Bipolar Disorder: Symptoms & Diagnosis

Table of contents:

Bipolar Disorder: Symptoms & Diagnosis
Bipolar Disorder: Symptoms & Diagnosis
Video: Bipolar Disorder: Symptoms & Diagnosis
Video: Bipolar disorder (depression & mania) - causes, symptoms, treatment & pathology 2023, February

Bipolar Disorder: Symptoms & Diagnosis

Bipolar disorder is characterized by manic, possibly hypomanic, and depressive episodes. With these, the moods alternate between “cheering up high” and “saddened to death”. In acute treatment, the focus is on relieving the depressive or (hypo-) manic symptoms. The long-term goal is to reduce or avoid further episodes. The hallmarks of bipolar disorder can be very complex. This is due to the changing phases, which can take on different characteristics and dimensions. A certain number of symptoms must be present for the diagnosis to be made, which are specified in diagnostic guidelines.


  • Continue reading
  • more on the subject
  • Advice, downloads & tools
  • Episodes and their characteristics
  • diagnosis
  • Risk factors & concomitant diseases
  • Whom can I ask?
  • How are the costs going to be covered?

Episodes and their characteristics

The following table is intended to provide an overview of the different episodes that occur in bipolar disorder:

episode Examples of features
Manic episode (duration: ≥ 1 week)
  • inappropriate, conspicuously elevated mood
  • Irritation through to aggression
  • increased drive
  • speaking quickly and incessantly
  • sudden, frequent and not always comprehensible topic changes in conversations, "going from the hundredth to the thousandth"
  • increased distractibility
  • decreased social inhibition threshold
  • reduced need for sleep
  • risky behavior and overconfidence, "omnipotence fantasies"
  • Abnormal thinking, delusionalism, hallucinations
  • increased sexual desire
Hypomanic episode (duration: ≥ 4 days)
  • characteristics similar to those of the manic episode, but mitigated
  • mainly concentration problems, leaps in thought and overabundance of ideas
Depressive episode (duration: ≥ 2 weeks)
  • cloudy mood
  • Listlessness
  • Loss of interests
  • social withdrawal
  • hopelessness
  • Suicidal ideation
  • sleep disorders
  • decreased appetite
  • in severe cases delusions (e.g. paranoia), hallucinations
  • reduced sexual desire
Mixed affective episode (duration: ≥ 2 weeks)

Mixture or rapid change between depressive and (hypo-) manic symptoms

adapted according to DGBS eV and DGPPN eV: S3 guideline for diagnosis and therapy of bipolar disorders. Long version 1.0, May 2012


In addition to a detailed survey of the medical history (anamnesis) or the symptoms, tests or scales can also be used for assessment (e.g. Altman Self-Rating Scale, Bech-Rafaelsen Mania Scale). A physical examination and, if necessary, a survey of laboratory results or further diagnostics form the basis for confirming the diagnosis and treatment plans.

Bipolar disorders are classified and assigned using the international classification of diseases (ICD-10 code). For the diagnosis, there must be at least two clear, easily distinguishable episodes in the course of the disease. If a particularly large number of episodes alternate, one speaks of rapid cycling.

Bipolar disorder should be differentiated from depression alone and cyclothymia (persistent instability of mood with several phases of mild depression and slightly elevated mood). Schizophrenia or organic causes must also be ruled out. In addition, certain medications can cause similar conditions (e.g. hormone preparations, antidepressants).

Risk factors & concomitant diseases

Risk factors for developing bipolar disorder include bipolar disorder in a family member or severe depression in childhood or adolescence, rapid changes in mood and substance abuse. People with bipolar illness have a higher risk of other mental illnesses (e.g. anxiety disorders, obsessive-compulsive disorder or personality disorders) as well as physical illnesses (e.g. heart disease, diabetes or migraines).

Whom can I ask?

If you suspect you have bipolar disorder, or if you would like to help someone in your area, a specialist in psychiatry and psychotherapeutic medicine is the right place to go. You can also talk to the general practitioner first. This person then initiates further steps. Specialized child and youth psychiatrists are also available for young people under the age of 18.

Under Services, Links and Brochures you will find helpful information on looking for a doctor or therapist as well as looking for self-help groups (also for relatives).

How are the costs going to be covered?

The costs for the medical examination are normally covered by the health insurance providers. For more information, see Costs and Deductibles and Prescription Fee & Co: This is how drug costs are covered. Information on costs for a hospital stay can be found under What does a hospital stay cost?

Popular by topic