What causes bipolar disorder?

The causation of bipolar disorder is largely genetic and biological. However psychosocial and physical stressors may impact the timing of an episode and not necessarily its causation. The most relevant stressors relate to circadian rhythm disturbances. 

What are the options for management of bipolar disorder?

Treatment options for management of BPAD can be broadly  classified as mood stabilizers, antidepressants, antipsychotic  medications, neuromodulation (rTMS), adjunctive medications and psychosocial interventions. Use of various treatment options is guided by the phase of illness (mania/hypomania/depression/mixed) in which patient presents to the clinician and past treatment history. The mainstay management of BPAD is mood stabilizers. The available mood stabilizers are lithium, valproate, lamotrigine, carbamazepine/oxcarbazepine and topiramate.Recommended Psychosocial include Interpersonal Social Rhythm Therapy (IPSRT) and Cognitive Behaviour Therapy (CBT).

What are the signs and symptoms of episodes of illness in a bipolar disorder?

An episode of mania is marked by the presence of persistently elevated and remarkably euphoric and expansive mood, increased levels of energy and activity coupled with inflated self-esteem, decreased need for sleep, distractibility, racing of thoughts and increased talkativeness; these symptoms tend to last for at least one week. Relatively milder form of similar symptoms presents for at least 4 days qualify as a hypomanic episode. As compared to a manic episode, in a hypomanic episode there is much less impairment in various domains and there is no need for hospitalization. 

Depressive episode on the other hand are marked by the presence of depressed mood that lasts for a period of at least two weeks. Individuals experience loss of interest in activities that they initially found very interesting or exciting for instance for a music lover listening or creating music might not be as stimulating and exciting as it was before the depression set in. They find it difficult to accomplish tasks due to decreased energy and might easily feel fatigued and tired. Inability to concentrate makes it challenging to focus on work and stay productive consistently. There is a decline in self-esteem and loss of confidence which makes it difficult for the individual to make decisions. Further the individual experiences sleep disturbances and changes in appetite. The person might also get thoughts of harming oneself. Severe depression may be marked by the presence of psychotic symptoms.

Bipolar disorder can also be marked by the presence of a mixed episode. During a mixed episode the individual experiences alternation between manic and depressive symptoms. The two set of symptoms are present for maximum duration of the current episode of illness.