Bipolar disorders are common, disabling, recurrent mental health conditions of variable severity. Onset is often in
late childhood or early adolescence. Patients with bipolar disorders have higher rates of other mental health disorders
and general medical conditions. Early recognition and treatment of bipolar disorders improve outcomes. Treatment
of mood episodes depends on the presenting phase of illness: mania, hypomania, mixed state, depression, or
maintenance. Psychotherapy and mood stabilizers, such as lithium, anticonvulsants, and antipsychotics, are first-line
treatments that should be continued indefinitely because of the risk of relapse. Monotherapy with antidepressants is
contraindicated in mixed states, manic episodes, and bipolar I disorder. Maintenance therapy for patients involves
screening for suicidal ideation and substance abuse, evaluating adherence to treatment, and recognizing metabolic
complications of pharmacotherapy. Active management of body weight reduces complications and improves lipid
control. Patients and their support systems should be educated about mood relapse, suicidal ideation, and the effectiveness
of early intervention to reduce complications. (Am Fam Physician. 2012;85(5):483-493. Copyright © 2012
American Academy of Family Physicians.)