Many people know about depression and anxiety disorders, but few people know about bipolar disorder (formerly known as bipolar disorder or bipolar disorder). In fact, bipolar disorder is a very common mental disorder. However, in clinical practice, the recognition and diagnosis rate of bipolar disorder is not high, more than half of the patients are misdiagnosed at the first visit, and more than 1/3 of the patients need to go through at least 10 years to be diagnosed. In addition, bipolar disorder is a highly disabling and fatal psychiatric disorder, with approximately 25% to 50% of patients likely to attempt suicide at some point in their lives, and 15% to 19% of those who do eventually succeed. At the same time, bipolar disorder has a severe economic cost to society. In Germany, 70% of people with bipolar disorder are unemployed and 72% need to apply for disability benefits. In the UK, the total annual cost of bipolar disorder is £459 million per year. Emotional highs and lows are unpredictable What is bipolar disorder? In layman’s terms, it means that the patient’s mood goes up and down disproportionately with the reality of the situation, i.e. alternating between manic or hypomanic (so-called hypomanic, as the name suggests, means that the mania is relatively mild, does not have a damaging effect on the patient’s social functioning or even has a facilitating and enhancing effect, and often does not require hospitalization) and depressive episodes, as shown in the diagram. This is different from depression that never has manic or hypomanic episodes (red or yellow parts of the figure). In addition, bipolar disorder differs from the mood ups and downs of normal people. In normal people, the magnitude and duration of mood changes are consistent with the reality of the situation, that is, they can be explained by the life events that the patient has encountered, such as the mourning mood after the death of a loved one or the exhilaration when a person achieves a high ranking, which are all understandable mood changes for normal people. In the case of bipolar disorder, the mood changes can be described as “no wind but also waves”, that is, the patient’s mood ups and downs appear without obvious triggers or very slight stimulation of events, the magnitude and duration of the mood changes can not be explained by their life situation, to be more professional, that is, their mood “highs” and “lows”. “The magnitude and duration of the mood changes cannot be explained by the life situation. Pathological mood high Bipolar disorder patients in mania or hypomania, that is, “high” mood state, can appear the following symptom groups: 1, mood high or irritable: most patients show a good sense of self, experiencing an unprecedented “sense of happiness “, “pleasure” and “intoxication”; while some patients are emotionally irritable, looking at everything, irritable, irritable, interpersonal tension. 2, exaggerated: manifested as overconfidence, self-evaluation is too high, think they have superior talents, skills or special status, status; over-optimistic about the reality of the situation, only see the positive side of things but not the negative side of things. Therefore, they are often self-righteous, unable to listen to others’ advice or suggestions, and cannot tolerate different opinions from themselves. Energetic: It shows that the need for sleep is reduced and the feeling of tiredness is not experienced. 1.Thinking: It is manifested as quick thinking, increased association, creative, feeling that “the brain is like oil”, “the mind is like a horse off the leash”, “thinking about anything seems to be solved. “. 2, increased activity: including instinctive activities and intentional activities, the former is mainly manifested as increased sexual desire, sexual demands than usual, and in serious cases, become casual friends with the opposite sex, sexual behavior reckless. The latter manifests itself as a wide range of interests, and becomes interested in things that originally do not fall within its own interest. 3. Psychotic symptoms: Patients with severe symptoms may have hallucinations, delusions and other psychotic symptoms, such as hearing someone talking to him/her out of thin air, suspecting that someone is jealous of him/her and wants to persecute him/her for no reason. If an individual has three or more groups of the above symptoms and the symptoms persist for three or more days, it is possible to consider the possibility of a manic or hypomanic episode. Morbid depressed mood When bipolar disorder patients are in a depressed state, their clinical manifestations are very similar to those of depression, which is one of the main reasons why bipolar disorder is often misdiagnosed as “depression”. The specific manifestations are: 1, depressed mood, lack of pleasure, do not feel happy, happy; 2, declining interest, can not be interested in anything or even if reluctantly participate in the lack of commitment; 3, decreased energy, feel less physical strength, feel tired all day, lethargic; 4, low self-esteem, self-blame, often troubled by a sense of uselessness, worthlessness; 5, difficulty in association, self-awareness thinking ability 6.Slow action or agitation, restlessness, distraction; 7.Little life, recurrent suicidal thoughts or self-injury, suicidal behavior; 8.Sleep disorder, insomnia, early awakening or excessive sleep; 9.Appetite increase or decrease, weight gain or loss; 10.Sexual desire Decrease in sexual desire. In addition to the first of the above symptoms, plus the remaining four or more, if the symptoms persist for more than two weeks, significantly affect the patient’s social function, and exclude the mood changes caused by bereavement, drug use, physical illness, etc., then a depressive episode can be diagnosed. Bipolar disorder can be diagnosed if the patient has had manic or hypomanic and depressive episodes successively or simultaneously.