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Diagnosing bipolar disorder

Visit us (http://www.khanacademy.org/science/healthcare-and-medicine) for health and medicine content or (http://www.khanacademy.org/test-prep/mcat) for MCAT related content. These videos do not provide medical advice and are for informational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any Khan Academy video. Created by Brooke Miller.

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  • marcimus pink style avatar for user V113
    So to get this strait Bipolar 1 has more mania than Bipolar 2.
    (6 votes)
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    • aqualine ultimate style avatar for user Sterre
      The diagnostic criteria for Bipolar 1 = at least one manic episode (depressive episodes are not necessary for the diagnosis. Bipolar 2 = no manic episodes, one or more hypomanic episodes and one or more major depressive episodes.
      (5 votes)
  • blobby green style avatar for user champanebday12
    I had a panick attack yesterday from my mom making a sound like click click click in a certain rhythm . why?
    (2 votes)
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    • female robot ada style avatar for user Samantha
      There are many different factors in why you are having panic attacks. It's best to talk to your parents or caregivers. Then you can see if you need to be referred to a psychologist or a psychiatrist, maybe both.
      (1 vote)
  • blobby green style avatar for user candace.v.stoughton
    Shouldn't the "greater than or = to" sign be shown to indicate that the symptoms must last at least a week in order to qualify for the diagnosis? The chalk board shows the "less than or = to" sign instead :-(
    (4 votes)
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  • female robot ada style avatar for user Taneisha marie royster
    do bipolar run in the family is that why people get it
    (1 vote)
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    • leafers sapling style avatar for user David Bandell
      Bipolar is indeed for a large part hereditary, this doesn't mean that is parents have it that the offspring will be affected but when someone has bipolar disorder is is very often (about 80%) that you can find a family member that has is too. There are a lot of other factors that are in play here, most not determent yet.
      (5 votes)
  • blobby green style avatar for user Eileen Zhan
    how long can these episodes of depression/mania last? Weeks? Days? Months? Years?
    (2 votes)
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  • leafers seed style avatar for user ariana.m.8663
    i was watching this video and i related to most of the descriptions of symptoms and should i see a doctor please HELP HELP HELP
    (0 votes)
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  • leafers ultimate style avatar for user evelynirenedicenzo
    What factors lead to a bipolar disorder?
    (1 vote)
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  • female robot grace style avatar for user Sadie
    What if someone doesn't completely qualify for depression, but still feels persistently depressed?
    (1 vote)
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    • female robot ada style avatar for user Katey Gordon
      There are many warning signs that can qualify you for Depression and if the emotions still permit then you keep seeking the proper physicians to diagnose depression, the thing is depression can also exhibit other types of Illnesses and diseases and usually physicians will do a general based of tests, this includes blood-work etc. the thing is sometimes a lack of vitamins , depression becoming a warning sign for some other factor like a disease which can overlap may be reasons why some don't completely qualify there may be other symptoms, or tests shows that another underlying condition is playing a factor in whats making a person depressed. Either way if someone continues to get symptoms they should seek several opinions as there are many physicians that do take the matter seriously and will listen to there patients.
      (2 votes)
  • primosaur seed style avatar for user Skyla  Brown
    Does being extremely focused on pleasurable activities with bad consequences include eating too much junk food?
    (1 vote)
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    • leaf green style avatar for user Shane McGookey
      It certainly could. The activities which are sought out are ones that stimulate pleasure (at least given the explanation the video provided), and these activities tend to stimulate our internal reward system. The reward system produces dopamine when we engage in activities that are beneficial to us, such as eating, drinking, having sex, etc.

      The reward system was originally purposed to allow us to pursue activities that would further our survival, however we are able to artificially stimulate that system as well (e.g. with drugs). To further the problem that drugs present with the reward system, we also have all those other natural pursuits in-bulk. We can eat large amounts of foods comparitive to what we were able to eat when the reward system developed, we can have many more partners (without running into sexual health walls or having children) due to advances in birth control and other technologies.

      One reason people consume junk food is because we are hardwired to pursue foods, especially ones high in fat and carbohydrates that will help to provide long-lasting fat that we can utilize over time. The problem is with the abundance of foods such as these, and seemingly unlimited access for some areas of the world, this leads to overeating and poor dietary habits due to the pleasure found in unhealthy foods.

      It's likely that this same reward system is what is causing the excessive pursuit of pleasurable yet unhealthy behavior in Bipolar Disorder, and so excessive eating of "junk food" would fall under the same category of activities.
      (2 votes)
  • duskpin seedling style avatar for user Diana Brown
    Is bipolor 2 worse than bipolor 1?
    (1 vote)
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Video transcript

- [Voiceover] We've previously talked about diagnosing Depression, but what about diagnosing Bipolar Disorder? Well, it turns out that the main focus is correctly diagnosing a manic episode in someone who already meets the criteria for Depression. And that's because those manic episodes are really the distinguishing feature of Bipolar Disorder. There is no disorder that consists of just mania. So as we talk about the symptoms for Bipolar Disorder, remember that we also expect to see these symptoms of Depression that we talked about in a previous video. And just as with Depression, we have a long list of possible symptoms for a manic episode and in order to meet the diagnosis, someone must have a certain number of them. In this case, they need three or more in order to qualify for the diagnosis. The first symptom is inflated self esteem and this isn't just thinking that your'e a good singer, this is thinking that you are the greatest singer in the world. So really, it's about having a lot of grandiose ideas about the self. The second symptom is racing thoughts, so thoughts coming into a person's head at a mile a minute, just idea after idea after idea. And this leads to the third system, which is pressured speech, or talkativeness. So someone having a manic episode might talk more or talk faster than we would generally deem to be appropriate. And the next symptom is distractibility. And that means that they can't keep their attention on any one topic. They're always jumping from one thing to the next. But also associated with this symptom is the fact that people with Bipolar Disorder are often distracted by unimportant details, things that other people might consider to be irrelevant. There are also changes in sleep patterns, specifically they might show a decreased need for sleep so they might feel rested after only three hours a night. There might also be psychomotor agitation and this can include pacing quickly around the room or pulling off clothes or putting them back on. People with Bipolar Disorder might also show an increase in goal directed activity so they might become really focused on work or on going to the gym and spend all of their time on that one task to the exclusion of everything else that they need to do in their lives. Another thing that might occur during a manic episode is that a person might become extremely focused on seemingly pleasurable activities, activities that, with repetition, tend to have dangerous consequences. So while a certain amount of sexual activity is normal in adulthood, these individuals might become over involved with risky sexual activity. And while some people might enjoy shopping, people having a manic episode might become really unrestrained in shopping behaviors. So they might just keep on shopping and spend way more money than they actually have. And lastly, there's going to be a general increase in energy, which is something that seems like an important element for all of the symptoms of a manic episode that we've described here. So as I said before, an individual needs three or more of these symptoms in order to be diagnosed with Bipolar Disorder but just like with Depression, we have some qualifiers that someone with Bipolar Disorder also needs to meet. The first is this mood must last for at least a week. Another thing is that one of these three symptoms must be that increased energy so the symptoms have to include an abnormally elevated mood but in some people, this mood doesn't come off as elevated. It might come off as irritable. So someone who has an irritable mood for over a week in addition to some of these other symptoms of a manic episode can also meet the diagnosis. And as before, with Major Depressive Disorder, the symptoms of Bipolar Disorder must be severe enough to negatively impact a person's life. So it must be negatively impacting their job or their relationships with friends and family. I also want to mention here that Bipolar Disorder isn't just one disorder. We have Bipolar I Disorder, which is characterized by full episodes of depression and full episodes of mania. And then, we also have Bipolar II Disorder and with this disorder, someone might have severe depressive episodes but they don't have full manic episodes. Instead, they have what we refer to as hypomania. And so in terms of whether or not someone should be diagnosed with Bipolar I or Bipolar II disorders, it really depends on the intensity of the symptoms and their duration. There isn't really a different list of symptoms so the symptoms need to last for at least a week to be diagnosed with mania but only need to be present for four days for a diagnosis of hypomania. For mania, the symptoms need to have a really negative effect on their day to day functioning but this not true of hypomania, where it can, at least on the surface, seem to actually make someone more productive or more social, at least temporarily. And so it's really up to the clinician to look at the symptoms that a person has and determine whether or not someone meets the qualifications for Bipolar I or Bipolar II.