The diagnosis of bipolar affective disorder is quite common (about 1% according to S.N. Mosolov), although there is an opinion that this figure is actually higher, since some patients with mild hypomania are diagnosed with recurrent depressive disorder, and patients with full-blown psychotic experiences in the structure of exacerbation often receive a diagnosis of schizophrenia. Previously, bipolar disorder was called manic-depressive psychosis. Why was the diagnosis changed? Firstly, with a mild course of affective phases, psychosis as such (the presence of delusions, hallucinations, disorders of consciousness, gross disorganization of the thought process, etc.) may not exist. Secondly, the word “manic” itself is stigmatizing and inspires fear in many, associated with the word “maniac,” although the concept of “maniac” in forensic psychiatric terminology has nothing in common with a patient in the manic phase of bipolar disorder. The term “bipolar affective disorder” quite accurately defines the essence of this disease. So, Bipolar disorder is a chronic mental disorder of the affective sphere, i.e. related to mood pathology. The disease manifests itself in young, sometimes in older adolescence and is recurrent in nature. Exacerbations occur as depressive, manic or mixed episodes (when symptoms of both mania and depression are present). During periods of remission, symptoms are usually completely reduced, the mood between affective phases is quite even, intermissions with complete restoration of pre-morbid functioning are not uncommon. The prognosis of the disease depends on the type of course of the disease (that is, the frequency of occurrence and severity of affective phases). In bipolar disorder, unlike schizophrenia, a specific personality defect does not develop. But the prognosis is unfavorable in terms of the frequency of completed suicides, the probability of which is about 20% throughout life, which is higher than with recurrent depression and 20-30 times higher than in the general population. Bipolar disorder is a serious disease that requires timely detection and diagnosis and treatment. But with the modern level of medicine, people suffering from bipolar disorder and regularly observed in this regard by a psychiatrist can maintain a fairly high (sometimes very high) level of social functioning, have long-term high-quality remissions or intermissions and assess the quality of life in general as good. To establish a diagnosis of bipolar disorder, the following criteria must be present: 1. The presence of an affective syndrome in the current mental status of a person: • During a depressive episode, the severity of symptoms can vary from subdepression, manifested, for example, by mild depression, anxiety and lack of energy - to severe depression. Its structure may include psychotic symptoms with delusions, hallucinations, and confusion. Hallucinations and delusions typically correspond to depressive affect. Delirium can be delirium of impoverishment, sinfulness, worthlessness, low value, illness, or impending misfortune. Hallucinations are also unpleasant or even painful in nature (accusing voices, smells of rot, etc.). Severe psychomotor retardation can develop into a depressive stupor, in which a person lies in bed all day long, with an expression of grief on his face, not getting up even to satisfy physiological needs. • Mania also varies in severity. From hypomania (which, in its mild variants in patients with long-term depressive episodes, can be difficult to separate from an even mood; since a person suffering from depression for a long time may simply perceive a good mood as pathologically elevated). Up to severe mania, including with psychotic features (delusions of grandeur, special significance, high origin). Hypomania is characterized by elevated mood, increased activity, motor restlessness, increased energy, decreased need for sleep, increased.