Evolve Psychiatry

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Unmasking Bipolar Disorder: How It's Diagnosed and Managed

What is bipolar disorder?

Bipolar disorder causes severe mood swings. The highs are known as manic and hypomanic episodes, while the lows are called depressive episodes. A manic episode is a period of time marked by an abnormally high mood and energy level that leads to impulsive behavior and delusions. A hypomanic episode is a milder type of manic episode. On the other hand, a depressive episode is a period in which the patient experiences the symptoms of depression, from low mood to loss of interest in hobbies to feelings of hopelessness.

These mood changes can affect not only a person’s emotional state but also their activity level and behavior. Often, the result is a rocky personal life and career. Which episodes a patient experiences determines which type of bipolar they have:

  • Bipolar I. Has had one or more manic episodes and may experience depressive episodes.

  • Bipolar II. Has experienced depressive and hypomanic episodes.

  • Cyclothymia (cyclothymic disorder). Has chronic mood swings, switching between mild depression and hypomania.

How bipolar disorder is diagnosed

A psychiatrist can diagnose all types of bipolar disorder. However, many people with bipolar go undiagnosed because their symptoms appear normal to them. It is common not to notice the pattern, especially with bipolar I. In part, this is because many report how good the manic episodes feel and, therefore, only seek psychiatric help when they are later faced with its negative effects.

With this in mind, psychiatrists are diligent when diagnosing bipolar disorder. They will ask questions about the low moods that come with depressive episodes, and they will look for signs of manic or hypomanic behavior. The process of diagnosing types of bipolar involves the following.

Checking for symptoms

Diagnosing any mental disorder requires looking for the symptoms laid out in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). If the psychiatrist suspects that a patient may have bipolar disorder, they will ask whether they have experienced any of the listed symptoms. For example, symptoms of manic episodes include excessive excitement, working on many projects at once but not finishing most of them, decreased need for sleep, rapid speech, impulsive behavior, and delusions or hallucinations. Depressive symptoms they may ask about include an overwhelming low mood, feelings of worthlessness, increased need for sleep, loss of enjoyment, and irritability.

Asking about personal struggles

Since the symptoms of bipolar disorder overlap with those of other conditions, the psychiatrist will consider one’s personal struggles as well. This also helps determine whether one’s symptoms are severe enough to warrant a diagnosis (i.e., the symptoms must interfere with the patient’s everyday life). Patients can expect to be asked about their social relationships, sense of well-being, work, and other aspects of life.

For instance, impulsive behavior during a manic episode can result in the patient struggling with debt from gambling and impulsive purchases once their mood plateaus. Alternatively, a depressive episode may leave a person isolated and behind in work. All types of bipolar episodes can result in strained and broken relationships.

Looking at family and medical history

The psychiatrist will also inquire about the patient’s family and medical history, such as whether other family members have been diagnosed with bipolar or another mental disorder. They may recommend that the patient have a physical examination and blood tests done to ensure there is no underlying physical health condition. Hyperthyroidism, for example, has symptoms similar to bipolar disorder.

At the end of this extensive evaluation, the psychiatrist will be able to determine whether the patient has bipolar. They may confer with other mental health professionals to come to an official diagnosis. However, getting diagnosed is just the start—treatment is the next step in finding relief.

Managing and treating your symptoms

A psychiatrist may recommend various treatments for bipolar disorder. Typically, this involves some type of prescription medication to level out one’s manic, hypomanic, or depressive episodes and psychotherapy (talk therapy) to learn how to manage one’s symptoms in the long term. The goal is a life less influenced by bipolar disorder.

Call a psychiatrist for more information

When mood swings cause problems in life, consult a psychiatrist. They can evaluate you for bipolar disorder and other conditions or factors that could be the root cause. Call our office to schedule an appointment today.


Become a new patient today or give us a call: 631-673-3233.