How Bipolar Disorder Is Diagnosed: What You Need to Know

28 June 2025

Ever felt like your moods were shifting way too fast—like you're on an emotional rollercoaster that won’t stop? One minute, you're on top of the world, getting everything done, feeling invincible. And the next, it's like the world has sucked the life out of you. If this sounds familiar, you're not alone. These extreme ups and downs could be more than just mood swings—they could be signs of bipolar disorder.

But how do you actually know if it's bipolar disorder and not something else? What does diagnosis even look like for a mental health condition like this? If you're asking yourself those questions, you're in the right place.

In this article, we’ll walk you through how bipolar disorder is diagnosed step-by-step. We’ll clear the confusion, bust a few myths, and most importantly—help you understand what to expect if you or someone you care about is going through this journey.

What Is Bipolar Disorder?

Before we dive into how it’s diagnosed, let’s make sure we’re on the same page about what bipolar disorder actually is. Also known as manic-depressive illness, bipolar disorder is a mental health condition that causes extreme mood swings. These swings range from emotional highs (mania or hypomania) to deep emotional lows (depression).

These aren’t just little mood shifts like being grumpy because you skipped lunch. We’re talking about full-blown changes in how you think, feel, and act—often lasting days, weeks, or even longer.

There are a few different types of bipolar disorder, including:

- Bipolar I Disorder: Characterized by full manic episodes lasting at least 7 days and depressive episodes that typically last 2 weeks or more.
- Bipolar II Disorder: Involves a pattern of depressive episodes and hypomanic episodes, but no full-blown manic episodes.
- Cyclothymic Disorder (Cyclothymia): A milder form with fluctuating low-level depressive and hypomanic symptoms lasting at least two years.

Why Getting a Proper Diagnosis Matters

Let’s be real—getting labeled with any mental health condition can feel overwhelming. But when it comes to bipolar disorder, an accurate diagnosis is not just helpful—it’s essential. That’s because the way bipolar is treated is completely different from how you’d treat, say, regular depression or anxiety.

In fact, misdiagnosis happens more often than you'd think. Many people are first diagnosed with unipolar depression because depressive symptoms tend to show up more frequently or are more noticeable. But treating bipolar depression with typical antidepressants alone can actually make things worse and trigger manic episodes.

So yes, getting the right diagnosis can literally change your life.

Step 1: Recognizing the Symptoms

Here’s the tricky part: Bipolar disorder doesn’t always show up in a neat, predictable way. It can look different from person to person, and even within the same person over time.

Mania or Hypomania Symptoms

These are the “highs,” and they can feel good—at first. But it’s not just being in a great mood. Symptoms might include:

- Feeling unusually elated or irritable
- Needing less sleep (and still feeling energetic)
- Racing thoughts or talking faster than usual
- Grandiose ideas or unrealistic beliefs in one’s abilities
- Impulsive or risky behavior (like spending sprees, reckless driving, or risky sex)

In mania, these symptoms are severe and disruptive. In hypomania, they’re milder and might not cause major life problems—but they’re still noticeable to those around you.

Depressive Symptoms

This is the “low” part of the cycle, and it often lasts longer than the high.

- Persistent sadness or hopelessness
- Fatigue or lack of energy
- Trouble concentrating
- Loss of interest in activities you used to enjoy
- Changes in appetite or sleep
- Thoughts of death or suicide

Seeing both sides—highs and lows—is what makes bipolar disorder stand out. But remember, you don’t always experience mania right away. That’s why the next steps in diagnosis are so important.

Step 2: Reaching Out for Help

Hard truth: Most people don’t go to a psychologist at the first sign of a mood swing. Sometimes it takes a crisis, like a hospitalization, a brush with the law, or a breakdown at work or school. But it doesn’t have to get to that point.

If you’re noticing patterns in your mood, energy, or behavior—and they’re hurting your relationships, your job, or your general well-being—reach out. That first step might be talking to someone you trust, like a friend or family member. But eventually, a mental health professional needs to get involved.

Step 3: The Diagnostic Evaluation

Once you decide to seek help, here’s what typically happens next.

A Full Psychiatric Evaluation

This usually starts with a long talk. You’ll meet with a psychiatrist, psychologist, or licensed clinical social worker, and they’ll ask you about:

- Your current symptoms
- Your medical history
- Your family’s mental health history
- Substance use
- Personal life—work, school, relationships

Yeah, it’s a lot of personal stuff. But the more honest you are, the better the picture they can paint of what’s really going on.

Assessment Tools and Questionnaires

You may be asked to fill out some forms or rating scales. These help clinicians measure the severity of your symptoms and spot patterns that might not be obvious in a conversation.

Some common tools include:

- Mood Disorder Questionnaire (MDQ)
- Bipolar Spectrum Diagnostic Scale (BSDS)

These aren’t magic quizzes that give you a yes or no answer, but they’re helpful pieces of the puzzle.

Step 4: Ruling Out Other Conditions

Diagnosing bipolar disorder isn’t as simple as checking boxes on a list. Your provider also needs to make sure your symptoms aren’t being caused by something else, like:

- Thyroid problems
- Substance abuse
- Medications (like steroids or antidepressants)
- Other mental health disorders (like borderline personality disorder or ADHD)

To rule these out, your doctor might suggest blood tests or a physical exam. It’s not about doubting your experience—it’s about being thorough.

Step 5: Observation Over Time

Here’s something most people don’t realize: You can’t always diagnose bipolar disorder in a single visit. Sometimes the manic or hypomanic episodes haven’t happened yet—or just haven’t been noticed. That’s why clinicians often want to observe you over time.

This might mean:

- Keeping a mood diary
- Regular therapy or check-ins
- Getting input from family or partners who’ve seen your behavior change

It can feel frustrating to wait, especially when you’re struggling. But patience and careful monitoring can make all the difference in getting an accurate diagnosis.

Step 6: Confirming the Diagnosis Using DSM-5 Criteria

Mental health professionals diagnose bipolar disorder using the Diagnostic and Statistical Manual of Mental Disorders (5th Edition), also known as the DSM-5. It lays out specific criteria for what counts as a manic, hypomanic, or depressive episode.

For instance:

- A manic episode must last at least 7 days (or be so severe it requires hospitalization).
- A hypomanic episode must last at least 4 days.
- A major depressive episode must include at least five symptoms lasting two weeks, and at least one of the symptoms must be either depressed mood or loss of interest.

The clinician uses your symptoms, history, and responses to evaluate whether your experience fits within these guidelines.

What Happens After Diagnosis?

Getting a bipolar diagnosis can be a mix of emotions. For some, it's a relief—it finally puts a name to what’s been happening. For others, it’s scary, and that’s okay too.

Here’s the good news: Bipolar disorder is treatable. While there’s currently no "cure," there are many effective treatments that can help people manage their symptoms and live full, meaningful lives.

The most common treatment paths include:

- Mood stabilizers (like lithium)
- Therapy (like cognitive behavioral therapy or psychoeducation)
- Lifestyle changes (sleep routine, stress management, etc.)
- Support groups and family therapy

Final Thoughts: You’re Not Alone

Let’s just say it—mental illness sucks. It's hard, unpredictable, and doesn't play fair. But if you're reading this now, know this: You’re showing courage just by looking for answers. That takes guts.

Whether you’re seeking help for yourself or someone you care about, understanding the diagnosis process for bipolar disorder is a powerful first step. With time, support, and the right professionals in your corner, healing is not just possible—it’s entirely within reach.

So, if anything in this article resonated with you, don’t brush it off. Talk to someone. Ask questions. And most importantly—keep going. There’s hope, and there’s help.