Do I have bipolar disorder? How to get an evaluation 

Bipolar disorder is a complex mental health condition that can make day-to-day life challenging. 

If you think you may have bipolar disorder or are struggling with your mental health, it’s important to see a qualified mental health professional, like a psychiatrist who can provide an evaluation, make an accurate diagnosis and provide effective treatment options so you can start feeling better. 

Below, we break down everything you need to know about the symptoms of bipolar disorder, when to get an evaluation, and what you should expect. 

What is bipolar disorder?

Formerly known as manic depression or manic-depressive disorder, bipolar disorder is a mood disorder characterized by intense emotions and swings in:

• Mood 
• Behavior 
• Energy levels
• The ability to function

These mood swings, or “episodes,” can last days or weeks at a time. They range from extreme highs (mania) to lows (depression). (More on how these episodes can feel in the symptoms section of this article.) 

It’s important to note that the intensity and frequency of these episodes can vary, and bipolar disorder will look different for everyone. Some people with bipolar disorder can function with few or no episodes throughout the year and maintain healthy professional and interpersonal relationships. But for most people, living with bipolar disorder disrupts their relationships, work, and day-to-day life.

What are the symptoms of bipolar disorder?

It’s important to keep in mind that occasional changes in mood are a normal part of life for everyone and experiencing “highs” and “lows” isn’t necessarily a definitive sign of bipolar disorder. However, when symptoms begin interfering with your ability to function on a day-to-day basis, that’s a sign to seek out professional help for what may be a more serious mental health condition.

Here are some common symptoms of bipolar disorder: 

What are the symptoms of mania?

Not all people with bipolar disorder will experience intense periods of mania. Mania can be mild and last for only a few days—this is known as “hypomania.” Often, people are unaware that they’re in a hypomanic episode since they may not experience major disruptions in day-to-day life. 

• Feelings of elation or extreme irritability
• A decreased need for sleep
• A sense of well-being that exceeds reality (euphoria) 
• Feeling grandiose 
• Talkativeness or faster speech that seems out of character
• Irrational thoughts
• Difficulty focusing
• Intense anger 
• Poor decision-making (spending sprees, reckless driving, unsafe sex) 
• Risky or out-of-control behavior and impulsivity

What are the symptoms of depression?

People with bipolar disorder can also experience periods of depression, often following a period of mania. Symptoms can include:

• Unstable self-image and poor sense of self 
• Feelings of hopelessness
• Fear of abandonment
• Lack of interest or enjoyment in activities
• Low energy or fatigue
• Lack of focus or concentration, slowed behavior
• Decrease or increase in appetite and disordered eating (binge eating or abstaining from eating) 
• Decrease or increase in sleep
• Excessive feelings of worthlessness or guilt
• Frequent thoughts of death, self-harm, or suicidal behavior 

Like “manic” episodes, depressive episodes can also vary in severity, and not everyone who has bipolar disorder will experience depressive episodes. 

Bipolar disorder symptoms can overlap with those of other conditions like depression, making it difficult to properly diagnose. That’s why, if you think you may have bipolar disorder or are struggling with your mental health, it’s important to see a licensed mental health professional, like a psychiatrist, who can provide an evaluation and make an accurate diagnosis. 

What are the possible causes of bipolar disorder?

While there’s no single cause of bipolar disorder, the best research suggests that brain chemistry and genetics may play a role.

• Brain chemistry: imbalances in certain chemical messengers (like dopamine and serotonin—our feel-good hormones) can be a factor 
• Genetics: bipolar disorder is one of the most genetically linked mental health conditions, especially when it comes to type I (which we explain further below). According to a 2009 review, adults who have family members with bipolar disorder have a 10x average increased risk of developing the disorder.

Additional risk factors include extreme stress and substance abuse. Also, those suffering from bipolar disorder may have other co-occurring conditions such as ADHD, anxiety disorders, substance use disorders, and post-traumatic stress disorder (PTSD).

What are the different types of bipolar disorder?

There are three main types of bipolar disorder: bipolar I, bipolar II, and cyclothymic disorder. Here’s what sets them apart:

1. Bipolar I: People with Bipolar I will experience one or more episodes of mania and may or may not experience depressive episodes. Manic episodes must last for at least seven days or are so severe they require hospitalization. 
2. Bipolar II: People with Bipolar II are primarily affected by major depression, with at least one experience of hypomania (a milder form of mania).
3. Cyclothymia, or Cyclothymic Disorder: People with Cyclothymic Disorder will experience long-term hypomania and mild depression. While they may have periods of “normal” moods, these usually last less than eight weeks. 

Keep in mind that people can experience symptoms differently, and symptoms can change over time. It’s important to seek help from a mental health professional who will be able to evaluate your needs and provide a personalized treatment plan based on your current symptoms and progress.

What to expect during a bipolar evaluation

If you think you may have bipolar disorder or are struggling with your mental health, a psychiatrist is a great place to start. In your first appointment, or initial evaluation, a psychiatrist will ask you about how you’ve been feeling. You’ll go over any current symptoms and your health history. 

Here are some examples of the types of questions you can expect to be asked: 

• What symptoms are you experiencing? 
• When did your symptoms first start? 
• How long have you been experiencing symptoms? 
• Do you have a family history of mental health conditions?

At Talkiatry, you can expect to have up to 60 minutes in your first appointment to allow plenty of time for you to discuss how you’ve been feeling and ask questions. 

After the evaluation, you’ll receive an initial diagnosis (if there is one). 

While this can feel scary, it can also be validating to finally put a name to what you’ve been experiencing. Your psychiatrist will help you navigate any emotions that come up and work with you on a path to move forward.

Once you’ve discussed your initial diagnosis, you’ll collaborate with your provider on an effective treatment plan.

Although bipolar disorder has no cure, treatment can drastically improve your symptoms. Treatment typically includes a combination of medication management and supportive therapy. 

Medication

The most common medications used to treat bipolar disorder are mood stabilizers. These include medications such as Lithium, seizure medications, and atypical antipsychotic medications, all of which also have FDA-approval for treating bipolar disorder.

Mood stabilizers work by decreasing abnormal activity in the brain, which can help eliminate and/or reduce the severity of mood episodes. In people with depressive episodes, an antidepressant may or may not also be added. 

Therapy

Therapy can be an important tool to help with symptom management. It can take various forms: 

• Cognitive behavioral therapy (CBT): helps you identify patterns of thinking around your condition and its symptoms while understanding exactly how your thoughts affect your actions 
• Dialectical behavior therapy (DBT): emphasizes regulating emotions, being mindful, and learning to accept pain. It focuses on helping people change their behavior patterns rather than trying to think or talk through the issues they are struggling with. DBT has shown promise as an effective treatment option for bipolar disorder, but more research is needed.
• Psychoeducation: helps you and your loved ones gain knowledge about the condition and what to expect 

About Talkiatry

Talkiatry is a national psychiatry practice that provides in-network, virtual care. Co-founded by a patient and a triple-board-certified psychiatrist, Talkiatry has over 300 doctors, 60 insurance partners, and first visits available in days. We treat patients with anxiety, depression, trauma, ADHD, and more. Get started with a short online assessment.

The information in this article is for informational and educational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

Sources:

Bipolar Disorder - StatPearls | NCBI Bookshelf

The genetics of bipolar disorder | NCBI

Genetics of bipolar disorder | PMC

The genetics of bipolar disorder | ScienceDirect

Clinical Practice Guidelines for Management of Bipolar Disorder | PMC

Diagnosing and treating bipolar spectrum disorders | American Psychiatric Association