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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Assessment online. A doctor can map your mood history, refer you to a psychiatrist and help in the meantime; the diagnosis and mood stabilisers are specialist-led.
- What it is: a long-term condition with episodes of extreme high mood (mania or hypomania) and low mood (depression), usually lasting days or weeks, with stable periods in between.
- How common: about 36 million people worldwide, 0.4%, had bipolar disorder in 2023. It is usually diagnosed in the teenage years or early 20s.
- Treatment: mood stabilisers such as lithium, antipsychotics and talking therapy. It cannot be cured, but it can be managed well.
- Emergency: call 112 for thoughts of suicide that you might act on, or a severe high with risky behaviour, hearing voices or not sleeping for days.
Do not book a video appointment if you are thinking about suicide and might act on it, have harmed yourself, or if you or someone close to you is in a severe high: barely sleeping, taking serious risks, hearing voices or believing things that are not true. Call 112 or go to an emergency department.
Can an online doctor help with bipolar disorder?
No, bipolar disorder is not diagnosed or treated online: a psychiatrist makes the diagnosis, and mood stabilisers such as lithium are started and monitored by a specialist, with blood tests. What a doctor by video can do is go through your highs and lows, ask about the highs before any antidepressant is considered, look for other causes, refer you to a psychiatrist, and help with sleep, routine and a plan for warning signs. If you might act on thoughts of suicide, call 112.
How an online consultation helps with possible bipolar disorder
- The highs asked about first: An antidepressant on its own can trigger a high in bipolar disorder, so the doctor asks about energy, sleep and spending before any treatment for low mood.
- Other causes checked: Drugs, alcohol, some medicines, thyroid problems and ADHD can all cause mood swings or look like bipolar disorder.
- A referral to a psychiatrist: When the pattern fits, a referral with your mood history set out, and how soon you need to be seen.
- A plan for the warning signs: A mood and sleep diary, a steady routine, and what to do if a high or a low starts.
What the doctor checks in an online bipolar consultation
The doctor asks about safety first, then maps your moods over time. The doctor asks about:
- Safety: thoughts of suicide or self-harm, risky behaviour, and any hallucinations or beliefs others do not share.
- The highs: energy, need for sleep, racing thoughts, fast speech, spending and risk-taking, how long they last, and whether others noticed.
- The lows: low mood, loss of interest, sleep, appetite, energy, and how long they last.
- The pattern: how often episodes come, what sets them off, and how you are between them.
- Alcohol, drugs and medicines: including cannabis, cocaine, steroids and antidepressants you have taken before.
- Health and family: thyroid problems, pregnancy or plans for it, and bipolar disorder, depression or suicide in the family.
Before the call, a daily record of your mood and sleep for a few weeks is the most useful thing you can bring. With your agreement, someone who has seen your highs can describe them.
What are the symptoms of bipolar disorder?
The main symptom is extreme changes in mood: highs, called mania or the milder hypomania, and lows, called depression. Episodes usually last a few days or weeks, and mood may be stable for weeks, months or years in between.
Swipe sideways to compare →
| High: mania or hypomania | Low: depression |
|---|---|
| Feeling very happy and excited, or very irritable | Feeling sad, empty or hopeless |
| A lot of energy and not needing much sleep | Low energy, sleeping badly or sleeping a lot |
| Racing thoughts, talking fast or a lot | Not being able to concentrate |
| Feeling overly confident, impulsive spending | Low confidence, feeling worthless |
| Doing things that are out of character, a high sex drive | Losing interest in things you usually enjoy, avoiding people |
| In severe mania: hallucinations, delusions or paranoia | Thoughts of suicide or self-harm |
Mania or hypomania?
Both have the same symptoms. Mania is more severe and can cause psychosis, a break from reality, while hypomania is milder and can feel good from the inside, which is why people often mention only the lows. A mixed episode means symptoms of a high and a low at the same time, and rapid cycling means 4 or more episodes in a year.
What is it like to have bipolar disorder?
Between episodes, many people feel well. During a high, plans and ideas can come fast and sleep seems unnecessary, and decisions made then, about money, work or relationships, can cause lasting problems. A depressive episode lasts at least 2 weeks and can be severe. Bipolar disorder does not get better on its own, but treatment helps most people manage it.
What are the types of bipolar disorder?
Doctors describe bipolar disorder by the kind of highs you have had:
Swipe sideways to compare →
| Type | What it means | Good to know |
|---|---|---|
| Bipolar 1 | At least one manic episode, often with episodes of depression | Mania can cause psychosis and may need hospital care |
| Bipolar 2 | At least one episode of depression and at least one hypomanic episode, but no full mania | A separate diagnosis, not a milder form: people can be depressed for longer |
| Cyclothymia | Many periods of milder highs and lows over at least 2 years, less severe than major depression | Assessed by a psychiatrist, like the other types |
| Linked to drugs or illness | Bipolar symptoms caused by drugs, alcohol or a condition such as a stroke or multiple sclerosis | Treating the cause comes first |
What causes bipolar disorder, and who gets it?
It is not known exactly what causes bipolar disorder. You are more likely to have it if a parent, brother or sister has it. Other possible risk factors are childhood trauma or abuse, a stressful event such as a bereavement or money problems, and recreational drugs such as cannabis or cocaine.
About 36 million people worldwide, 1 in 226, had bipolar disorder in 2023. It is usually diagnosed in the teenage years or early 20s, but it can start at any age. People with bipolar disorder die on average 13 years earlier than others, and the condition raises the risk of suicide, so treatment and physical health both matter. Many people are misdiagnosed or not treated.
What triggers a bipolar episode?
Stress, not getting enough sleep and being too busy are common triggers. Shift work, very long hours, night flights and flights across time zones disturb sleep and can set off an episode, and so can alcohol, drugs and large amounts of caffeine.
Bipolar disorder or something else?
Swipe sideways to compare →
| Condition | How it can look similar | How it differs |
|---|---|---|
| Depression | Episodes of low mood | No highs: asking about the highs is the key |
| Mood swings | Changes in mood | Swings over hours, often with stress, sleep or hormones, rather than episodes lasting days |
| ADHD | Restlessness, fast talking, impulsive decisions | Lifelong and constant, rather than in episodes |
| PMDD | Severe low mood and irritability | Tied to the menstrual cycle, easing once a period starts |
| Drugs, alcohol or medicines | Highs or lows during or after use | Settle when the substance is stopped |
| An overactive thyroid | Restlessness, poor sleep, irritability | Found with a blood test |
How is bipolar disorder diagnosed and treated?
A psychiatrist makes the diagnosis by asking about your moods, behaviour, health and family history, sometimes with a mood diary, a physical examination and blood tests to rule out other causes. It can take time, because the symptoms resemble other conditions. An online questionnaire cannot diagnose it.
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| Treatment | What it does | What to know |
|---|---|---|
| Mood stabilisers, such as lithium | Help control highs, and may help lows | Lithium needs regular blood tests and enough fluids; do not cut salt suddenly, and avoid regular ibuprofen |
| Antipsychotics | Stabilise mood, alone or with a mood stabiliser | Proven to help manage mania |
| Antidepressants | Treat depression | Used with care, usually with a mood stabiliser or antipsychotic, because on their own they can trigger a high |
| Talking therapy | CBT, interpersonal and social rhythm therapy, learning about the condition, family therapy | Reduces depressive symptoms and the chance of them coming back |
| Hospital or crisis team care | For a severe episode, or a risk to you or others | For as long as needed |
Some bipolar medicines are taken all the time, and others only when symptoms get worse. Do not stop bipolar medicine unless a doctor tells you to, even if you feel better.
What might the doctor recommend for possible bipolar disorder?
What happens next depends on your mood history, how unwell you are, and whether anyone is at risk. This is the framework the doctors use:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Past highs and lows that affected your life, now stable | Mood history, other causes ruled out, referral to a psychiatrist | Yes, to assess | For the diagnosis and any mood stabiliser |
| Low mood now, with past periods of high energy and little sleep | Assessment for bipolar depression before any antidepressant | Yes, to assess | A psychiatrist decides the treatment |
| Diagnosed bipolar disorder, worried a high or low is starting | Contact with your specialist team, sleep and routine steadied | Partly | The team reviews your treatment |
| A severe high: barely sleeping, serious risks, hearing voices | Emergency care | No | Call 112 now |
| Thoughts of suicide that you might act on | Emergency help | No | Call 112 now |
| Pregnant or planning a pregnancy on bipolar medicine | Review with your specialist before changing anything | Partly | Before you stop or change any medicine |
Highs and lows that feel out of control? A doctor can tell you in one consultation whether you need a psychiatrist.
See available times →Living with bipolar disorder: what helps
What you can do yourself
- Keep a regular routine for sleeping, eating and activity, and protect your sleep.
- Keep a daily record of your mood and sleep, and learn your early warning signs with someone you trust.
- Manage stress, eat a healthy diet and exercise regularly.
- Avoid recreational drugs and smoking, and keep alcohol and caffeine low.
- Avoid shift work, very long hours, night flights and flights across time zones where you can.
- Take your medicine as agreed, and do not stop it without talking to your doctor.
Prescription treatment
A prescription is never issued without a consultation. Mood stabilisers such as lithium, and antipsychotics, are started and monitored by a psychiatrist, not online. An antidepressant on its own can trigger a high in bipolar disorder, so the doctor asks about the highs before prescribing anything for low mood. Benzodiazepines and Z-drugs are controlled medicines and are never prescribed online. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Stopping medicine because you feel well. Alcohol and drugs, which make the condition harder to manage. Irregular sleep. An online quiz in place of an assessment.
Special situations
Pregnancy
Some bipolar medicines are not safe in pregnancy, so talk to your doctor before you become pregnant, and never stop a medicine suddenly. In the EU, valproate is banned for bipolar disorder in pregnancy, and women who could become pregnant can take it only within a pregnancy prevention programme. Some mood stabilisers can also make hormonal contraception less effective.
While travelling in Europe
Night flights and crossing time zones disturb sleep and can trigger an episode, so plan rest and keep your routine. If you take lithium, drink extra fluids in hot weather and during exercise, sip water if you have diarrhoea or vomiting, keep alcohol low, and do not cut your salt suddenly: dehydration can raise lithium to a dangerous level. Carry enough medicine and a list of what you take.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When bipolar disorder is assessed online, and when you need in-person care
Assessed online: mood changes that could be bipolar disorder, screening for highs before treatment for low mood, referral to a psychiatrist, sleep and routine, and questions alongside specialist care.
In-person care: the diagnosis, starting and monitoring mood stabilisers, lithium blood tests, a severe high or low, and any risk to you or others.
When to get in-person care
Call 112 or go to an emergency department now for:
- thoughts of suicide that you might act on, or having harmed yourself
- a severe high: barely sleeping for days, serious risk-taking, or behaviour that puts anyone in danger
- hearing or seeing things that others do not, or beliefs that are not true, with feeling unsafe
- signs of too much lithium: being sick or diarrhoea, blurred vision, drowsiness, confusion, shaking, muscle twitches or difficulty speaking
Get medical advice the same day for:
- thoughts of death or self-harm without a plan to act on them
- the early signs of a high: less need for sleep, racing thoughts, unusual spending
- low mood that is getting worse quickly
- side effects from bipolar medicine that worry you
You can also find a free, confidential crisis helpline in your country at findahelpline.com.
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your moods: describe your highs and lows and how long they last, bring a mood and sleep diary if you have one, and list your medicines.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s bipolar disorder? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Mood Swings can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about bipolar disorder
What is bipolar disorder?
Bipolar disorder is a long-term mental health condition with extreme changes in mood: highs, called mania or hypomania, and lows, called depression. Episodes usually last days or weeks, with stable periods in between. It cannot be cured, but treatment helps most people manage it.
What are 5 signs of bipolar disorder?
Signs of bipolar disorder during a high: lots of energy and little need for sleep, racing thoughts and fast speech, overconfidence and impulsive spending. During a low: low mood and loss of interest. The key sign is that these come in episodes lasting days or weeks.
Am I bipolar? Is there a test?
No test or quiz can tell you whether you are bipolar. A psychiatrist makes the diagnosis from your mood history, behaviour, health and family history, and may ask you to keep a mood diary. A doctor can tell you whether a referral makes sense.
What is the difference between bipolar 1 and bipolar 2?
Bipolar 1 means at least one episode of full mania. Bipolar 2 means episodes of depression and hypomania, a milder high, without full mania. Bipolar 2 is a separate diagnosis, not a mild form, and depression can last longer.
What is cyclothymia?
Many periods of milder highs and lows over at least 2 years, less severe than mania or major depression. It is one of the bipolar and related disorders, and a psychiatrist assesses it in the same way.
What triggers bipolar episodes?
Stress, lack of sleep and being too busy are common triggers of bipolar episodes. Shift work, night flights and crossing time zones, alcohol, drugs and large amounts of caffeine can also set off an episode.
Is bipolar disorder hereditary?
Bipolar disorder often runs in families: you are more likely to have it if a parent, brother or sister has it. Childhood trauma, stressful events and drugs such as cannabis or cocaine are other possible risk factors.
What is the life expectancy of someone with bipolar disorder?
On average, people with bipolar disorder die 13 years earlier than others, and the condition raises the risk of suicide. Getting treatment, and looking after your physical health, are both part of managing it.
What is the long-term outlook with bipolar disorder?
With treatment, most people with bipolar disorder have long stable periods and live full lives, working, studying and raising families. Episodes tend to return over a lifetime, which is why treatment usually continues long term, and each one managed early is shorter and less damaging. The main risks are untreated episodes, suicide, which is why thoughts of ending your life always need urgent help, and physical health problems such as heart disease, so regular physical check-ups matter as much as mental health care.
Can bipolar disorder be cured?
No, bipolar disorder cannot be cured, but it can be managed well. Mood stabilisers, antipsychotics and talking therapy reduce episodes. Some medicines are taken all the time, and others only when symptoms get worse.
How can bipolar episodes be prevented?
Taking the medicines a psychiatrist has prescribed every day, even when you feel well, is the most effective way to prevent bipolar episodes. Alongside that: keep a regular sleep and daily routine, because lost sleep is a common trigger; avoid alcohol, drugs and large amounts of caffeine; learn your early warning signs, such as needing less sleep or spending more, and agree with your doctor and family what to do when they appear; and keep a mood diary. Talking therapy teaches these skills.
Can an online doctor prescribe lithium or other bipolar medicines?
No. Mood stabilisers such as lithium, and antipsychotics for bipolar disorder, are started and monitored by a psychiatrist, with blood tests for lithium. A doctor by video can assess your symptoms, refer you and help with sleep and warning signs.
Can antidepressants trigger mania?
Yes. In bipolar disorder, an antidepressant on its own can trigger a high, so it is usually given with a mood stabiliser or an antipsychotic. That is why a doctor asks about past highs before treating low mood.
- Bipolar disorder, NHS, National Health Service (UK), reviewed 28 October 2024.
- Bipolar disorder: fact sheet, WHO, World Health Organization, 11 September 2026.
- Bipolar disorder: symptoms and causes, Mayo Clinic (US), updated 8 May 2026.
- Bipolar disorder: diagnosis and treatment, Mayo Clinic (US), updated 8 May 2026.
- Valproate and related substances: new measures to avoid exposure in pregnancy, EMA, European Medicines Agency, 2018.
- Side effects of lithium, NHS, National Health Service (UK), reviewed 9 August 2023.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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