A typical clinical picture of bipolar disorder is the alternation of depressive phases with manic episodes.
While the depressive phase is characterized by a negative mood, listlessness, sleep disturbances and lack of concentration, euphoria, overconfidence, and hyperactivity are classic symptoms of mania.
In Austria, 0.5 to 2% of the population are affected by a severe bipolar disorder (Bipolar I) with the full picture of mania and depression. Another 5-10% suffer from a Bipolar II disorder, in which hypomania and depression are present. Genetic predisposition, biological and psychosocial parameters as well as certain lifestyle habits can influence the onset as well as the course of the disease. From a neuropsychological point of view, in mania and depression there is a change in the transmitter metabolism of serotonin, dopamine, noradrenaline and GABA between the nerve cells as well as within the nerve cells.
For successful therapy, it is necessary to tailor treatment to the individual patient’s disease course. First-line agents for the treatment of the acute manic phase are mood stabilizers such as valproic acid and lithium, or atypical antipsychotics such as olanzapine, risperidone, quetiapine and aripiprazole. For acute therapy of the depressive phase, the combination of an antidepressant with a mood stabilizer is recommended. Drug treatment is supplemented by special psychotherapy and psychoeducation.1
1 Simhandl C., DFP literature: Management of bipolar disorder, Österreichische Ärztezeitung, Issue No. 5/10.03.2013, pp. 26-35.