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Bipolar Disorder: How to Diagnose, Treat, and Live with It

Revital Ordan, psychiatric nurse, Director of the Ambulatory Array, Mental Health Division, Ministry of Health ;  Dr. Marnina Shwartz Vontik, Director of the Department of Psychiatry, Leumit Health Services
16 June 2025

Bipolar disorder is a complex but treatable mental condition. An accurate diagnosis is the first step in coping, including a comprehensive assessment, gathering information about medical history, examining the current mental state, and sometimes physical exams to rule out other causes.
In addition, differential diagnosis (the process, during diagnosis, of distinguishing between different illnesses or disorders that may have similar symptoms) is essential to distinguish between regular depression and bipolar disorder during a depressive phase, as incorrect treatment can be harmful.

Treatment, which continues throughout life, combines several strategies:

  • Medication, including mood stabilizers, antipsychotics, and sometimes antidepressants.
  • Psychotherapy, such as CBT, psychoeducational guidance, and family therapy.
  • Maintaining a healthy lifestyle.
  • Intensive inpatient treatment or an alternative to inpatient treatment for severe episodes.
  • In resistant cases, electroconvulsive therapy (ECT) offers high success rates.

Daily coping includes:

  • Maintaining a healthy routine.
  • Acquiring tools for mental coping.
  • Monitoring mood changes.
  • Building a support system.
  • Ensuring continued medication even when feeling well.
  • Regular medical monitoring.

It is worth remembering: With proper treatment and perseverance, stability and a good quality of life can be achieved.

Bipolar disorder is a complex mental health condition that poses unique challenges for those who deal with it and those around them, but it is a treatable and effectively managed disorder. An accurate diagnosis is the first and essential step towards successful coping, as it allows for the adaptation of an optimal treatment plan.

It is important to understand that bipolar disorder is a chronic condition, but a treatable one. With proper diagnosis and appropriate treatment, it is possible to achieve balance and live a full and fulfilling life. Modern treatment combines different approaches – from medication to psychotherapy – and is personalized to the unique needs of each individual.
The process of diagnosing bipolar disorder, the available treatment options, and ways to cope on a daily basis – all of these can help in dealing with the challenges posed by the disorder, and contribute to improving the quality of life of those living with it and those close to them.

Diagnosis

Diagnosing bipolar disorder involves a comprehensive assessment of the patient, which includes the following:

  • Detailed medical and psychiatric history.
  • Assessment of current mental status.
  • Psychosocial assessment.
  • Functional assessment.
  • Assessment of associated physical conditions and physical examination.

Currently, there are no research-based laboratory and imaging tests used to diagnose mental disorders. However, because some symptoms can be indicative of other medical conditions, the patient may be asked to undergo additional diagnostic tests to rule out a physical cause for the current episode.

It is important to emphasize

The term "differential diagnosis" refers to the process within the framework of diagnosis, in which different diseases or disorders that may manifest themselves in similar symptoms are distinguished. The goal is to reach an accurate diagnosis by ruling out other conditions that may appear similar. When a person comes for a diagnosis with symptoms of depression, the goal of a professional is to distinguish whether it is ordinary depression or whether it is actually bipolar disorder in its depressive phase. The reason for this is that the treatment in both cases is different, and providing the wrong treatment can be harmful – for example, in the case of bipolar disorder, the wrong treatment with antidepressants can cause a manic episode.
More information about the diagnostic process can be found in the article "Intake Interview: An Initial Assessment Session in Mental Health"

Combined treatment

Treatment for bipolar disorder usually lasts a lifetime and usually includes a combination of several methods:

Use of mood stabilizers, antipsychotics, antidepressants, or a combination of these. The goal is to treat the symptoms of the disorder, reduce the duration of the episode, prevent further episodes, and help achieve balance and mood regulation.

Cognitive behavioral therapy (CBT), psychoeducational guidance, supportive therapy, and family therapy can be effective, especially when combined with medication.

Maintaining regular physical activity, a healthy diet, stable sleep patterns, and avoiding drugs or alcohol can help manage symptoms and reduce risk factors.

Sometimes hospitalization or alternatives to hospitalization are necessary, especially during a severe episode or if the person is a danger to themselves or others.

It is important to note

It is important to note

In cases that are resistant to treatment and are complex, or when there is a contraindication to effective drug treatment, one of the effective options is electroconvulsive therapy (ECT). The decision on this treatment and its suitability is made by a specialist medical team, under brief anesthesia and with the consent of the patient or guardian. It is worth noting that despite the many stigmas surrounding this treatment, it has very high success rates, even among patients who have not responded to other treatments for many years.

Dealing with bipolar disorder

Living with bipolar disorder involves a long-term struggle. On the one hand, dealing with treatment management in order to prevent imbalance and recurrence of episodes, and on the other hand, recovery, that is, how to continue a routine, satisfying, and meaningful life, beyond the boundaries of the illness.
Treatment and rehabilitation for people with bipolar disorder include a focus on several issues, including:

  • Maintaining a healthy lifestyle, regulating the sleep-wake cycle, balanced nutrition, physical activity and daily functioning.
  • Acquiring skills and tools for adaptive mental coping and strengthening mental resilience.
  • Regular monitoring of mood changes and attention of the patient or a loved one to early signs of an episode. In these cases, it is recommended to seek help as soon as possible.
  • Reinforcement and support from friends, family or therapeutic groups.
  • Adherence to treatment plans and medication schedules. Special emphasis should be placed on continuing to take regular medication. It is important to avoid stopping taking medications on your own, even when you feel well. If you are thinking about stopping taking medications, you should first consult your healthcare provider, as there are sometimes additional and effective solutions, such as changing medications or reducing the dosage. In any case, if you choose to stop taking medications, it is important to do so correctly and gradually to prevent sudden worsening of symptoms, and to continue to be under psychiatric supervision (even when there is no medication treatment).
  • Conducting periodic blood tests when necessary to monitor medication levels or prevent side effects.

Bipolar disorder is considered a long-term illness, requiring professional attention, monitoring, and management – even during periods of balance. With proper treatment, adherence to a healthy lifestyle, and help from appropriate supporting entities, it is possible to achieve long-term stability, good symptom control, and a full and fulfilling life.
It is worth remembering that coping is a personal and long-term process, with ups and downs. It does require perseverance, flexibility, taking responsibility, and understanding that treatment is an integral part of life – but with a positive and tolerant attitude towards yourself and your disorder, you can achieve significant improvement and live a life full of meaning and self-fulfillment.

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