What Increases Your Risk

Bipolar disorder can be passed down through families. If anyone in your family has been diagnosed with bipolar disorder, your risk of having it is higher.

If you have bipolar disorder, changes in sleep or daily routines can increase your risk for a manic episode. Antidepressant medicine can trigger a manic episode in someone who has bipolar disorder.⁸ But this may occur before someone is diagnosed with bipolar disorder, while he or she is seeking treatment for an episode of depression.

A stressful event may trigger an episode of mania or depression.

Your risk of either a depressive or manic episode increases if you do not take your medicines as prescribed by your doctor. It is common for people to stop taking their medicines during a manic phase when they feel good. Even if you are feeling better, you must take your medicines as prescribed to control bipolar disorder.

Alcohol or drug use or abuse puts you at a high risk for having a relapse of mood disturbances.⁵

When To Call a Doctor

If you have bipolar disorder, callor other emergency services if you:

• Think you cannot stop from harming yourself or someone else.
• Hear voices that are new or more upsetting than normal.
• Want to commit suicide, or you know someone who has mentioned wanting to commit suicide.

Warning signs of suicide include:

• Use of illegal drugs or drinking alcohol heavily.
• Talking, writing, or drawing about death, including writing suicide notes and speaking of items that can cause physical harm, such as pills, guns, or knives.
• Spending long periods of time alone.
• Giving away possessions.
• Acting aggressive or suddenly appearing calm.

Watchful Waiting

Watchful waiting may be enough if a mood episode has just started and you are taking proper medicines. If your mood episode has not improved within 2 weeks, call your doctor.

If you have a loved one who is experiencing a manic episode and is behaving irrationally, help the person seek treatment.

Who To See

Bipolar disorder is complex and hard to diagnose because it has many phases and symptoms. Sometimes it is misdiagnosed as only depression (unipolar depression), because people are more likely to seek treatment during a period of depression.

After you are diagnosed with bipolar disorder, it is important to keep a long-term relationship with your doctor or therapist to make sure that your treatment is consistent and that your medicines can be adjusted as needed.

Although other health professionals can diagnose bipolar disorder, you will probably be referred to a psychiatrist who specializes in treating such disorders and can prescribe medicines and provide counseling. Other health professionals who can diagnose bipolar disorder include:

• Family doctors (general practitioners).
• Internists.
• Psychiatric nurse practitioners.

Counseling can help you deal with mood changes and the impact bipolar disorder can have on your work and family relationships. In addition to psychiatrists, health professionals who can provide counseling include:

• Psychologists.
• Social workers.
• Licensed professional counselors.

Family member support

If a loved one has bipolar disorder, it may be helpful for you to get counseling to deal with its impact on your own life. Manic episodes can be particularly hard. Talk with a psychiatrist, psychologist, social worker, or licensed professional counselor for your own therapy.

Therapy can also be helpful for a child who has a bipolar parent. The parent's mood swings may negatively affect the child, causing tearfulness, anger, depression, or rebellious behavior.

To prepare for your appointment, see the topic Making the Most of Your Appointment.