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.