There are more than three million cases of type one bipolar depression per year. This disorder is associated with episodes of mood swings such as having depressive lows and high manics. Major depressive episodes is a period of two weeks or longer which a person experiences sadness or hopelessness as well as other symptoms such as weight gain or loss, changes in sleeping habits, loss of interest in activities one used to enjoy, or as well as thoughts of suicide. Approximately sixty percent of manic episodes occur immediately after a major depressive episode. More than eighty percent of all cases of this disorder are classified as serve. Many people with this disorder explain how confusing it can be to try to understand it viewing it from the outside. This disorder can last years or even be lifelong. Some risk and prognostic factors include environmental, genetic, and physiological factors. With an environmental factor, this disorder is more common in a high income country rather than a low income one. Also being divorced or separated is another reason that causes the risk for this disorder to be higher, but the reason behind it is still unclear. Genetic and physiological factors include family origin and the families prior history with the disorder. The family history is a more consistent risk factor to obtaining bipolar depression. Schizophrenia and bipolar depression share the same origin. Women are more likely to experience having this disorder more than men, they are likely to experience more depressive symptoms than men. With women having bipolar depression, there is a high risk of alcohol use disorder than in men. The lifetime risk of suicide in individuals with bipolar disorder is estimated to be at least fifteen times that of the general population. This disorder is accounted for one quarter of all completed suicides. With a past history of attempts in suicide, they are associated with a greater risk of suicide attempts or completions. People with this disorder with attempt suicide at least once in their lives, and they also have low life expectancy. The life expectancy is greater for men, than for women. Some bipolar suicides are planned over time or are impulsive acts that were not thought out. It’s always appropriate to treat all thoughts of suicide seriously because we never know if people can impulsively act upon it. Type two bipolar disorder is similar to type one because it also involves major depressive episodes, but with type two they have hypomanic episodes as well. Hypomanic episodes over the course of at least four days, involve elevated mood plus symptoms such as pressured speech, inflated speech, or grandiosity as well as decreased sleep. The difference between mania and hypomania is that signs of mania are serve and signs of hypomania are less severe, but hypomania can still affect a person’s life in a hasty way especially when depressive episodes also known as “crash” occur. Bipolar two disorder is characterized by a clinical course of recurring mood episodes consisting of one or more major depressive episodes and at least one hypomanic episode. This disorder can be diagnosed by a doctor, psychologist, or other specialist, but you have to meet certain criterias to be diagnosed as having type two bipolar depression. The major depressive episode must last up to two weeks and the hypomanic episodes have to last up to four days, to meet diagnostic criteria. While having mood episodes the requisite number of of symptoms must be present most of the day, nearly everyday, and represent noticeable change from usual behavior and functioning. Type two bipolar disorder can begin adolescence and throughout adulthood the average onset age is mid twenties, which is a bit later than type one bipolar depression, but is still earlier than major depressive disorder. There is not much evidence to bipolar gender differences, but some suggest it more common in women than in men. There are some triggers in hypomanic episodes for women such as childbirth or the postpartum period. When men are affected they tend to have roughly equal numbers of hypomanic and depressive episodes. However, for women the depression tends to dominate them. Bipolar type two is more often associated with one or more mental disorders, anxiety disorder is the most common one. Other disorder would be substance use disorder, eating disorder, and co-occurring anxiety disorder. The suicide risk in type two bipolar depression is high, one third of individuals with type two report a lifetime history of attempts in suicide. To try to prevent a suicide from occuring we can take the situation seriously, talk to them directly about how suicide is not the answer, and trying to get help from a therapist or psychiatrist as well as emergency services. There are also suicide hotlines that can be resourceful as well. The loss or damage of the brain cells in the hippocampus can be a factor to this disorder. The hippocampus involves memory, but it can indirectly affect mood and impulses. Imbalances with neurotransmitters are with bipolar depression. When, a brain with bipolar depression is scanned it shows a reduction in grey matter volume. It shows the grey matter shrinking in the prefrontal and temporal regions the brain. People with this disorder suffer from shrinkage of the brain. Long term effects would be loss of brain tissue in areas controlling memory, face recognition, and coordination. Bipolar depression can cause progressive damage to the brain, and it can cause memory problems as a side effect with having this disorder. Also some studies show that memory and cognitive problems are at their worst during manic episodes. Bipolar disorder also causes chemical imbalances in the chemicals that are responsible for controlling the brain’s functions that include noradrenaline, serotonin, and dopamine. When people are going through their manic episode on doesn’t tend to remember that’s how it can affect their memory. Systems in the body that are affected with this disorder are the nervous system, the endocrine systems, and at times the immune system. There are disturbances in body rhythms. The circadian rhythm is a twenty-four hour cycles of the body which is the exact length of which is determined by the amount of light that the hypothalamus senses in a day light cycles. When this cycle is upset it can cause mood disturbances, maina, and symptoms of depression. Seasonal rhythms are determined by the amount of daylight experienced in a given season. This rhythm can affected the same way the circadian rhythm is. Unfortunately, there is no cure for this disorder but there are many treatments that can help control it. Treatments for bipolar disorder generally involve medications and forms of psychotherapy. Psychotherapy involves counseling services and it is centered on talking through the person’s emotions and problems associated with bipolar disorder and other life problems. It may also include behavioral management which is creating action plans on what to do and prepare for mood alterations. Some other treatments would be mood stabilizers, antipsychotics, and antidepressants. Antidepressants can make bipolar disorder worse and can trigger more a manic episode . Some of the best medications to help with this disorder are Olanzapine, Quetiapine, Risperidone, Ariprazole, Ziprasidone, and Clozapine. There are also many treatment programs or self management strategies to help try to control disorder. Occasionally, hospitalization may occur. Hospitalization is considered an emergency option in bipolar care. It only becomes necessary in extreme cases when the disorder is an immediate threat to themselves and others or it may be because medications need adjustment or monitoring. Warning sign of needing to be hospitalized when exhibitions of extreme or dangerous behavior occurs and as well as extended periods of behavior associated with mood swings puts one at risk. Hospitalization can last a few days, weeks, or longer depending on how one’s conditions is. There is no direct side effect of being hospitalization but there can be complications. Being hospitalized can be a voluntary unless the person is an immediate danger to themselves or others. People should always plan ahead incase hospitalization becomes necessary. It’s always important to be prepared because we never know what can happen.