A doctor may need to know your physical and psychological background, existing medical conditions, and family history.
This article explains a diagnosis of bipolar disorder and how doctors reach it. You also will learn what to do if you think you or a loved one is living with the condition.
Bipolar disorder is a mental health condition involving episodes of mania and depression. Bipolar disorder was previously known as manic depressive disorder.
According to the National Alliance on Mental Illness, the disorder affects males and females (assigned at birth) equally.
People living with bipolar disorder can experience episodes of mania and depression that alternate. Mania can include elevated, extreme changes in mood, behavior, and activity and energy level. Depressive episodes can include low energy, sadness, and despair.
People with bipolar disorder can experience severe complications, including psychosis, paranoia, and suicidal thoughts and attempts.
Suicide prevention
If someone you know is at immediate risk of harming themselves or others, or at risk of suicide:
- Ask the question, “Are you considering suicide?” even if it is tough.
- Listen without judgment.
- Call 911 or your local emergency number.
- Stay with them until emergency services arrive.
- Try to remove any weapons, medications, or other potentially harmful items.
If you or someone you know is having suicidal thoughts, contact the National Suicide Prevention Lifeline:
- Call 988
- Chat with the lifeline
This service is available 24-7.
What are the 3 types of bipolar disorder?
There are three types of bipolar disorder:
- bipolar I disorder: A person experiences at least one manic episode lasting at least 1 week.
- bipolar II disorder: A person experiences one hypomanic episode lasting at least 4 days, and one major depressive episode lasting about 2 weeks.
- cyclothymic disorder: This is a mild form of bipolar disorder in which a person experiences frequent mood changes. However, these changes are not severe enough for the classification of bipolar disorder.
What are the symptoms of bipolar disorder?
Symptoms of bipolar disorder
Manic episodes | Depressive episodes |
Feeling high, elated, excited | Feeling excessively sad or down |
Being more active than usual, feeling wired | Feeling low on energy |
Having racing thoughts, unable to still the mind | Being unable to focus or concentrate |
Showing pressured speech, talking an unusual amount, sometimes at high speeds | Finding it difficult to talk or have a conversation, talking very slowly |
Having high interest in activities such as eating or sex | Lacking interest in any activity |
Feeling like you are able to do many things at once | Lacking desire or energy for even simple tasks |
Feeling highly important, talented, famous, or powerful | Feeling worthless, hopeless, in despair |
Read more about bipolar disorder here.
The main symptoms of bipolar disorder are mood swings. Doctors will first rule out other medical conditions that can cause mood changes. A stroke, brain tumor, or overactive or underactive thyroid can cause mood changes. Your doctor may order imaging tests, brain scans, or blood tests.
Your doctor will question you about your symptoms. A diagnosis of bipolar disorder is based on markers
- severity of the manic or depressive episodes
- length of an episode or how long the episodes have persisted
- frequency of an episode
- frequency of symptoms
- experiences over a lifetime
Sometimes, people may seek help for depressive disorders, but manic episodes can go unnoticed. This is one reason bipolar disorder can be difficult to diagnose. In addition, bipolar disorder can mimic psychotic symptoms and be misdiagnosed as schizophrenia. Conditions such as thyroid disease, some medications, and drug use can mimic symptoms or worsen mood. These contribute to difficulty of diagnosis.
What is the treatment for bipolar disorder?
Treatment for bipolar disorder includes:
- mood stabilizers, such as lithium
- medications for depression and mania
- therapy to recognize episode triggers
- psychological treatment, such as talk therapy
- antipsychotic medications
If your doctor thinks you may have bipolar disorder, they will refer you to a psychiatrist.
The psychiatrist may ask questions such as:
- What symptoms are you experiencing?
- What moods or feelings do you experience?
- When did you first experience these symptoms?
- How long do the moods or feelings last?
- Is there anything that makes them worse or better?
- How do you feel leading up to the symptoms?
- What other symptoms do you have?
- Do you have any psychiatric or medical problems?
- Do you have a family history of mental illness?
- Are you taking any medications?
- Do you drink alcohol or use illegal drugs?
- Do you ever have thoughts about harming yourself?
Your psychiatrist will assess your symptoms and determine a diagnosis using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). This is published by the American Psychiatric Association.
Before seeing a doctor for bipolar disorder, take note of your symptoms, along with criteria
- whether the episodes have been manic or depressive
- what has happened during the episodes
- how severe episodes have been
- how long an episode has lasted
- how long you have experienced such symptoms and episodes
- your moods and feelings throughout
Also be prepared to talk with your doctor about:
- changes in your sleep
- changes in your energy levels
- changes in your speech
- changes in your behavior
- family history regarding mental illness
- your own medical history, including medications you take
- lifestyle habits
- stress in your personal life, such as in employment or relationships
Sometimes, taking a family member along with you can help. They may be more aware of behavioral changes.
In addition to asking questions about symptoms, doctors may order:
- imaging tests to rule out physical conditions
- brain scans to rule out brain-related conditions, such as a tumor
- blood tests to check for conditions such as an overactive or underactive thyroid
- urine tests
Doctors do not use brain tests to diagnose bipolar disorder.
If you think a loved one may have bipolar disorder, it is important to educate yourself about it. Then, you can use your understanding to support them.
You can also:
- be a good listener, do not invalidate their feelings
- affirm their value as a person through times of despair
- support their treatment and therapy
- make plans to deal with unpredictable behavior, including coping mechanisms for episodes
- refrain from pushing them into treatment
- be patient, as bipolar disorder is a long-term condition
Here are questions people also ask about bipolar disorder.
Can I self-diagnose bipolar?
Only a healthcare professional can give a true diagnosis.
What can mimic bipolar disorder?
Symptoms of bipolar disorder can be similar to other conditions, which may make it hard to diagnose. Other conditions that mimic bipolar disorder include:
- disorders from substance misuse
- attention deficit hyperactivity disorder (ADHD)
- borderline personality disorder
- schizophrenia
- major depressive disorder
Can you be slightly bipolar?
Cyclothymia is a more mild form of bipolar.
Bipolar disorder is a mental condition in which you experience manic and depressive mood swings. Although manageable, bipolar disorder is a lifelong condition.
To reach a diagnosis, a doctor first will rule out underlying physical conditions that could cause mood swings. They will then refer you to a mental health professional, who will question you about the episodes. They will need to know the frequency, severity, and how long you have experienced the episodes.