Since the author opened the special clinic for bipolar disorder, more and more patients with bipolar disorder have been coming to the clinic, and many problems have been found: one is that a considerable number of patients with bipolar disorder are diagnosed as monophasic depression during depressive episodes, that is, simple depression, and are treated only with antidepressants, and the other is that even though they are diagnosed with bipolar disorder, a considerable proportion of them exist without first using mood stabilizers. To summarize the above two cases, there is mainly a problem of diagnostic identification, but also a problem of irregular treatment, the ending of which leads to patients failing to achieve satisfactory results, recurring episodes and delaying final recovery. So what is the standardized treatment for patients with bipolar disorder? The author introduces some basic knowledge for the benefit of patients and friends and some doctors. 1, according to domestic and international treatment guidelines, whether bipolar I, or type II patients, must first use mood stabilizers, at least in depressive episodes do not first use antidepressants alone. This is a basic treatment principle, and clinicians must have this awareness! 2, biphasic typing: mainly includes biphasic type I and biphasic type II. The so-called type I, the current or previous presence of at least one typical manic episode, accompanied by at least one depressive episode or current depressive episode; biphasic type II refers to the presence of at least one light manic episode and depressive episode. There are also more complex clinical phases such as mixed episodes, single manic episodes and even soft bipolar disorder, which need to be carefully identified. 3, drug use and the understanding of the concept: mood stabilizers include traditional mood stabilizers such as lithium carbonate, bivalproate (sodium valproate, magnesium valproate), lamotrigine, oxcarbazepine, carbamazepine, etc.; second-generation antipsychotic drugs – olanzapine, quetiapine, risperidone, aripiprazole, ziprasidone, etc. can have mood Only quetiapine (extended-release tablets) can be used as a mood stabilizer in bipolar mania and bipolar depression. There are some concepts that need to be clarified. Anti-manic drugs include traditional mood stabilizers, but also include all second-generation antipsychotic drugs and some first-generation antipsychotic drugs (haloperidol), and antidepressants include all current cyclic drugs and the most common SSRI, SNRI and NaSSA class at present. 4.How to reasonably regulate the use of mood stabilizers? Whether it is biphasic type I or type II, and whether it is manic episode or depressive episode, you should still use mood stabilizers first, including some traditional and non-traditional drugs in appeal. Only if a mood stabilizer is used first can a decision be made on what other medications to use in combination based on an assessment of the condition. For example, the patient has a diagnosis of bipolar I and is currently having a depressive episode. First of all, after 2-4 weeks of using mood stabilizers (also combined with quetiapine or olanzapine), the symptoms are not relieved well, you can consider combining with drugs with low transient mania such as bupropion, etc. Of course, if the symptoms are very severe such as suicidal, sluggish and immobile, refusing food and drugs, you should also use MECT (twitch-free electroconvulsive shock) treatment as early as possible according to your condition, but you need to assess the progress of your condition in due time to prevent transient mania! As another example, for example, in bipolar II depressive episode, lamotrigine is the first recommended mood stabilizer, but also lithium carbonate and dipropionate, and quetiapine extended-release tablets, and of course, oxyfluorfen combination is also the recommended first-line medication. In conclusion, the symptoms of bipolar disorder are complex and not as easy as one might think, and require careful identification, especially after correct diagnosis, and standardized treatment. What medications are appropriate? When to use antidepressants? As doctors are still so careful, patients and family members should not use medications without authorization, which may lead to unnecessary fluctuations in the condition, but should first contact a specialist as soon as possible and systematically treat the symptoms under expert assessment in order to recover!