March 30 is the birthday of Impressionist painter Van Gogh. After Van Gogh’s death, some scientists deduced that it was likely that he ended up suffering from bipolar disorder, so this day was designated as World Bipolar Disorder Day. World Bipolar Day is celebrated on March 30, and this year Chinese psychiatrists have adopted the theme “I’m glad to be close to you”. This “approach” has two meanings, one is to refer to the bipolar disorder and the disease day itself, hoping to let more people know and understand it; the other is to refer to bipolar disorder patients and families, they suffer from both the pain of the disease and social pressure, hope that people can approach them, give more tolerance, understanding and support. Bipolar disorder – Clinical manifestations The clinical manifestations of bipolar disorder can be divided into depressive episode, manic episode or mixed episode according to the characteristics of the episode. 1. Depressive episodes Bipolar depressive episodes are difficult to distinguish from monophasic depressive episodes because of the similarity of clinical symptoms and biological abnormalities, and bipolar depression is often overlooked because of the atypical performance. Correct diagnosis of bipolar depressive disorder is a prerequisite for reasonable treatment. There are significant differences in the treatment plan and prognosis of the two, and the differences are mainly in: (1) Demographic characteristics Gender The prevalence of monophasic depression is almost twice as high in women as in men, but the gender difference is not obvious in patients with bipolar disorder; ② Age The average age of onset of bipolar disorder is 30 years old and 40 years old for monophasic depression, and the former is significantly earlier than the latter, especially the first onset of depression before 25 years old is an important predictor of bipolar Family history Family surveys and bipolar studies have confirmed the family aggregation of bipolar disorder, and compared with monophasic depression, the family transmission of patients with bipolar disorder (especially bipolar I) is more closely related to genetic factors. 2, manic episodes (1) high state of mind Self-perception of good, all day long, cheerful, smiling, with a certain infectious power, often win the resonance of the surrounding people, cause a burst of laughter. Some patients are unstable and unpredictable, sometimes joyful and happy, sometimes excited and angry, despite their high mood. Some patients are characterized by anger, irritability, hostility, and even destructive and aggressive behavior, but often quickly turn anger into joy or immediately apologize. (2) Thinking is fast and furious, with a lot of plans and goals, feeling that their tongues are racing with their thoughts, words cannot keep up with the speed of thinking, words are increasing, talking incessantly, mouth is hanging, hands are dancing, eyebrows are flying, even if the mouth is dry and the voice is hoarse, they still have to talk incessantly, and the content is impractical, often changing the subject; the eyes are empty, pretentious, overbearing, and The person is unbeatable. (3) Increased activity Energetic, tireless, wide range of interests, rapid movement, busy, love to meddle, but often tiger’s head, snake’s tail, nothing is accomplished, arbitrary, reckless, often extravagant, generous, in order to attract attention to over-grooming themselves, clamoring for favor, domineering, good for others, like to boss others around, frivolous, often in entertainment venues, attracting butterflies. (4) Somatic Symptoms Red face, shining eyes, accelerated heart rate, dilated pupils. Reduced need for sleep, difficulty in falling asleep, early awakening, disturbed sleep rhythm; hyperphagia, overeating, or irregular eating due to excessive busyness, plus weight loss caused by overconsumption; increased interest in the opposite sex, hypersexuality, uncontrolled sexual life. (5) Other symptoms Attention cannot be concentrated and sustained, easily shifted by the influence of the external environment; memory is enhanced, disorderly and changeable; when the attack is extremely serious, the patient is extremely excited and agitated, there may be brief, fragmentary hallucinations, disordered behavior without purposeful direction, accompanied by impulsive behavior; there may also be a disorder of consciousness, with delusions, hallucinations and incoherent thinking and other symptoms, called delirious mania. Most patients lose self-knowledge in the early stage of the disease. (6) Light manic episodes Manic episodes with lighter clinical manifestations are called light mania. Patients may have a high state of mind lasting at least several days, high energy, increased activity, significant self-perception, inattentiveness and inability to sustain, mild profligacy, increased social activities, increased sexual desire, and reduced need for sleep. It sometimes manifests as irritability, conceited pride, and more reckless behavior, but is not accompanied by psychotic symptoms such as hallucinations and delusions. There is a mild impact on the patient’s social functioning, and some patients sometimes do not reach the level of impact on social functioning. It is often not easy to be noticed by the general public. 3, mixed episodes refers to manic symptoms and depressive symptoms in an episode at the same time, clinically rare. Usually occurs when mania and depression are in rapid phase change. For example, a manic episode of patients suddenly turned to depression, and a few hours later again manic, so that people get the impression of “mixed”. However, this mixed state usually lasts for a short time, and most of them turn into manic phase or depressive phase sooner. The manic and depressive symptoms are atypical in mixed episodes, which can be easily misdiagnosed as schizophrenia or schizoaffective disorder.