Background: Bipolar disorder (BD) is considered as one of the most common chronic diseases among populations that are always conjugated by depression; however, in chronic cases, it might increase the risk of death.
Case presentation: A 65-year-old Saudi male presented to the Emergency Department due to irritation and agitation symptoms. He had a history of hypertension but with no previous history of strokes, seizures, any other psychotic or depressive symptoms, and substance use. The patient was admitted in psychiatry, where a lot of investigations were performed, and thus, he underwent computed tomography and magnetic resonance imaging. The patient was started on valproic acid 500 mg and olanzapine 5 mg for 15 days. The patient's results were all within the normal range, and the imaging showed no significant findings. The symptoms gradually improved with an improved mental state. The patient was finally discharged on valproic acid 1,000 mg/day and olanzapine 10 mg/day.
Conclusion: This case ensured that the late onset of BD should be considered even though bipolar affective disorder typically presents in the younger populations. Valproic acid and olanzapine drugs helped in the enhancement of the mental state of the patient.
Key words: Bipolar disorder, depression, manic episode, chronic disorders