What are characteristic features of bipolar disorder?

Bipolar disorder involves episodes of mood elevation and depression. Mania (Bipolar I) — duration ≥7 days OR severe enough for hospitalization. Criteria: distinct period of abnormally elevated, expansive, or irritable mood AND increased goal-directed activity/energy; plus 3+ of (or 4+ if irritable): (1) Inflated self-esteem or grandiosity (sometimes delusional); (2) Decreased need for sleep (3 hours and feels rested); (3) More talkative than usual or pressured speech; (4) Flight of ideas or racing thoughts; (5) Distractibility; (6) Increased goal-directed activity or psychomotor agitation; (7) Excessive involvement in activities with painful consequences (spending sprees, sexual indiscretions, foolish business). Hypomania (Bipolar II): similar but less severe, lasting ≥4 days, no severe functional impairment. Bipolar I: mania required (depression typical but not required). Bipolar II: hypomania plus major depression. Cyclothymic disorder: chronic, less severe fluctuations. Treatment: mood stabilizers (lithium — gold standard, requires blood level monitoring 0.6-1.2 mEq/L therapeutic, narrow window, toxicity at 1.5+, watch for dehydration); anticonvulsants (valproate, lamotrigine, carbamazepine); atypical antipsychotics (quetiapine, olanzapine, risperidone, lurasidone, others); ECT for severe/treatment-resistant. Antidepressants used cautiously — can trigger mania. Nursing care during mania: low-stimulation environment, simple structured activities, brief frequent meals and snacks (they can't sit for full meals), set limits on intrusive behavior, ensure rest, monitor for exhaustion.