Bipolar Disorder: Treatment, Symptoms, Diagnosis, and Online Care

At Talkiatry, we know that navigating mental health can feel overwhelming. Our mission is to make it easier—starting with information you can trust. As a national mental health practice with over 600 psychiatrists and other providers, we combine clinical excellence with real-world understanding to deliver incredible care and reliable information. This article has been medically reviewed by the same doctors who treat our patients every day, ensuring it meets the highest standards. Whether you’re seeking care now or simply looking to learn more, we’re here to help.

Bipolar disorder is a serious but manageable mental health condition that affects millions of people in the United States. With the right combination of professional care, medication, therapy, and lifestyle support, many people living with bipolar disorder can find stability and have a full life.

What is bipolar disorder?

Most people experience mood swings from time to time, but bipolar disorder goes beyond typical ups and downs. It’s characterized by intense shifts in mood, energy, and activity levels. These episodes range from emotional “highs” (mania or hypomania), which can feel euphoric, energized, or irritable, to “lows” (depression), which can bring deep sadness, hopelessness, or a sense of emotional numbness. These episodes typically last for days or weeks and often disrupt daily life and relationships. 

Bipolar disorder affects how you think, feel, and function in nearly every area of life. It can take time to get an accurate diagnosis—symptoms often overlap with other conditions, especially depression, and misdiagnosis is common. But once bipolar disorder is identified and properly treated, it can be managed. 

With the right diagnosis, consistent psychiatric care, and a personalized treatment plan, many people with bipolar disorder find relief from symptoms. If you think you may be experiencing bipolar disorder, speaking with a psychiatrist is an important first step toward balance and stability.

What are the types of bipolar disorder?

There are several types of bipolar disorder, each with its distinct patterns: 

• Bipolar I involves one or more episodes of mania, an extreme increase in energy and/or abnormally elevated mood that may last over 7 days. It can include feelings of euphoria (a sense of well-being that exceeds reality) or intense irritability, and can cause sleep and behavior changes that are noticeable by others. It is often extremely disruptive to a person's daily life and may lead to psychiatric hospitalization.
• Bipolar II does not involve mania. Instead, people with bipolar II disorder tend to shift between periods of depression and periods of hypomania. Hypomania is a milder form of mania that is less disruptive but still represents a clear departure from a person’s typical emotions and behavior. There may be neutral periods in between.
• Cyclothymia, or cyclothymic disorder, is a rare form of bipolar disorder characterized by mood oscillations that fall short of meeting the criteria for hypomania and major depressive episodes. Individuals may experience periods of mild depression and mood elevations that are less intense than hypomania, with neutral periods in between. 

While bipolar I is often recognizable because of manic symptoms, bipolar II can be a little trickier to identify. Many people with bipolar II first seek out treatment during a depressive episode. They may not realize they have also had hypomanic episodes, which can lead them to be misdiagnosed with depression. That’s why it’s so important to have symptoms of bipolar disorder evaluated by a qualified mental health professional, who will take a careful history to provide an accurate bipolar disorder diagnosis. 

What are the symptoms of bipolar disorder?

It’s natural to experience mood changes, but when those shifts last for days or weeks and start to affect your relationships, work, or daily functioning, it could be a sign of bipolar disorder. Bipolar disorder causes episodes of mania, hypomania, and depression that go beyond typical ups and downs. These symptoms may be noticeable to others and can feel very different from your usual self.

Symptoms of mania

Manic episodes can feel good at first, but quickly become uncomfortable and erratic. They may last 7 days or longer. In some cases, manic symptoms may be severe enough to require hospitalization. These symptoms include: 

• Elation or extreme irritability
• Decreased need for sleep
• Euphoria or a feeling of invincibility
• Rapid speech or talkativeness
• Racing thoughts or poor focus
• Risky behavior or poor judgment (e.g., spending sprees, reckless driving) 

Symptoms of hypomania

Hypomania involves milder symptoms than mania and may last fewer than 7 days. You might feel energized, productive, or unusually motivated—often without recognizing anything is wrong. However, others may notice behavioral changes during hypomanic episodes.

Symptoms of depression

Symptoms of bipolar depression are more severe than everyday sadness. They may last two weeks or longer and include: 

• Persistent sadness, anxiety, or emptiness
• Loss of interest or enjoyment in activities
• Fatigue or low energy
• Trouble concentrating or slowed thinking
• Changes in appetite or sleep
• Feelings of worthlessness or guilt
• Suicidal thoughts or frequent thoughts of death 

People with bipolar I may also experience symptoms of psychosis, including delusions or hallucinations, during manic episodes. (Hypomania does not include psychotic symptoms.) Virtual treatment can help manage these symptoms in some cases. For more severe episodes, your psychiatrist may recommend in-person or hybrid care outside of Talkiatry.

What causes bipolar disorder?

The exact cause of bipolar disorder is still unknown. Researchers believe there’s a strong genetic component—between 80 and 90% of people with bipolar disorder have a relative with depression or bipolar disorder. 

Additional risk factors for bipolar disorder include: 

• Extreme stress, for instance, as a result of abuse, the loss of a close family member, or the end of a relationship
• Drug or alcohol abuse

In addition, people with bipolar disorder may have other conditions, like: 

• Substance use disorders
• ADHD
• Anxiety disorders

How a psychiatrist can help

With bipolar disorder, an accurate diagnosis is critical, and it starts with a conversation. A psychiatrist’s role begins with listening closely to your experiences, mood patterns, and medical history to understand what you’re going through. Because bipolar disorder can be complex and is often mistaken for other conditions, working with a trained professional can make all the difference in finding clarity. 

Psychiatrists don’t just diagnose—they partner with you to create a care plan that’s tailored to your needs. Bipolar disorder is almost always managed with medication. Treatment can also include therapy referrals and support with lifestyle adjustments. Over time, your psychiatrist will continue to monitor how you're feeling and make adjustments when needed. With consistent support, many people living with bipolar disorder can achieve more stability and feel more in control of their mental health. 

If you’re wondering what starting care looks like, here’s a closer look at getting an evaluation for bipolar disorder.

Bipolar disorder diagnosis

A qualified psychiatric provider can diagnose bipolar disorder through a comprehensive mental health assessment. This typically includes in-depth questions about your symptoms and your family history. They’ll use standardized diagnostic criteria to determine whether your experiences are consistent with a bipolar disorder diagnosis. The process may also include a physical exam and lab tests to rule out medical issues that could be contributing to your symptoms. 

It can take time to get an accurate diagnosis for several reasons. People may not fully remember what happens during a manic episode. In addition, symptoms of bipolar disorder often overlap with other mental health conditions, and many people with bipolar disorder also have other conditions like anxiety, ADHD, or PTSD. Bringing a trusted friend or family member to your appointment can help provide a fuller picture, especially if they’ve noticed behavior changes during manic episodes or hypomanic episodes that you may not be aware of.

Psychiatry vs. therapy

Psychiatry focuses on diagnosing conditions and managing them with medication when appropriate. Therapy helps you process your experiences, develop coping skills, and work toward longer-term healing.  

Both can be powerful tools for treating bipolar disorder, but medication is the cornerstone of treatment. While bipolar disorder isn’t effectively treated with therapy alone, many people find that combining medication with therapy provides a more comprehensive approach to managing symptoms and maintaining stability.

Bipolar disorder treatment options

Bipolar disorder has no cure, but treatment can drastically improve your symptoms. Most commonly, bipolar disorder is managed with a combination of medications and supportive therapy. Cyclothymia, although considered “milder” than bipolar I or bipolar II, is generally treated the same way.

Medication management

The most common medications used to treat bipolar disorder are mood stabilizers and antipsychotics. Mood stabilizers work by decreasing abnormal activity in the brain, which helps minimize or eliminate mood episodes. Antidepressants may be used to treat depressive episodes, but they’re typically prescribed alongside a mood stabilizer or antipsychotic medication to reduce the risk of triggering a manic episode. 

It may take several weeks for these medications to reach their full effect. If one medication doesn’t work for you, you may respond to another, so it’s important to work closely with a psychiatrist who can adjust your treatment based on your individual needs. Ongoing treatment is key to managing your condition and keeping your symptoms under control. That means taking your medication consistently, even when you feel well.

Therapy

Therapy can be a powerful part of bipolar disorder treatment, helping you build practical skills, increase self-awareness, and maintain stability over time. It can also offer guidance and support for your family or caregivers. 

There are specific therapy approaches that have been proven to help manage the symptoms of bipolar disorder: 

• Cognitive behavioral therapy (CBT) is an evidence-based talk therapy technique that helps you recognize and change unhelpful thought patterns and behaviors. For people with bipolar disorder, it can be especially helpful for recognizing mood episode triggers, reframing negative thoughts during depressive episodes, and building routines and healthy coping strategies.
• Interpersonal and social rhythm therapy (IPSRT) focuses on stabilizing daily routines related to your mood, like sleep, eating, and social engagement. ‍
• Psychoeducation is a type of therapy that can be helpful for both people with bipolar disorder and their families. The goal is to gain knowledge about the condition and its treatment, so you, your loved ones, and your psychiatrist can work together to achieve the best possible outcome.

Online bipolar disorder treatment: How Talkiatry can help

If you have or think you might have bipolar disorder, Talkiatry can help. To get started, fill out a short form online so we can learn more about you and what you’re looking for—it only takes 10 minutes. We’ll match you with one of our psychiatrists who specializes in mood disorders, and you can have your first visit within days. 

During your first appointment, your psychiatrist will ask about your symptoms, health history, and goals, and make sure virtual care is the right fit for you. If they make a diagnosis, they’ll guide you through any emotions that come up. From there, you’ll work together on a personalized treatment plan. Ongoing care includes regular check-ins to track progress and make any needed adjustments, so you’re always supported as you move forward.