Many people with bipolar disorder first see a doctor during a depressive phase. If past 'high' periods are not recognised, treatment may be less effective.
Family members often notice highs that the person does not remember as a problem.
Key concepts
- Bipolar disorder involves depression plus periods of elevated or irritable mood
- Treatment differs: mood stabilisers are central in bipolar disorder
- A careful history, often from family, is key
Symptoms and signs
- Past periods of very little sleep without tiredness
- Talking fast, big plans, overspending or risky decisions
- Depression that starts suddenly or at a young age
Causes
- Strong genetic contribution
- Disrupted sleep and body clock
- Stress can trigger episodes
Risk factors
- Bipolar disorder in a parent or sibling
- Postpartum mood episodes
- Substance use
Evidence-based management
- Ask family about past highs during assessment
- Mood stabilisers and selected medicines for bipolar depression
- Regular sleep schedule and mood charting
- Psychoeducation for patient and family
When to seek professional help
- Depression with any history of high or irritable periods
- Becoming restless or 'too energetic' after starting an antidepressant
- Any thoughts of self-harm or suicide — call Tele-MANAS 14416 or 112 today
Frequently asked questions
Can a self-test tell me if I have bipolar disorder?
No. Screening can raise suspicion, but diagnosis needs a clinical assessment, ideally with family input.
Is bipolar disorder lifelong?
It is usually long-term, but with treatment most people stay well for long periods and live full lives.
Medical references
Guidelines and official sources used for this article.
- Bipolar disorder: assessment and management (CG185). NICE, UK, 2014.
- Depression in adults: treatment and management (NG222). National Institute for Health and Care Excellence (NICE), UK, 2022.
- ICD-11 for Mortality and Morbidity Statistics. World Health Organization.
- Author
- Dr. Kuldeep Budania, MBBS, MD Psychiatry
- Medical reviewer
- Dr. Kuldeep Budania, MD Psychiatry
- Last reviewed
This article is for general information and is not a substitute for personal medical advice.
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