The individual must have had at least one episode of true mania. Mania consists of at least a week of an abnormally elevated, irritable or grandiose mood. The affected individual may experience decreased need for sleep, pressured speech, racing thoughts, physical agitation, distractibility, and grandiose psychosis. Individuals often experience depressive episodes or mixed mood states. Recurrent depression or bipolar disorder associated with specific times of the year.
Psychotic thoughts are often unrelated to the individual s overall mood.
The individual has periods of depression, and periods when they feel either unusually good or pressured and irritable. Genetics plays a significant role. There is growing evidence that patients with less frequent and more intense mood swings respond best to lithium, while those with more than 4 mood swings per year respond best to the anticonvulsant mood stabilizers. When a person is acutely manic, they may require hospitalization. Lithium or an anticonvulsant mood stabilizer can be quite effective, but may take several days or weeks to take effect.