Understanding Bipolar Disorder
Bipolar disorders involve episodes of depression and periods of mania or hypomania—changes in mood, energy, sleep, activity, and judgment that go beyond typical ups and downs.
Why assessment matters
Diagnosis requires careful review of mood episodes, duration, sleep changes, medication and substance effects, family history, and functional impact. Bipolar depression can resemble other depressive conditions, but treatment considerations differ.
Treatment and long-term stability
Care often includes mood-stabilizing medication, psychotherapy, regular sleep and activity patterns, monitoring for early warning signs, and a plan for managing mood episodes. Antidepressant treatment requires particular caution and clinician oversight in bipolar disorders.
CBT and other therapies can support coping and routines, but practice alone is not a substitute for appropriate treatment of mania, hypomania, or severe depression.
Correct diagnosis is about more than a label. It helps determine which medications and interventions are likely to work—and which may create unnecessary risks. Unipolar depression and bipolar depression can look similar, but their treatment considerations are different.
If you are experiencing severe agitation, unsafe behavior, psychosis, or thoughts of self-harm, seek urgent medical evaluation. For crisis support in the United States, call or text 988.
Mania versus hypomania
Both involve a distinct change from usual mood and increased energy or activity, often with less need for sleep, racing thoughts, unusually fast speech, impulsive decisions, or increased goal-directed behavior. Mania typically lasts at least seven days (or any duration when hospitalization is needed), causes marked impairment, or can include psychosis. Hypomania lasts at least four consecutive days and is observable as a change from baseline, but does not cause marked impairment, require hospitalization, or include psychosis. The distinction affects whether bipolar I or bipolar II is considered.
Bipolar versus unipolar depression: why diagnosis matters
Unipolar depression involves depressive episodes without a history of mania or hypomania. Bipolar disorders include episodes of mania or hypomania, even when depression is the reason a patient first seeks care. Correct diagnosis guides medication choices and safety: an antidepressant alone can be inappropriate in bipolar I disorder.
Ask about periods of unusually elevated or irritable mood, decreased need for sleep, impulsivity, antidepressant-associated activation, and prior episodes. The Mood Disorder Questionnaire (MDQ) → can support evaluation when bipolar disorder is suspected, but is not diagnostic and should not be used as routine population screening. A clinical interview remains essential.
Family history matters: bipolar disorder has a substantial hereditary component. Ask about relatives with bipolar disorder, severe mood episodes, hospitalization, suicide, and alcohol or other substance use disorders. Alcohol use can coexist with bipolar illness, but does not by itself establish inherited bipolar disorder.
Common Medications for Bipolar Disorder
Learn how medications differ for mania, bipolar depression, and maintenance treatment.
Explore the Medication Table →Bipolar screening: Mood Disorder Questionnaire (MDQ)
The MDQ is a validated screen for possible lifetime mania or hypomania. A positive screen warrants a clinical assessment; a negative result does not rule out bipolar II disorder or other bipolar-spectrum conditions. Screening does not establish a diagnosis.
Complete the validated MDQ
Use the original, unmodified instrument and bring the results to your clinician. Symptoms need to be interpreted alongside episode duration, functional changes, substance or medication effects, and family history.
Complete the original questionnaire below or open the source PDF to print it. Its questions, response options, formatting, and scoring instructions are supplied unchanged by the originating source.
Open / print original questionnaire →
Source: University of Iowa MDQ. This instrument is a screening aid, not a diagnosis. EvolveMD does not collect responses through this embedded PDF. Some browsers may require opening the PDF in a new tab.
Find a therapist who fits your needs
Use Psychology Today to search for therapists in your area. Filter by location, insurance provider, specialties, and treatment approaches such as cognitive behavioral therapy (CBT). Confirm insurance participation and coverage directly before scheduling.
Find a therapist on Psychology Today →Original MDQ Questionnaire
Open or download the original reference PDF. Screening cannot diagnose a condition; bring completed results to a clinician.
Open PDF →