- You would like to make the term "bipolar affective disorder" clearer.
- In such an illness, depression has its "antipodes". These are states of mania or hypomania. Hence, the term 'manic-depressive illness' is also used for this type of disorder.

- The Polish language dictionary defines the term 'hypomania' as 'passionate love of horses'. This is a very 'Polish' affliction.
- The prefix 'hypo-' can come from the Greek word 'hippos' meaning horse, but also from the word 'hypo' meaning something of lesser intensity. In this case, 'hypomania' means a state of mania of lesser intensity. Such a state is generally a pleasant experience and patients sometimes function better in a state of hypomania than in a state of even mood. However, if there is a transition from a state of hypomania to a state of depression, and such a transition can sometimes be extremely abrupt, the experience can be very dramatic. Such cases carry a high risk of suicide attempts.

- Etymologically, the term 'mania' is derived from the Greek and means 'madness'. Am I close now?
- In the case of manic-depressive disorder, the term 'mania' describes an episode of illness characterised by increased mood, grandiose thinking and a prominent, often chaotic increase in activity. The functioning of patients in a state of mania is sometimes completely impaired. The ability to manage one's behaviour rationally, to evaluate and anticipate the consequences of behaviour may be abolished.

- Is it possible to prevent this upward and downward descent? To the patient's peregrination between the equator and Antarctica?
- Half of the cases of bipolar affective disorder begin with depression and half with mania. The stigmatisation of the depressive state is no longer as great as for schizophrenia, but in men, for example, there is still a psychological mechanism at work that makes it difficult to seek help, because how can a 'real man' be depressed at all? The US Mental Health Institute even had such a "Real Man - Real Depression" campaign a year ago. On the other hand, a patient who is in a state of mania or hypomania will certainly not see a doctor on his own, because he thinks he knows everything better than his surroundings and all the doctors put together.

- From what you say, there is little optimism for the chances of early diagnosis of bipolar disorder.
- US studies indicate that it takes about eight years from the first clinical symptoms to a correct diagnosis. In the meantime, the patient may be diagnosed with intermittent depression if the hypomanic states are not severe, or with schizophrenia if psychotic symptoms are present in the manic state. Clearly, with incorrect diagnosis and treatment over a period of several years, very large impairments in the functioning of such individuals can, and usually do, occur.

- Could a diagnosis of 'borderline' personality in adolescence be any indication here?
- Symptoms similar to borderline personality disorder can be a harbinger of later bipolar disorder. A number of studies, including ours, show that if the first depressive episode occurs before the age of 25, the likelihood of having a future bipolar disorder is very high.

- Genetic factors?
- Their influence in bipolar affective disorder is generally greater than in intermittent depression. The concordance of the disease among so-called monozygotic twins, i.e. twins with an identical genetic suit, is up to 80 per cent. In the case of periodic (unipolar) depression, the importance of genetic factors is greater in women than in men.

- The doyen of Polish psychiatry, Professor Antoni Kępiński, once called schizophrenia 'the disease of kings'. There are many first names among those diagnosed with bipolar affective disorder. Conclusions, Professor.
- It is generally believed that traits such as increased explorativeness, creativity, etc., can be associated with bipolar disorder. And indeed, during periods of heightened drive, but when controlled, such a condition may favour creative activity. Genetic and molecular studies carried out in our Clinic have shown that a variant of a certain gene that increases the predisposition to bipolar disorder, at the same time predisposes to greater intellectual performance. But take, for example, the problem of suicidal behaviour. Although depression increases the risk of suicidal behaviour the most, there are people with depression who do not have suicidal tendencies and there are families where suicide attempts are repeated, so to speak, from generation to generation. So, too, increased creativity is not an identical trait to bipolarity.