Bipolar disorder is a mental health condition characterized by shifts in mood that last days to weeks.
About 40 million people worldwide live with bipolar disorder. Even though it’s common, it’s often misdiagnosed because some of the symptoms overlap with other diagnoses, like depression, anxiety, or ADHD.
Psychiatrists are medical providers with specialized training to diagnose and treat conditions like bipolar disorder. Because medication is usually a necessary part of effective treatment for bipolar disorder, working with a psychiatrist can be a good place to start.
Bipolar disorder affects your energy, sleep, focus, and behavior, and the impacts on your life can be severe. Psychiatric care can be an important part of learning how to manage bipolar symptoms in a healthy way. A psychiatrist may diagnose bipolar disorder by asking detailed questions about your moods, sleep, energy levels, and how often your symptoms appear.
A psychiatrist will also review your medical history, rule out other health issues, and use special guidelines to see if your symptoms match bipolar disorder. Bipolar disorder is treatable. With the right care, many people can manage their symptoms and live full, balanced lives.
When to consider an evaluation for bipolar disorder
If you have strong mood changes that last for days or weeks and they affect your daily life, it’s a good idea to talk to a psychiatrist.
Watch out for these signs:
High energy and little sleep: You may feel wired, talk fast, and stay active with little to no sleep. This can be signs of mania or hypomania. Some people may also see or hear things that aren’t real, or have very unrealistic, inflated feelings of self-importance.
Feeling very sad or hopeless: You may go from feeling very happy or energetic to feeling down. These depressive episodes are a common part of bipolar disorder.
Risky behavior: During manic episodes, people might drive dangerously, binge on alcohol or other drugs, spend too much money, have risky sex, or make big decisions quickly.
Trouble with relationships, work, or friends: Mood swings can make it hard to maintain friendships, family relationships, or a steady job.
Not everyone who has bipolar disorder has the same experience, as the condition exists on a spectrum. Three main types of bipolar disorder exist:
Bipolar I disorder: This diagnosis requires at least one manic episode that lasts at least seven days or is so serious it needs hospital care. These episodes cause big problems in their life like job losses, hospitalizations, or arrests, often due to impulsive, erratic, or risky behaviors. They may also have had depressive episodes, but they aren’t required for a diagnosis.
Bipolar II disorder: This involves at least one major depressive episode and at least one hypomanic episode (a less intense form of mania). Depression in bipolar II tends to last longer and cause more problems with functioning than hypomania. People with bipolar II may feel deeply sad or down for long periods, then suddenly have bursts of energy that last a few days. Hypomanic episodes may cause some problems in relationships or in their work, but people are usually still able to manage daily life. Some even experience these periods as positive and productive.
Cyclothymic disorder: This is another form of bipolar disorder. It causes less severe mood swings between depression and hypomania. In cyclothymia, this pattern of mood shifts have happened over a period of at least two years, with only short breaks (less than eight weeks), of feeling “normal.”
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How a psychiatrist diagnoses bipolar disorder
To figure out if you have bipolar disorder, a psychiatrist will ask questions about your symptoms and their impact on your life. They may order blood tests and consider your medical history to rule out conditions, like thyroid dysfunction, substance use, or even reactions to certain medications. That’s because these issues can have symptoms that look like mania or depression.
A psychiatric provider may also ask you questions, like:
How often do your moods change?
Is your sleep pattern normal?
Does anyone in your family have bipolar disorder?
Do your relationships have ups and downs?
Have you ever had thoughts of suicide?*
Psychiatrists use a guide called the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), to diagnose mental health conditions. It’s important to get the right diagnosis since bipolar disorder can sometimes be confused with other conditions, like borderline personality disorder (BPD). It also can occur along with other diagnoses like substance use disorders or ADHD.
It might take some time to get a diagnosis. That’s because bipolar symptoms can change over time, and accurately identifying or remembering episodes and symptom patterns can be difficult. Sometimes, your doctor may ask you to track your symptoms for a while to get a clearer picture, or ask you to include loved ones in your care to get more information about patterns over time (this can be really helpful!).
If you’re diagnosed with bipolar disorder, your psychiatric provider can then help you build a care plan that works for you.
*If you are experiencing suicidal thoughts, please contact the National Suicide & Crisis Lifeline by calling or texting 988 from any phone for 24/7 crisis support.
Living with a bipolar disorder diagnosis
After you’re diagnosed with bipolar disorder, a psychiatrist will help create a tailored treatment plan. This plan may include therapy, medicine, and changes to your daily habits. While bipolar disorder can’t be cured, many people go for long stretches without major symptoms.
To help you feel your best, a psychiatrist might suggest:
Medication: Your psychiatric provider will recommend medications to help you manage the symptoms of bipolar disorder. These usually include mood stabilizers and antipsychotic medications. Antidepressants may be helpful for some people, but for many with bipolar disorder, they can actually worsen symptoms. A psychiatric provider can offer support and expert guidance as you find the right medication combination for you.
Going to therapy: Therapy can help you understand your thoughts and feelings. Common types of therapy for bipolar disorder include cognitive behavioral therapy (CBT), interpersonal and social rhythm therapy (IPSRT), family-focused therapy (FFT), and dialectical behavior therapy (DBT). The kind of therapy that’s best for you depends on your symptoms and personal goals.
Learning about bipolar disorder: Knowing more about your condition helps you take part in your care. You can learn how to spot mood changes early, understand what triggers them, and learn how to cope in healthy ways.
Tracking your symptoms: Your psychiatrist might ask you to keep a mood journal or use an app to track how you feel, your sleep patterns, and any side effects from medicine.
Making healthy lifestyle changes: Consistent sleep is one of the keys to managing bipolar disorder, so your psychiatrist will work with you to make a plan for improving your sleep patterns. You may also work with them and a therapist to figure out ways to lower stress and stay active through regular exercise. Little changes can make a big difference with your bipolar symptoms.
Getting support: Joining a support group or attending family therapy can help you and your loved ones understand bipolar disorder better. Your psychiatrist might also help you create a crisis plan in case of serious mood swings.
Why a careful bipolar diagnosis matters
Being diagnosed with bipolar disorder can be validating, confusing, or even overwhelming. It might be hard to accept that you have a long-term mental health condition that will require care. But learning more about bipolar disorder is the first step in feeling better and taking charge of your health. The earlier you get the right diagnosis and treatment, the better.
Some common challenges include:
Accepting the diagnosis: If you feel unsure about your diagnosis or want a second opinion before starting medication, that’s OK. Getting the right diagnosis is key to getting better.
Dealing with mood swings: Even with treatment, mood changes can still happen. If your medication isn’t helping or causes strong side effects, talk to your doctor. They may adjust your dose or try something new.
Sticking with treatment: Finding the right medicine can take time. Some people stop taking their meds during a manic phase because they feel good or because of side effects. Yet, stopping suddenly can make symptoms worse. Always talk to your psychiatric provider first so you can make a plan together.
Feeling alone or misunderstood: Some people don’t understand bipolar disorder. This can make it hard to talk about your diagnosis and lead to feeling lonely.
Sticking to a routine: Having a regular schedule for sleeping, eating, and staying active is very important when managing bipolar disorder. Stress, not getting enough sleep, or big changes in your routine can bring on symptoms.
Something I’ve learned over time is if I see someone who has tried multiple antidepressants with little relief, it’s important to dig deeper to see if their symptoms are actually on the bipolar spectrum. The faster we are able to find the right diagnosis and treatment, the better.
Stephanie J Reed, MSW, MSN, PMHNP-BC
Clinical reviewer
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Bipolar disorder is a lifelong condition, but with the right help, most people can learn to manage it and lead full lives. By working with a psychiatrist, you can get a diagnosis and develop a treatment plan that works for your symptoms and life.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.
Linda Childers
Linda is an award-winning medical writer with experience writing for major media outlets, health companies, hospitals, and both consumer and trade print and digital outlets.
Her articles have appeared in the Washington Post, USA Today, WebMD, AARP, Brain+Life, HealthyWomen.org, The Rheumatologist, California Health Report, Everyday Health, HealthCentral, and many other media outlets.
While juggling the responsibilities of being part of the “sandwich generation” and caring for both her toddler son and terminally ill mother, a nurse friend encouraged her to seek therapy, which helped her to learn coping strategies and manage her depression. Linda hopes her work will help to destigmatize mental health conditions and encourage others to get the help they need.
Stephanie J Reed, MSW, MSN, PMHNP-BC
Stephanie started her career in mental health as a clinical social worker in 1997. She’s been practicing as a psychiatric nurse practitioner since 2020. She’s worked in many settings, including in labor and delivery as an RN, in child protection, in community mental health, and in an urban clinic affiliated with the Indian Health Service.
Her passion for mental health comes from a desire to provide the kind of care and education for people that she wishes had been available to her family. Good mental healthcare can be transformative for people and families, and it’s work that she’s very proud to be part of.
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