Introduction
Bipolar disorder is a severe and chronic illness with recurrent episodes
of mania and depression. The overall lifetime prevalence of bipolar
spectrum disorders, based on a large cross-sectional survey, was 2.4%,
with an account of 0.6% prevalence for bipolar type I and 0.4% for
bipolar type II [1]. The notion of risk and protective factors is
one of the important parameters linked with predicting the outcome of
bipolar disorder. These factors, of various forms as bio-psycho-social,
have multidimensional operations starting from individual to family,
school, neighborhood, and a broader societal level. The more chance of
having the positive effects of protective factors that outweighs
negative risk factors, the better is the prognosis. Major protective
factors for a positive outcome in a bipolar patient include social
support (from at least one caring adult) which is protective about a
wide range of adversities [2].
The Second wave of COVID-19 was recorded in Nepal by April/May 2021,
after the exponential rise of cases [3]. We report a case of 23
years old male who was rescued by the neighbors after the exacerbation
of the second episode of mania and brought to our center amid the
COVID-19 second wave. We intend here to point out the implication of the
dynamics of the protective and risk factors for bipolar mood through a
23-year patient from eastern Nepal which is largely harmonious in its
multi-ethnic, multilingual, and multicultural social composition.