Short answer: bipolar disorder involves episodes of depression and episodes of unusually elevated or irritable mood (mania or hypomania). Because most people seek help during a low period, it is frequently diagnosed as depression first. An accurate diagnosis matters, because the treatment is different.
Signs that may point to bipolar disorder
- Periods of needing much less sleep without feeling tired
- Racing thoughts, rapid speech or jumping between ideas
- Unusual confidence, risk-taking or impulsive spending
- Episodes of depression that come and go, sometimes starting in the teens or twenties
- Antidepressants that seemed to make you agitated or “wired”
- A family history of bipolar disorder
How a psychiatrist makes the diagnosis
There is no blood test for bipolar disorder. A psychiatric evaluation looks at your full mood history, sleep patterns, family history, substance use and medical conditions such as thyroid problems that can affect mood. With your permission, input from a partner or family member can help, because highs are often easier for others to notice.
What treatment usually includes
- Mood-stabilizing medication, chosen with your health history and goals in mind, with lab monitoring when required
- Protecting sleep, since irregular sleep is a common trigger for episodes
- Therapy and education to recognize early warning signs
- A relapse plan agreed in advance with your psychiatrist and, if you wish, your family
Consistent medication management visits are where most of the long-term progress happens: adjusting doses, managing side effects and catching early changes in mood.
When to seek help
If you recognize several of the signs above, or depression treatment has not worked the way you hoped, ask for an evaluation. If you ever have thoughts of harming yourself, call or text 988 right away.
Psych Boston sees adults, teens and children from across Greater Boston in Lexington and by telehealth. Request an appointment.
This article is general information, not medical advice. If you are in crisis, call or text 988 or call 911. Psych Boston is an outpatient psychiatry practice at 35 Bedford St #17, Lexington, MA781-218-9550).