Table of Contents

What is Bipolar Disorder?

Bipolar disorder is a serious mental health condition characterized by recurring depressive, manic, and/or hypomanic mood episodes. Those with bipolar disorder can experience periods of intense happiness, energy, and clarity as well as episodes of deep sadness, fatigue, and confusion. The severity of these mood episodes can be so overwhelming that some affected individuals may contemplate suicide.

Everyone with bipolar disorder experiences manic episodes, which are marked by unusually elevated or irritable moods lasting at least a week and impacting daily functioning. However, not everyone with bipolar disorder experiences depressive episodes.

Types of Bipolar Disorder

Bipolar I

In Bipolar I, patients experience mania that is at least one week in duration and depression that is at least two weeks in duration. In some cases, mental health professionals may give someone a diagnosis of Bipolar I when these episodes are shorter but intense enough to put that person in the hospital.

Bipolar II

In Bipolar II, each stage is shorter, and the symptoms of mania can be less intense. While the manic symptoms may be less severe, Bipolar II patients still need the same support, compassion, and quality of care as those with Bipolar I given the severity of depressive symptoms.

Cyclothymic Disorder (Cyclothymia)
Cyclothymic Disorder (Cyclothymia) is a milder, chronic form of bipolar-related disorder lasting at least two years in adults (one year in children). It involves periods with symptoms of hypomania and depression that do not meet full criteria for major depressive or hypomanic episodes.

Symptoms of Bipolar Disorder

Bipolar disorder causes elevated moods that can be so severe that the person stops taking care of the basic things in life, ignoring work, family, and even money. Manic episodes can involve impulsive behavior that puts the individual and those around them at risk.

These individuals also experience episodes of deep depression, the polar opposite of their manic behaviors. Suicidal ideation can be experienced in either depressive or manic episodes, so both episodes can be associated with significant risk. These swings do not only happen for a few days, but for weeks at a time in some cases.

Manic Symptoms

  • Excessive energy levels
  • Feelings of extreme elation
  • Insomnia
  • Irritability with others
  • Racing thoughts
  • Excessive risk taking

Depressive Symptoms

  • Feelings of hopelessness
  • Low energy levels
  • Insomnia or sleeping too much
  • Fatigue
  • Feelings of emptiness and detachment
  • Avoidance of favorite activities
  • Suicidal thoughts

Bipolar Disorder Testing & Evaluation

Bipolar disorder evaluation is typically recommended for individuals who exhibit symptoms or experiences that raise concerns about the possibility of Bipolar Disorder.

If an individual experiences extreme mood swings characterized by periods of unusually high energy, euphoria, or irritability (manic or hypomanic episodes) alternating with episodes of depression, and these mood swings significantly impact a person’s ability to function in various areas of life, such as work, school, relationships, or self-care, it is important to consider a bipolar evaluation.

Sometimes, individuals may have been misdiagnosed with other conditions such as Depression, Generalized Anxiety Disorder, or ADHD when Bipolar Disorder is the underlying cause of their symptoms. If symptoms persist despite treatment or if there is a lack of response to medications typically used for other conditions, a Bipolar Disorder evaluation may be necessary.

What Is Bipolar Disorder Testing?
You cannot test for bipolar disorder with a blood test or a brain scan. The only way to diagnose this disorder is to have a mental health professional assess the individual in a clinical setting.

Bipolar disorder testing is the process through which an individual receives an official diagnosis. Typically, it involves multiple types of testing, including a physical evaluation and psychiatric review that assess signs of bipolar disorder. People need to have had at least one manic or hypomanic episode to receive the diagnosis, and mood swings alone are not enough to qualify for a diagnosis.

Diagnosis requires unusual periods of extreme elevation then irritability alongside increases in energy, sleeplessness, and fast thinking or speech. Symptoms will be fully assessed alongside criteria from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders or DSM-5.

If you have symptoms that make you believe you may have bipolar disorder, it is best to seek out a trained medical professional for a formal bipolar disorder testing and evaluation.

Comorbid Conditions
During the evaluation process of bipolar symptoms, a mental health professional will consider a differential diagnosis to consider all conditions that can cause symptoms similar to those in bipolar disorder.

This process is just like the core diagnostic procedure. Patients answer questions, fill out questionnaires, and create an overall picture of their mental health for the therapist.

Bipolar Disorder 1 Testing
As the main difference between Bipolar Disorder 1 and 2 is the presence of severe manic episodes, a doctor can diagnose bipolar 1 on this basis alone. An extreme manic episode, not better explained by schizophrenia or psychosis, is enough to diagnose bipolar disorder.
A manic episode involves a severe period of mania that is disruptive to daily life but can sometimes be confused for productivity. For that reason, physical tests are required to rule out other health conditions that may cause these symptoms. Features of Bipolar Disorder 1 testing include:

  • Blood tests. Blood tests will be taken to ensure there are no underlying conditions that may be causing symptoms of erratic mood.
  • Brain imaging testing. This will provide a more thorough check of any other physical conditions if required.
  • Psychological review. A psychiatric assessment will highlight the patient’s mood, thoughts, and feelings, as well as how the individual reacts to triggers.
  • Mood journal. Keeping a daily mood diary may help psychologists identify extreme patterns in behavior, attitude, and sleep, assisting in a diagnosis.
  • Manic episode. At least one manic episode lasting around one week is typically required for diagnosis.

Bipolar Disorder 2 Testing
Bipolar disorder 2 is difficult to diagnose due to the difficulties associated with differentiating between bipolar and recurrent unipolar depression, the depressive periods present in depressed patients.

As with bipolar 1, a physical examination is required to rule out other medical disorders that might be the source of these symptoms. In the absence of manic episodes, the identification of hypomanic episodes is crucial to diagnose bipolar 2. Hypomanic episodes are the same as manic episodes, only less severe. Bipolar disorder 2 testing characteristics include:

  • Blood tests. In order to rule out any underlying disorders that could be contributing to the symptoms of unpredictable mood, blood tests will be performed.
  • Brain imaging. If necessary, this will offer a more complete examination of any further physical issues.
  • Psychological examination. A psychiatric evaluation will focus on the patient’s disposition, ideas, and emotions as well as how they respond to stimuli.
  • Mood diary. Keeping a daily mood journal can aid psychologists in making a diagnosis by allowing them to spot severe trends in behavior, attitude, and sleep.
  • Hypomanic phase. Typically, a diagnosis requires at least one hypomanic episode lasting 4 days or more.

Bipolar Disorder Tests and Quizzes Online
While there are online tests and questionnaires available that claim to assess Bipolar Disorder, it is important to understand their limitations. Online tests can provide a preliminary indication of potential symptoms or risk factors but should not be used as a definitive diagnostic tool. Bipolar Disorder is a complex mental health condition that requires a comprehensive evaluation by a qualified mental health professional for an accurate diagnosis.

LifeStance Health specializes in Bipolar Disorder Treatment with multiple locations in 33 states. Services vary by location.

Find a location near you:

Psychotherapy for Bipolar Disorder

Many types of therapy are effective for bipolar disorder, and the most commonly used are:

Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) involves changing thinking patterns to help people face common triggers in constructive ways. Through role-playing, individuals will learn how to handle problematic situations in a non-stressful environment, equipping them with the tools to thrive in daily life. This therapy usually takes place in a one-on-one setting, with a therapist and patient, which works as a resource for finding healthy ways of dealing with life’s difficulties.

Interpersonal and Social Rhythm Therapy (IPSRT)
This form of therapy is rooted in the idea that changes in routine can trigger episodes in people with bipolar. It encourages them to set up a stable routine to support them, highlighting the fact that stress caused by interpersonal conflict can affect mood. IPSRT teaches people the essential skills needed to protect themselves against potentially triggering events and minimize the severity of future episodes.

Family-Focused Therapy (FFT)
Family-focused therapy is typically implemented following an episode, involving family members in treatment. By focusing on psychoeducation regarding bipolar disorder symptoms, communication enhancement training, and problem-solving skills training, family conflict may be reduced. As the symptoms of bipolar disorder often have a significant impact on the people a diagnosed person is close to, family therapy offers support for them as well. In the long term, FFT is highly successful at helping people manage their condition.

Psychoeducation Therapy
As its name suggests, psychoeducation therapy focuses on educating a person with bipolar on the root causes of their condition. Highlighting the biological causes of manic and depressive episodes will provide people with faith in the medications prescribed to counteract these symptoms. Additionally, education will empower people to identify their symptoms ahead of time and take preventative measures. This type of therapy usually takes place in a group setting.

The most effective treatment for Bipolar Disorder is psychotherapy alongside medication. Following the advice offered to you by your healthcare provider should involve a mood stabilizing medication as well as an extended period of therapy.

LifeStance Health mental health clinics offer all the types of psychotherapy that treat Bipolar Disorder along with medication management treatment. We offer in-person and telehealth options. Find a clinic or provider near you.

Bipolar Disorder Medication Management

Medication management is a critical component of the treatment for Bipolar Disorder. It involves the use of various medications to help stabilize mood, manage symptoms, and prevent relapses. Below is the list of the most common medication used to treat Bipolar Disorder.

  • Mood stabilizers. Mood stabilizers are used to control manic or hypomanic episodes. Examples of these include lithium, valproic acid, divalproex sodium, carbamazepine, and lamotrigine.
  • Antipsychotics. If symptoms of mania persist alongside other types of treatment, an antipsychotic may be prescribed too. Examples of these include olanzapine, risperidone, quetiapine, aripiprazole, ziprasidone, lurasidone, or asenapine.
  • Anti-anxiety medication. Anti-anxiety medication may improve sleep and ease anxiety, but these are generally only used in the short term. Benzodiazepines are a common example.
  • Antidepressants. may be prescribed to help symptoms, but usually in conjunction with an antipsychotic, as antidepressants may trigger a manic episode.
  • Antidepressant-antipsychotic. Symbyax combines antidepressants with antipsychotics to stabilize mood while treating depression.

LifeStance psychiatrists offer medication management treatments for Bipolar Disorder in-person and via telehealth. Find a psychiatrist near you.

Bipolar Disorder Treatment in Children under 12

For most cases of pediatric bipolar disorder, the American Academy of Child and Adolescent Psychiatry recommends a combination of medication and psychotherapy. Mood stabilizers and antipsychotic drugs, which have been used for decades to treat Bipolar Disorder in adults, are also effective in pediatric populations.

Different types of therapy may be employed, such as cognitive-behavioral therapy (CBT), family-focused therapy, or psychoeducation. Family therapy can provide support, education, and strategies for managing the child’s symptoms within the family context. It can also help improve family communication, reduce stress, and enhance the overall functioning of the family unit. Collaborating with the child’s school is important to ensure appropriate accommodations and support are in place. This may include developing an Individualized Education Program (IEP) or a Section 504 plan to address educational needs, providing support from school counselors, and fostering open communication between the school and the child’s treatment team.

LifeStance Health mental health clinics offer all the types of psychotherapy that treat Bipolar Disorder in young children along with medication management treatment. We offer in-person and telehealth options. Find a clinic or provider near you.

Bipolar Disorder Treatment Online

LifeStance offers comprehensive treatment plans for people with bipolar disorder. Depending on the person’s needs, this may include therapy, medication, and lifestyle changes. The purpose of treatment is to enhance general functioning, manage symptoms, stabilize mood, and prevent relapses.

LifeStance also offers online appointments for bipolar disorder to help increase access to high quality care when individuals have difficulty attending onsite appointments.

An online session is similar to an in-person appointment but is conducted online via a computer, phone, or tablet. This remote option can make it more convenient for patients and others (such as family members or other professionals) to attend.

Outpatient and In-Patient Treatments for Bipolar Disorders
Typically, treatment for Bipolar Disorder is managed in an outpatient setting. Regular meetings between psychotherapist and patient can ensure the person is on the right track, with crisis help available when needed.

In some cases, in-patient treatment will be appropriate, supporting rapid recovery under observation. When someone is considered a danger to themselves or others, residential treatment is the preferred option to keep them safe during an episode. If you are having feelings of harming yourself or others, reach out to a medical professional or helpline to receive the support you need.

References

Bipolar Disorder (n.d.). National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/bipolar-disorder

Bipolar Disorder Statistics (n.d.). Depression and Bipolar Support Alliance. https://www.dbsalliance.org/education/bipolar-disorder/bipolar-disorder-statistics/

photo of LifeStance provider Stephen Fleming

Clinically Reviewed By:

Stephen Fleming, MD
View Profile
Dr. Stephen Fleming is a psychiatrist who has been practicing since 2012. He obtained his bachelor’s degree at the University of Georgia and his medical school education at the Medical College of Georgia in Augusta, GA. He received training in general psychiatry as well as child and adolescent psychiatry at the Medical College of Georgia while completing his residency and fellowship. Dr. Fleming seeks to utilize his clinical expertise to help those who are struggling with mental illness not only treat their illness to remission but also achieve the sense of well-being and fullness of life they desire. Since 2018 he has been a prescriber of Transcranial Magnetic Stimulation, a non-invasive magnetic therapy approved for the treatment of depression and OCD. In his time away from the office, Dr. Fleming enjoys spending time with his family and his dogs, exercising, reading, watching sports–in particular the Georgia Bulldogs, and traveling.