Symptoms used to diagnose
The ruleBipolar I: at least one manic episode (7+ days, or any length if hospitalised). Bipolar II: at least one hypomanic episode (4+ days) and one major depressive episode.
Core symptoms
- Abnormally elevated, expansive or irritable mood
- Abnormally increased energy or activity
Other symptoms
- Inflated self-esteem or grandiosity
- Much less need for sleep
- Unusually talkative, pressured speech
- Racing thoughts
- Easily distracted
- Increased goal-directed activity or agitation
- Risky behaviour (spending, sex, business)
- Depressive episodes between highs
How diagnosis works
- Bipolar I: at least one manic episode — 1 week or more of elevated/irritable mood and increased energy, with symptoms like reduced need for sleep, racing thoughts, risk-taking or grandiosity, causing serious impairment.
- Bipolar II: at least one hypomanic episode (4+ days, less severe) and at least one major depressive episode.
- Cyclothymia: 2+ years of fluctuating milder highs and lows.
A diagnosis is made by a qualified clinician after a full assessment — this summary is to help you understand it, not to self-diagnose.
Commonly used medications
Therapies & support
- Psychoeducation
- CBT
- Family-focused therapy
- Interpersonal and social rhythm therapy
Good to know
- Antidepressants alone can trigger mania in bipolar disorder — specialist advice is essential.
Sources
- 01Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR)
American Psychiatric Association, 2022
- 02ICD-11 for Mortality and Morbidity Statistics — Chapter 6: Mental, behavioural or neurodevelopmental disorders
World Health Organization, 2022
- 03The Maudsley Deprescribing Guidelines
Horowitz & Taylor, Wiley-Blackwell, 2024