According to the National Institute Mental Health (NIMH) booklet (2008), Bipolar disorder is commonly known for a manic-depressive illness. This is caused by a brain disorder that usually shifts in mood, energy, activity levels, and carried out day by day. The symptoms of bipolar disorder are severe. The different norms that can go from up or down moods. Bipolar symptoms can damage a healthy relationship, job and school performance, and even suicidal.

People with bipolar disorder can live a productive life with the proper treatment. Bipolar disorder can be diagnosis in early teens or early adult years. Before the age of 25 there has been some case studies diagnosis with bipolar disorder. Some people may have been diagnosis in their early childhood, while others have been diagnosis in their late adult years.
Bipolar disorder is hard to determine in the beginning. The symptoms are hard to recognize because the problems are separated. The diagnosis may have placed the problem in a different category. People may have suffered over years before getting treatment or diagnosis. This is a long-term illness and must be treated like diabetes or heart diseases.

People with intensive mood episodes are commonly diagnosis for bipolar disorder. There state of mind is like an emotional roller coaster. Several episodes a person could have being bipolar (NIMH booklet, 2008).
• Manic episode: a person who is overly joyful or overexcited.
• Depressive episode: a person who is extremely sad or hopeless state.
• Mixed episode: a person who has both manic and depression.
• During a mood episode a person may also become irritated and explosive.
Bipolar disorder may also cause a long lasting experience in unstable moods. Most of the day or nearly every day a person with bipolar disorder may experience a number of manic or depression episodes. This could last between one or two weeks. Some of the symptoms are so severe that a person cannot perform correctly on the job or school.
According to Veronica fisher (2007), the other episodes that determine bipolar disorder, hypomania and severe mania. Hypomania is a person with increased energy and activity levels. They also feel good, function well and very productive. Family and friends may recognize some of the symptoms. But people with hypomania are in denial about their actions. Hypomania without the proper treatment could lead to severe mania or depression. In a mixed episode a person could have trouble sleeping, become agitated, appetite change and suicidal. People with bipolar disorder may have severe episodes that may cause manic or depression.
Psychotic symptoms also occur in people with bipolar disorder. The symptoms can be from hallucinations and delusions. People with psychotic symptoms have extreme reflected moods. Some diagnosis can be determined wrong. People with psychotic behavior are often diagnosis of being schizophrenia because of the hallucinations and delusions. People with bipolar disorder may also have behavior problems and substance abuse with alcohol or drugs. Their relationships and poor work habits may also be affected by it.
Diagnostic challenges
According to NIMH booklet (2008), people try to treat their bipolar symptoms with substance abuse. This pro-long the process by triggering the behavior control. The mania result causes a person to drink too much. Other disorders that can be diagnosis with bipolar disorder are:
• Post-traumatic stress disorder (PSTD)
• Social phobia
• Attention deficit hyperactivity disorder (ADHD)
• These symptoms may overlap with bipolar disorder and cause a restless and easy distracted area.
Other diseases can also be determined in bipolar patients such as: thyroid disease, migraine headaches, heart diseases, obesity and other physical illnesses. These illnesses may cause mania or depression. Some of these illnesses may cause a problem in diagnosis and treatment (NIMH Booklet 2008).
Common assessing tools
A person with bipolar disorder must take the first step to see a doctor. After seeing a doctor a physical exam an interview is given. Lab tests are being ran to determine if any illnesses are found. Once blood work has been found negative and no signs of stroke or brain tumor the doctor can begin mental health evaluation. A referral may also be provided to a trained mental health professional, who is experienced in diagnosis and treatment. Family history should be discussed during evaluation to determine if any history of bipolar disorder or mental illnesses. An interview should also be given to close family or friends. People with mania or hypomania symptoms are more likely to seek help. A medical history should be carefully examined to assure that bipolar disorder is not mistakenly diagnosis or treated.
Most effective treatment
Bipolar disorder has not been properly cleared for a cure. No cure for the disorder and most people depend on the proper treatment to control their mood swings and related symptoms. Bipolar does have a lifetime recurrent illness and people are diagnosis need a lifetime supply of treatment. Medication and psychotherapy are an effective treatment plan that helps prevent relapse and symptom severities. Having a daily life chart can help the doctor keep track of the patient’s mood, treatment, sleep patterns and life events (NIMH Booklet 2008).
According to U.S. Food and Drug Administration (FDA, 2007), some of the medication may have some side affect that may cause a trauma or severe illness. The following medications are:
• Mood stabilizers
• Atypical Antipsychotics
• Antidepressants
Psychotherapy is another word for “talk” therapy. In talk therapy it provides support, education, and guidance to people and their family who are diagnosis with bipolar disorder the psychotherapy treatments are (NIMH Booklet, 2008):
• Cognitive behavioral therapy (CBT) this helps people with bipolar disorder to change negative thought patterns to positive.
• Family-focused therapy involves the family and it educates the family on recognizing early behavior before it reoccurs.
• Interpersonal and social rhythm therapy helps improves people with bipolar disorders relationships with others and it manages their daily routines.
• Psychoeducation educates people with the disorder about the illness and treatment. It also helps them to recognize a sign if a relapse seeks early.
Developmental or breakthrough within five years
According to NIMH (April 2007),
“A clinical trial called Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) was funded. In this study researchers compared two large groups. In the first group was treated with collaborative care (three sessions of Psychoeducation over six weeks). The second group was treated with medication and intensive psychotherapy (30 sessions over nine months of CBT, interpersonal and social rhythm therapy, or family-focused therapy)”.
According to the researchers they found that the second group had fewer relapses than the first one also there was a lower hospitalization rates and they felt better about sticking to the treatment.
NIMH believes that by supporting this research more cases can be solved through combinations of psychotherapy and medication. They want people to live a symptom free life from being by bipolar.
They want to help research determine more accurate results of delaying the start of bipolar disorder in children and adults that are at high risk to get the illness.

Akiskal, HS. (2005). “Mood Disorders: Clinical Features.” in Sadock BJ, Sadock VA. Kaplan & Sadock’s Comprehensive Textbook of Psychiatry. Lippincott Williams & Wilkins: Philadelphia
Bizarre JV, Sbrana A, Rucci P, May 2007, “The spectrum of substance abuse in bipolar disorder: reasons for use, sensation seeking and substance sensitivity. P. 213-220.
Fisher, Veronica. (March 2007). “Different Bipolar Disorder Symptoms of the Manic and Depressive Phases.” P.1-2
Goodwin FK, Jamison KR. (2007) Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression, Second Edition. Oxford University Press: New York.
Kessler RC, Berglund P., June 2005, “Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Co morbidity Survey Replication. Arch Gen Psychiatry. 62(6):593-602.