Liu Cola, a 90-year-old bipolar girl from the Oddball Conference, said, “There are so many rules and regulations in life, we don’t have to be in all of them, we don’t have to be in all places all the time.” So, what exactly is bipolar disorder and how much do we know about it? Let us use the following case to unveil the veil of bipolar disorder. Q lost his job a year ago, and his worries about life made him easily agitated, and he often quarreled with others over trivial matters. Later, he became very conceited and often boasted in front of others, thinking that he was great and had a colorful life, just like living in paradise. About a week later he seemed to have suddenly fallen from heaven into hell, sulking all day, lying in bed, not willing to go out, not talking to others, not communicating. He felt pessimistic and desperate about everything. Because this situation often recurred, it made Q feel very painful, so he came to the hospital for medical treatment. Q said that when he was hyper, he felt like the Monkey King, who could do anything in heaven and earth. When he is depressed, he feels that the world is gray, he can’t breathe, and he even has thoughts of lightness. Nowadays, many people pay more attention to anxiety disorder, obsessive-compulsive disorder and depression, but few people know about bipolar disorder. In fact, bipolar disorder is also a common psychological disease, but clinically, its identification rate is not high. According to statistics, there are one-third of patients, from the first onset to the diagnosis of bipolar disorder, it usually takes 8 to 10 years. Compared with depression, bipolar disorder is more difficult to cure. Early identification and long-term treatment can improve the treatment effect of bipolar disorder, prevent relapse and suicide, and avoid deterioration of the disease. Early identification and early diagnosis is the key to treating bipolar disorder, so how to diagnose and identify bipolar disorder? Second, what is bipolar disorder? Bipolar disorder, also known as bipolar disorder, is a type of mood disorder, like depression, and is a serious, persistent, up and down mood fluctuation psychological disorder. Because of its higher rate of suicide, self-injury and injury, bipolar disorder is managed according to severe mental illness. The diagnosis of bipolar disorder is relatively strict, and primary care physicians can determine whether they have encountered a patient with bipolar disorder by the following symptoms: the patient experiences two or more significant mood highs and mood lows, where the mood high lasts at least one week and the mood low lasts at least two weeks, and the highs and lows occur in a mixed or alternating manner. The disorder generally has periodic movements, and each episode is followed by a respite period, during which the mental activity is completely normal. Patients with bipolar disorder will sometimes be like riding a roller coaster, with high and low moods, up and down. When the mood is low, they will be very decrepit, feel desperate about themselves and life, unwilling to see anyone, unkempt, and basically lose the ability to work. When the mood is high, it will be excited and thrilled, bent on self-expression, energetic, chattering, full of passion for everything, and can even not rest or sleep for 24h. Because of its complex and diverse clinical manifestations, it is easy to be misdiagnosed as depression and youthful schizophrenia, so it is important to pay attention to the distinction. Third, the disease identification 1, depression General bipolar disorder patients in the light manic episodes, often high emotions, self-perception good. Some people often reflect to the doctor that: I was particularly good some time ago, the efficiency of work is particularly high, you let me return to that time can not? Then when they are in depression they will say: I am sad and don’t want to do anything, so it is easy to be misdiagnosed as depression. Bipolar disorder and depression are not treated with the same principles and should be differentiated. The two have some common parts, which include persistent low mood, feeling empty, loss of interest in previous activities, frequent crying, decreased concentration, low energy, guilt, feeling hopeless and helpless, insomnia, social withdrawal, self-harm, etc. But there are also different from depression, bipolar disorder generally has an early age of onset, is cyclical, has excessive excitement during the onset period, hurts people and destroys things, rapid changes in the state of mind, the inter-onset period is completely normal. The biggest difference between the two is that bipolar disorder will have the state of mania or hypomania. The specific manifestation is high mood or irritability, feeling that they can do anything, sometimes they feel very happy, even self-indulgence. Some patients may be irritable, have a violent temper, have strained interpersonal relationships, have trouble with everything, and may clash with others over trivial matters. 2, youth-type schizophrenia Bipolar disorder also needs to be distinguished from youth-type schizophrenia. Although the two are in the youth onset, manifested as excitement talk a lot. However, the latter often has strange behavior, language confusion, thinking and emotion dissonance and other internal experience and the surrounding environment incongruent performance, accompanied by varying degrees of social function deficits. In contrast, manic episode is a coordinated psychomotor excitement based on high emotion, with coordinated action-emotion and environment. Because bipolar disorder is dangerous, they can easily injure others or self-injure, and the vast majority of patients need to be hospitalized, so it is not recommended for primary care physicians to treat themselves. The treatment of bipolar disorder patients is a comprehensive treatment, which includes: medication, physical therapy, and professional systematic psychotherapy. IV. Comprehensive treatment 1. Medication In the onset of the disease, adequate amount of medication should be given according to the course of treatment. Medication can reduce the pain in the acute period, and a small number of patients need long-term use of lithium, carbamazepine, valproic acid and other mood stabilizers. 2.Physical therapy Severe excitement and agitation can be treated with modified electric convulsions to speed up the control of the disease. 3.Psychotherapy Patients who have recovered by drug treatment must do continuous psychotherapy after stopping the drug. Without psychotherapy, patients will still be in a state of mood swings after clinical cure, and the relapse rate is extremely high. Some statistics say that 90% of patients will relapse and more than half of them may die by suicide. Psychotherapy mainly includes: cognitive-behavioral therapy, psychoanalytic therapy and family therapy. (1) Cognitive-behavioral therapy: It can improve patients’ cognitive attitudes and behavioral patterns, and help patients release or reduce their excessive psychological burden and stress as much as possible. (2) Psychoanalytic therapy: It can guide patients to discover deep-seated problems, improve their perception, and mobilize their potential power to promote their development for the better. (3) Family therapy: The psychiatrist examines the patient’s psychological problems from the family’s point of view, and through influencing any form of language patterns and interaction patterns of the patient and family members, the family can make changes and indirectly change the patient’s inner feelings, so that the patient can be treated more effectively. In psychotherapy, if you want to completely cure bipolar disorder, psychoanalytic therapy and family therapy play a more important role. Then what can patients and their families do in addition to professional treatment? Five, patient care 1, family support In order to effectively prevent relapse, family support is also indispensable. Family members can help create a good environment for patients. For example, maintain a quiet environment, do not have hostile conversations with patients, do not watch TV or party for a long time to avoid stimulating patients, and let them maintain adequate sleep and a regular life. The most important thing is that family members should give enough care to the patient, not only in food, clothing, housing and transportation, but also in understanding the various changes in the patient’s heart and responding positively to the patient’s inner emotional reactions. 2, pay attention to seasonal changes In the time of seasonal changes, especially from late autumn to the beginning of spring of the next year, this period is the high incidence of depression in bipolar disorder, and patients should be beware of suicidal behavior. Summer is the high incidence of mania, what is needed is to reduce stimulation and avoid such foods as ornithine and arginine that may aggravate the disease. Some patients may also be triggered by certain foods, so it is necessary to closely observe the patient’s food and whether some of them will be more prone to develop after consumption. Finally, it should also be noted that it is important not to overemphasize the dangers of the disease with the patient to avoid excessive psychological burden.