Functional Connectivity in Mood Regulating Circuit In Bipolar Depression and Mania

Inclusion Criteria: Inclusion criteria for Bipolar Subjects * Ages 18-60 years and able to give voluntary informed consent. * Satisfy criteria for Bipolar Depression using the Structured Clinical Interview for Diagnostic and Statistical Manual -4th edition (DSM-IV) (SCID-IV). * Bipolar depressed subjects: 25-item Hamilton Depression Rating Scale (HDRS) score \> 18.Young Mania Rating Score (YMRS)\<10. * Bipolar hypomanic/manic subjects will have a YMRS score\>12 and a 25-item HDRS score\<10. * Bipolar Euthymic subjects will have YMRS score \< 10 and HDRS score \< 10 and would have been euthymic for \> 14 days. * Subjects will be drug and medication free and would have no significant history of medical or neurological illness. * Satisfy criteria to undergo an MRI scan based on MRI screening questionnaire * Able to be managed as outpatients for initial assessment and during treatment as ascertained by the following: * Symptoms not worsening by more than 10 points on either the HDRS or the YMRS during the course of the study. * No danger to self or others. * No psychotic symptoms. Inclusion criteria for Healthy Subjects: * Ages 18-60 years and able to give voluntary informed consent. * No history of psychiatric illness or substance abuse or dependence as assessed by SCID for non-patients (SCID-NP). * No significant family history of psychiatric or neurological illness. * Not currently taking any prescription or centrally acting medications. * No serious medical or neurological illness as assessed by history, physical examination and laboratory examination including CBC and blood chemistry. Exclusion Criteria: Exclusion criteria for Bipolar Subjects * Meeting DSM-IV criteria for schizophrenia, schizophreniform disorder, schizoaffective disorder, atypical psychosis, mental retardation, or organic mental (including organic mood) disorder. * Use of neuroleptic past 2 weeks * Use of antidepressants in the past 2 weeks. If on fluoxetine in the past then should not have been on this medication for 4 weeks. * Use of mood stabilizers in the past 2 weeks * Use of benzodiazepines in the past 2 weeks. * Acutely suicidal or homicidal or requiring inpatient treatment. * Meeting DSM-IV criteria for other substance dependence within the past year, except caffeine or nicotine. The criteria will be evaluated by interview and urinary toxicology screening initially and on test days. * Use of alcohol in the past 1 week. * No serious medical or neurological illness as assessed by physical examination and laboratory examination including complete blood count (CBC) and blood chemistry. * Current pregnancy or breast feeding. * Metallic implants. * Previously known positive Human Immunodeficiency Virus (HIV) blood test as reported by the subject. Exclusion criteria for Healthy Subjects: * Under 18 years of age. * Pregnant or breast feeding.