Bipolar Disorder
Bipolar disorder involves episodes of depression and episodes of mania or hypomania, with periods of stable mood in between. It is treatable, and early, accurate diagnosis changes the treatment plan.
Bipolar disorder is a condition of mood episodes. Periods of depression alternate with periods of mania or hypomania, when energy, activity and self-confidence rise far above a person’s usual level. Between episodes, many people feel and function well. Because depression is usually what brings people to a doctor, bipolar disorder is often first treated as “simple” depression.
Bipolar I, bipolar II and the wider spectrum
Bipolar I: at least one manic episode, lasting at least a week or leading to hospital admission, often with depressive episodes as well.
Bipolar II: at least one hypomanic episode (milder, at least four days) and at least one major depressive episode.
Milder forms, where mood swings do not meet full criteria but still affect life.
In a survey of 61,392 adults in 11 countries, lifetime prevalence was 0.6% for bipolar I, 0.4% for bipolar II and 2.4% for the whole bipolar spectrum. Three in four people also had at least one other condition, most often an anxiety disorder, and fewer than half had received mental health treatment [1].
What mania and hypomania can look like
much less need for sleep without feeling tired;
racing thoughts, talking fast, jumping from idea to idea;
unusual self-confidence or grand plans;
spending, driving or making decisions in a way that is out of character;
irritability, especially when others slow you down.
Hypomania can feel pleasant and productive, so people rarely mention it. That is why I ask specifically about periods of unusually high energy, and not only about low mood.
Bipolar disorder or ADHD?
Both can involve impulsivity, distractibility and restlessness. The key difference is the pattern: ADHD is present more or less continuously since childhood, while bipolar disorder comes in episodes with a clear change from a person’s usual self. Before any ADHD treatment, I screen for hypomania with structured questionnaires such as the HCL-32. When bipolar disorder is suspected, mood is stabilised first, because some ADHD and depression treatments can trigger mania. Read about adult ADHD assessment.
Is bipolar disorder hereditary?
Genes play a large role. Estimates of heritability range from about 58% in a Swedish national register study [2] to about 85% in a British twin study [3]. A family history is therefore an important part of the assessment, but it does not mean that a relative will necessarily develop the condition.
How bipolar disorder is treated
Treatment aims to settle the current episode and to prevent new ones. The UK’s National Institute for Health and Care Excellence (NICE) recommends, for bipolar depression, a psychological therapy developed specifically for bipolar disorder or a high-intensity therapy such as cognitive behavioural therapy, with close monitoring for signs of mania. Medication is chosen with care: antidepressants are not used on their own in bipolar disorder without protection against mania, and long-term treatment is planned to reduce relapses [4].
How I work
An “if… then…” plan from day one: what we will do if mood rises, if it drops, or if a side effect appears.
We start low and adjust gradually, and when something needs to change we prefer a targeted addition to replacing the whole treatment.
Regular follow-up with rating scales, so that changes are noticed early, before they become an episode.
Sleep, a regular daily rhythm and limiting alcohol and other substances are part of the plan, not an afterthought.
When to seek help urgently
If there are thoughts of ending one’s life, or behaviour that puts someone at risk, seek help now: call the 24-hour suicide prevention line 1018, or 112 / 166, or go to the nearest emergency department.
Frequently asked questions
Can bipolar disorder be cured? It is a long-term condition, but with treatment many people stay well for long periods and live full lives.
Will I need medication for life? Often long-term treatment is advised to prevent relapses. The plan is reviewed with you over time, based on your history and your wishes.
Can family members be involved? Yes, with your consent. People close to you often notice early signs of an episode before you do.
Can I be seen online? Yes, in Greek or English, from anywhere in Greece or abroad, when online care suits your clinical needs. Some situations need an in-person assessment.
Psychiatrist for bipolar disorder in Trikala and online: practical questions
When should I see a psychiatrist about possible bipolar disorder?
When periods of low mood alternate with periods of unusually high energy, little need for sleep or out-of-character decisions, or when bipolar disorder runs in your family and you have had episodes of depression. Read more: Psychiatrist or psychologist?
How do you tell a good period from hypomania?
One question helps: during that period, did you need much less sleep and still feel full of energy? With your agreement, I also ask someone close to you to fill in questionnaires, because self-report is not always objective, especially about periods that felt good.
I live in Larissa, Karditsa or Kalambaka. Can I be treated?
Yes. You can come to the practice in Trikala, or have your sessions online by video from anywhere in Greece, in Greek or English, via Google Meet, WhatsApp or Viber. Online follow-up makes the regular reviews that bipolar disorder needs easier to keep. See Psychiatrist in Trikala and online therapy.
How much does it cost?
Each session costs 130 €. The first appointment lasts 45 minutes and follow-up sessions 30 minutes. If, after the assessment, we decide together that medication is needed, the prescription is issued electronically. Book an appointment or call +30 24310 32281.
Related pages
Book an appointment – in person in Trikala or online, in Greek or English.
Sources
Merikangas KR, Jin R, He JP, et al. Prevalence and correlates of bipolar spectrum disorder in the World Mental Health Survey Initiative. Arch Gen Psychiatry 2011;68:241–251. https://doi.org/10.1001/archgenpsychiatry.2011.12
Song J, Bergen SE, Kuja-Halkola R, et al. Bipolar disorder and its relation to major psychiatric disorders: a family-based study in the Swedish population. Bipolar Disord 2015;17:184–193. https://doi.org/10.1111/bdi.12242
McGuffin P, Rijsdijk F, Andrew M, et al. The heritability of bipolar affective disorder and the genetic relationship to unipolar depression. Arch Gen Psychiatry 2003;60:497–502. https://doi.org/10.1001/archpsyc.60.5.497
NICE. Bipolar disorder: assessment and management (CG185). Published 2014, last updated 2023. https://www.nice.org.uk/guidance/cg185
Medical Disclaimer
This content is for informational purposes only and does not replace professional medical advice. If you experience persistent or severe symptoms, consult a qualified healthcare professional.
At a glance
- First appointment: 45 minutes, 130 €
- Follow-up sessions: 30 minutes, 130 €
- Language: English or Greek
- Where: in person in Trikala (wheelchair accessible) or online by video call
- Payment: cash, card or contactless at the practice; online appointments are paid electronically
- Hours (Greek time): Monday–Thursday 08:15–13:00 and 17:15–20:00, Friday 08:00–15:00
