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　Bipolar disorder is a mental disorder that involves a manic or hypomanic state and a depressive state, and was once called manic-depressive disorder and was considered one of the two major mental disorders along with schizophrenia. Major depressive disorder, on the other hand, is a disorder in which only depressive states occur, and the two are sometimes referred to together as “mood disorders. This review will introduce the pathophysiology, diagnosis, epidemiology, and treatment of bipolar disorder, focusing on the current situation in Japan.Juntendo Medical Journal2022. 68(1), 17-24Special ReviewsIntroductionBipolar disorder is a psychiatric disorder charac-terized by recurrent manic or hypomanic and depressive states, and was formerly called “manic- depressive illness” and was considered one of two major psychiatric disorders along with schizo-phrenia. Major depressive disorder is a disorder in which only the depressed state occurs. The two are sometimes referred to together as “mood disor-ders”, though DSM-5 discarded this category because bipolar disorder also shares some features with schizophrenia. One manic episode is sufficient for the diagnosis of bipolar I disorder, whereas at least one hypomanic episode and one major depres-sive episode are necessary for the diagnosis of bipolar II disorder. In this review, pathophysiology, diagnosis, epide-miology and treatment of bipolar disorder are summarized, and the current situation in Japan is also introduced.Key words: depression, mania, lithium, mood stabilizers, anticonvulsantsDepartment of Psychiatry and Behavioral Science, Juntendo University, Faculty of Medicine, Tokyo, JapanCorresponding author: Tadafumi KatoDepartment of Psychiatry & Behavioral Science, Juntendo University Graduate School of MedicineHongo 2-1-1, Bunkyo, Tokyo 113-8421, JapanTEL: +81-3-5802-1070　FAX: +81-3-5802-1070　E-mail: tadafumi.kato@juntendo.ac.jp354th Triannual Meeting of the Juntendo Medical Society “Recent topics in Psychiatry” 〔Held on sep. 9, 2021〕〔Received　Sep. 10, 2021〕〔Accepted　Oct. 11, 2021〕J-STAGE Advance published date: Dec. 17, 2021Copyright © 2022 The Juntendo Medical Society. This is an open access article distributed under the terms of Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original source is properly credited. doi: 10.14789/jmj.JMJ21-0026-RBipolar disorder In the manic state of bipolar I disorder, a patient moves around without sleeping and continues to talk without rest, and because of this, the family is exhausted. While being active, the patient cannot focus on one thing and cannot work efficiently. In addition, it is common for a manic patient to make expensive purchases, make large amounts of debt, or cause legal problems. In many cases, they lose their social credibility by making unreasonable efforts that are likely to fail. It may develop into a gran-diose delusion such as having supernatural powers.In a manic state, the patient is often unaware of his or her changes and feels refreshed and in better shape than usual, so even if he or she is having two contrasting mental states, that is, manic or hypo-manic episodes and depressive episodes. Between these episodes, patients experience euthymic, remission states. 17Bipolar Disorder: From Pathophysiology to TreatmentTadafumi KATOSymptomsis characterized by Manic state