Bipolar Disorder

Bipolar disorder is an episodic illness involving mood, energy, activity, sleep, cognition, and behaviour. Episodes reflect interacting genetic, circadian, neurochemical, and environmental factors rather than a single neurotransmitter deficit. The nursing priority is determined by the patient's current state and immediate risks, not by the diagnosis label alone. During mania, increased energy can coexist with impaired judgement. A patient may remain active while taking in little food or fluid, act on grandiose beliefs, become involved in unsafe spending or sexual activity, or progress to exhaustion, injury, conflict, or exploitation. During bipolar depression, hopelessness, psychosis, substance use, and access to lethal means can increase suicide risk. Mixed presentations combine depressive symptoms with activation or agitation and require the same deliberate safety assessment. The RN assesses the state, protects safety, gathers a timeline and collateral information when permitted, monitors treatment effects, and promptly communicates changes to the authorized prescriber and interprofessional team. Diagnosis and prescribing remain the responsibility of authorized clinicians. Long-term treatment aims to prevent recurrence and preserve function as well as treat the acute episode.