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Bipolar affective disorder is a major mood disorder characterized by recurrent episodes of mania, hypomania, and depression. It is associated with significant changes in mood, energy, activity level, behavior, and cognitive functioning. The disorder usually begins in late adolescence or early adulthood, although it may occur at any age. Bipolar disorder has a chronic course with periods of remission and relapse, requiring long-term treatment and monitoring. The exact cause of bipolar affective disorder is multifactorial. Genetic factors play a major role, as the disorder is more common among first-degree relatives of affected individuals. Neurobiological factors include abnormalities in neurotransmitters such as serotonin, dopamine, and norepinephrine, as well as alterations in brain structure and function. Environmental stressors, sleep deprivation, substance abuse, and significant life events may trigger episodes in genetically vulnerable individuals. Mania is characterized by an abnormally elevated, expansive, or irritable mood lasting at least one week. Individuals experience increased energy, inflated self-esteem or grandiosity, decreased need for sleep, excessive talking, racing thoughts, distractibility, increased goal-directed activity, and involvement ______ _________ ______ _____ _______ ________ __________ _________ ________.
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