kidney and thyroid function. Most patients tolerate it well with appropriate monitoring.
Yes � Dr. Jitendra Prasad Yadav (NMC 8029) provides bipolar disorder assessment and treatment at Kathmandu Neurology Clinic & Cognitive Center.
Mood episodes can strain relationships. Psychoeducation for patients and families, combined with consistent treatment, improves relationship outcomes and reduces caregiver burden.
Common triggers include sleep deprivation, substance use, major life stressors, and seasonal changes. Maintaining routine sleep patterns and avoiding substances are key preventive strategies.
Comprehensive psychiatric evaluation for mood, anxiety, psychosis, and other mental health concerns, including medication assessment and long-term care planning.
Structured, evidence-based cognitive behavioral therapy for anxiety, depression, insomnia, and related conditions.
Evaluation and treatment for major depressive disorder, persistent depressive disorder, and depressive episodes associated with medical conditions.
Generalized anxiety disorder (GAD) involves persistent, excessive worry about everyday matters that is difficult to control and may cause physical symptoms.
Major depressive disorder (MDD) is a common mood disorder characterized by persistent sadness, loss of interest, and a range of emotional and physical symptoms that impair daily functioning.
Substance use disorder (SUD) is a chronic condition involving compulsive use of a substance despite harmful consequences, characterized by loss of control over use and continued use despite adverse effects.
Content on this website is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified healthcare professional. Always seek the advice of your physician or other qualified provider with any questions regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. In case of a medical emergency, contact emergency services immediately. No doctor–patient relationship is established by use of this site or by contacting the clinic through the site.
Reviewed by Dr. Jitendra Prasad Yadav • Last reviewed: 2026-09-04
Content is educational and aligns with standard medical references; individual evaluation may vary. External links provide context and do not imply endorsement.
Doctor — medically reviewed
Dr. Ruja Shrestha
Consultant Psychiatrist & CBT Therapist • MBBS, MD (Psychiatry) • NMC 19766
This condition guide was medically reviewed by Dr. Ruja Shrestha.
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