Written by:Dr. Muhammad Munir, MD

Published On: May 4, 2022

Medically reviewed by: Bisma Anwar, MA, MSc, LMHC

Reviewed On: May 4, 2022

Updated On: June 23, 2023


Hoping for an answer to the question: how is bipolar disorder diagnosed is normal if you’re concerned that you or a loved one might be exhibiting symptoms of this mental health condition.

Unfortunately, the process isn’t as simple as diagnosing some physical conditions. It’s not possible to just take a blood sample, or order lab work and get results that suggest you have bipolar disorder. There’s not one single test that can confirm a bipolar disorder diagnosis. An official diagnosis must be made by a qualified psychiatrist who utilizes a combination of techniques to assess your condition so they can make a clinical, informed diagnosis.

What Are the Signs and Symptoms to Look For?

How is bipolar disorder diagnosed? Bipolar disorder is primarily characterized by mood swings. Everyone will experience these a bit differently. Most people who live with bipolar disorder bounce between depressive-low and manic-high mood swings.

Each type of episode (manic episode or depressive episode) can last for several days, or several weeks, depending on the person and the severity of symptoms. Many people with bipolar disorder fluctuate rapidly between depression and mania.

Some people with this mental health condition have weeks or longer when their moods are neutral and stable. Eventually, however, the episodic cycle resumes, moving between depression and mania.

According to the The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition  (DSM-5), some key signs psychiatrists look for when diagnosing bipolar disorder include:

  • Grandiose thoughts or feeling enormously powerful
  • Suicidal thoughts or intense feelings of self-hatred
  • Trouble completing tasks or concentrating
  • Loss of interest in activities once enjoyed

Other markers of bipolar disorder include making high-risk decisions, impulsive behavior, diminished need for sleep, and feeling high, tense, or elated.

A bipolar disorder diagnosis requires a minimum of 1 manic or hypomanic episode and 1 depressive episode. Either one without the other will not justify a BD diagnosis.

Similar conditions to bipolar disorder

There are several other mental health conditions that cause similar mood symptoms to bipolar I disorder or bipolar II disorder. These must be ruled out prior to diagnosis and are a big part of why a BD diagnosis can be so difficult to get. Further, many people have bipolar disorder and one or more other mental health conditions, making diagnosis even more challenging.

Research tells us that many people with bipolar disorder have comorbid (coexisting) conditions like anxiety disorder, substance abuse or misuse disorder, or attention deficit hyperactivity disorder (ADHD), all of which can have symptoms similar to bipolar.

Additionally, medical comorbidities are common, too. Metabolic syndrome, obesity, and diabetes are all more commonly diagnosed in people with bipolar disorder.

Preparing for a Bipolar Disorder Diagnosis

How is bipolar disorder diagnosed? If you experience the symptoms of bipolar disorder and are considering trying to get a diagnosis, the best place to start is by visiting a mental health care professional.

You’ll likely be scheduled for a physical examination along with an appointment to sit down and discuss some basic information, including your symptoms, medical history, life experiences, and family history.

Depending on your interview and physical exam results, you can be further referred to a psychiatrist who specializes in bipolar disorder treatment for a more in-depth mental health assessment.

Getting a diagnosis will be different depending on age.

Bipolar diagnosis for adults:

Be prepared for a psychiatrist to ask you questions like:

  • Do other members of your family have bipolar disorder or other mental health conditions?
  • What are the differences in your thoughts during manic episodes vs depressive episodes?
  • Do you have a current or past substance misuse or abuse problem?
  • When you feel manic, how long do episodes typically last?
  • At what age did you begin experiencing symptoms?
  • Do you ever want to harm or kill yourself?
  • Do you take any medication?
  • Have you ever been diagnosed with any other physical or mental health conditions?

A psychiatrist might also want to speak with your family, spouse, children, or other loved ones to better understand your symptoms and situation.

Bipolar diagnosis for children:

Bipolar can be diagnosed at any age. Because symptoms can mimic many other conditions, however, it’s often misdiagnosed as depression, anxiety, attention deficit disorder (ADHD), or conduct disorders. Just like when diagnosing adults, there’s no diagnostic test that can determine if a child has bipolar disorder.

A psychiatrist will ask several questions relating to a child’s behavior and mood before making a diagnosis. They can include things such as:

  • How long does the child sleep every night on average?
  • How common and often are emotional outbursts?
  • How common and often is the mood episode happening, is it intense irritability and aggressive behavior?

They’ll also want to discuss family history and will most often rule out thyroid dysfunction.

“Bipolar simply means that the mood symptoms are fluctuating between two different poles. A lot of people keep on getting worse with depression treatment and never get to the right diagnosis. Getting an accurate diagnosis is the key to the best treatment. It’s important to be honest with the psychiatrist and share the past mood symptoms as well as present ones. It’s also important to share any drug use or risky behaviors during the psychiatric assessment. It’s not that simple to diagnose bipolar disorder by just filling out an online rating scale. An expert evaluation by a psychiatrist is also needed.”

Psychiatrist, MD, DFAPA Muhammad Munir

What Tests Are Used to Diagnose Bipolar Disorder?

Diagnosing bipolar disorder typically involves several distinct types of testing. A psychiatrist will have you fill out a mood questionnaire or other mental health checklist to guide the interview process.

They also may want to assess your urine, blood, or hair to check for the presence of illicit or prescription drugs that might be causing your bipolar symptoms.

While blood work can’t indicate the presence of bipolar disorder, it’s also useful in checking thyroid hormones, because depression is often linked to sluggish thyroid action (hypothyroidism).

Psychiatrists don’t typically depend on brain imaging or scans during a bipolar diagnosis. However, some neuroimaging can be helpful for making a targeted diagnosis of other conditions.

Because of this, sometimes a CT scan or an MRI may be ordered, particularly if you’ve had a sudden change in behavior, mood, or thinking. Again, these tests are helpful in ensuring that no underlying neurological conditions are causing your symptoms.

Ruling out other conditions

As discussed, a psychiatrist will want to ensure no other potential medical or mental health conditions are of concern when making a bipolar diagnosis. Some conditions that must be ruled out can include:

  • Brain tumor
  • Seizure disorders
  • Cerebrovascular accidents (CVAs)
  • Encephalitis, meningitis, or other infectious disease

They’ll also be on the lookout for Alzheimer’s disease, Parkinson’s disease, or other dementia-related conditions.

Wondering if you have bipolar disorder? Take this free online bipolar test today to learn more about symptoms and to find out how to get help.

Seeking Treatment Post-Diagnosis

If you do receive a bipolar disorder diagnosis, it’s not uncommon to experience a wide range of emotions, including sadness and surprise. For many people, a sense of relief follows a diagnosis. Knowing that they can now begin to understand what’s going on can offer an incredible sense of empowerment and renewed hope for the future. So, how to treat bipolar disorder? Is there a natural bipolar disorder treatment available?

While bipolar is a lifelong mental health condition, effective treatment options are available and a long, happy life is achievable.

Treatment for bipolar I disorder and bipolar II disorder most often involves a combination of prescription medication, routine in person or online therapy sessions with a therapist who specializes in BD, and practicing lifestyle modifications as well as natural treatment options that encourage holistic health and well-being.

Medication: Some medications for bipolar can be used to treat symptoms. They can include antidepressants, anticonvulsants, lithium, and second-generation antipsychotics.

Psychotherapy (talk therapy): Types of therapy for bipolar disorder to help manage the symptoms better can include interpersonal therapy, cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and family-focused therapy.

Lifestyle changes: Lifestyle modifications that can be immensely helpful for managing a bipolar disorder symptom include:

  • Daily exercise
  • A healthy diet
  • Adequate hydration
  • Natural sunshine
  • Yoga
  • Tai chi
  • Pilates
  • Mindfulness meditation
  • Repeating positive mantras

Wondering if it’s possible, and how to diagnose, bipolar disorder? Although it can be challenging in some cases to make a diagnosis, a trained psychiatrist knows how to diagnose bipolar disorder. If you’re diagnosed with this common and treatable mental health condition, know that a fun-filled, enjoyable, and healthy life is very possible. You have support and just need to reach out to start the process.

See References

Dr. Muhammad Munir, MD

Dr. Muhammad Munir, MD, DFAPA, has over 20 years of clinical experience specializing in mood disorders, anxiety disorders, bipolar disorder, PTSD, panic disorder, and ADHD. Dr. Munir believes in “back to basics” the therapeutic alliance between the physician and patients. The hallmark of this alliance is the emphatic process whereby the patient is not only enabled, but educated and encouraged, to take an active role in their psychiatric care and wellbeing.

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