ABSTRACT
The term 'bipolar disorder' is a relatively recent designation in the American Psychiatric Association (APA) guidelines. It refers to what was called manic depression and suggests the presence of two poles in the affective experience of the patient. Bipolar disorder is characterized by manic and depressive phases, and the mood swings can be debilitating. If he or she observes symptoms and behavior consistent with bipolar disorder, he or she must decide whether referral to a psychiatrist is best for the patient. Electroconvulsive therapy (ECT) has been used for decades, and at one time was the only treatment available for depression. The conditions of mania and depression may at first glance appear unrelated. People with hypomanic personalities have an essentially depressive organization, which is counteracted by the defense of denial. Most people who maintain a degree of mania suffer from episodes in which their denial fails and their depression surfaces, the term cyclothymic has been sometimes used to describe their psychology.
