You can be pleased by good news and upset by an argument on the same day. That alone does not mean bipolar disorder. A doctor looks at a broader history: how your sleep, energy and behavior changed2, whether you have had similar periods before1, and how you were between them. Those details say more than “my mood keeps changing” when you explain what concerns you.
If things have changed sharply right now, start with When do you need urgent help?. You can seek care before you understand all the medical terms.
For example, staying up to finish important work and then feeling exhausted differs from sleeping far less than usual1 with an unfamiliar sense that you do not need sleep, taking on many projects, speaking rapidly or rushing into financial decisions4. During depression, loss of interest and energy or difficulty concentrating can make previously ordinary tasks, such as studying or preparing a meal, difficult. These are examples of what to describe to a doctor, not a way to confirm a diagnosis.
Ask what has changed from usual: Has your need for sleep changed2? Have your activity or judgment changed? What have you or someone who knows you well3 noticed? Have you had similar periods before? A change happening around stress or an event does not settle its cause, and one happy or energetic day does not establish an episode.
If changes persist, recur or concern you, you can start with a family doctor or psychiatrist4, even if you do not know what to call the problem. You do not need to lose your job or experience both depression and mania before asking for help. Some changes need urgent help3, as explained in the dedicated section below.
A depressive episode may involve intense sadness or loss of interest1 and pleasure, with changes in sleep, energy and concentration. Depression alone does not establish bipolar disorder, so it is also important to tell the doctor about previous periods of increased activity. Depressive symptoms can occur alongside increased activity or irritability2, rather than as two separate states of happiness and sadness.
Bipolar I disorder involves a manic episode. Depressive episodes may occur, but are not required for this type. Bipolar II disorder involves depressive and hypomanic episodes1 without a full manic episode. The word “hypomania” does not mean that the person's suffering or depression is mild. Episodes and the periods between them vary16; they do not have to alternate in a fixed order.
When do you need urgent help?
Urgent assessment, even without obvious danger
Seek urgent medical assessment if mania is possible: for example, a major change from usual involving reduced need for sleep1 and increased activity or irritability, with impulsive behavior or impaired judgment. Do not wait a week3, wait to lose your job or wait for a stated intention to cause harm. You do not need a previous bipolar disorder diagnosis.
Contact the doctor or treatment team using any agreed contact plan, if there is one and they can be reached. If there is no plan or team, contact details are missing or you cannot reach them, seek urgent medical assessment3. While you are safe, you can call 937 for medical consultation13 and guidance on where to seek care within Saudi Arabia; the service is available around the clock. If you cannot obtain suitable assessment promptly, go to a hospital emergency department9. A consultation call must not delay emergency help when there is danger.
Emergency help now
Seek emergency help now if there is immediate danger to life9 or you cannot keep yourself or another person safe. Voices commanding harm18, rapidly worsening hallucinations, severe agitation or aggression, or speech that has become incoherent also need emergency assessment, even without a stated intention to harm.
Also seek emergency care if any of the following has happened recently and has not been medically assessed: a suicide attempt12, serious injury, actual or suspected poisoning11, or an actual or suspected overdose9. If you suspect someone has taken a harmful substance or an overdose, do not wait for confirmation or symptoms.
Getting to care safely
Ask a trusted person who can accompany you safely for help. Do not drive if you have signs of mania, psychotic symptoms or sudden confusion10, or if poisoning or an overdose is suspected11; have someone else drive you. If you are alone or no safe companion is available, tell the medical service when you call. Call 997 for an ambulance14 in Saudi Arabia if travel is unsafe or you cannot keep everyone safe. In immediate danger, call for an ambulance from a safe place.
If you are helping someone who does not think they need care or refuses it, seek professional advice7 and explain what you have observed. Do not wait until you agree on the diagnosis. Do not force them to travel, restrain them or give them medicine secretly.
Bipolar disorder, psychosis and schizophrenia: why do the names differ?
Experiences such as hearing voices other people do not hear, firmly held beliefs that do not match reality, or noticeably disorganized thinking and speech.
This does not identify the cause or diagnosis. These experiences can occur with different disorders, physical conditions, medicines or substances.
Bipolar disorder
A disorder involving episodes of changes in mood, energy and activity, understood through the history of those episodes and the periods between them.
Mood swings alone do not establish the diagnosis, and psychotic symptoms do not automatically change it to schizophrenia.
Schizophrenia
A disorder that may include psychotic symptoms and difficulties with motivation, expressing emotions and concentration, which vary from person to person.
Hearing voices alone does not establish schizophrenia. The diagnosis does not mean having multiple personalities or being permanently out of touch with reality.
Psychotic symptoms can occur during mania or severe depression2 in someone with bipolar disorder. The clinician therefore asks when they occurred, how they relate to mood3, what happened before and between those periods, and what other causes may be involved8. Taking a medicine used for both conditions does not show that the diagnoses are identical; a medicine may treat symptoms they share.
Schizophrenia does not make violence inevitable6; most people with it are not violent. Treatment can help symptoms and everyday life, and the amount of support someone needs varies. Describing the person's actual experience is more useful for assessment than judging them by a diagnostic label.
What causes bipolar disorder?
No single cause is known; genetic and environmental factors contribute to the likelihood of developing it. Having an affected relative2 can increase that likelihood without making it inevitable. Life stress, disrupted sleep and some substances1 may trigger an episode in a susceptible person, but none of these alone fully explains the condition. This information can help you discuss your history and care plan; it is not a reason to blame yourself or your family.
How do you get an assessment that clarifies the picture?
You might seek help for depression now and leave out an earlier period of unusual energy and confidence because you felt well at the time. Mention it too. Bipolar depression can resemble depression in someone who has never experienced mania or hypomania, but knowing about those earlier periods can change treatment decisions. Antidepressants taken alone can trigger mania2 in some people with bipolar disorder. Ask the prescriber how your history affects the plan, and do not change medication on your own.
The clinician will ask about the periods you have experienced, including:
When the change began, how sleep, energy and behavior differed from usual, and its effect on study, work and relationships.
Previous periods and what happened between them, family history, and treatments that helped or caused problems.
You can note a few examples or bring someone you trust if you wish. You do not need a complete record before the visit, and should not delay seeking help to prepare one. The doctor may request an examination or tests to investigate other causes, such as thyroid disorders2. A blood test or brain scan alone does not establish bipolar disorder; symptoms, their course and other possible explanations are essential parts of assessment3.
Clarifying a diagnosis can take time, especially when little is known about previous periods or symptoms overlap with other conditions. If you are told the diagnosis is provisional, or it changes later, ask what the doctor has learned and what remains unclear, together with a plan for care and follow-up3. Useful questions include: “What makes this explanation more likely? What else could explain it? What information do we need? When will we review the assessment?” You can ask for an explanation or another opinion without changing treatment on your own.
For children and teenagers: unusual changes need an assessment suited to their age. A pediatrician or family doctor can be a starting point for reaching a professional experienced in working with children and teenagers. Signs may overlap with development and other conditions15. Do not try to diagnose a child using descriptions for adults or give them medication prescribed for someone else.
What does care after assessment involve?
Treatment for the current episode may differ from a plan for longer-term stability. Medicines and care are chosen3 according to symptoms and their severity, physical health, previous response, side effects and the person's priorities. The plan may include psychological therapy2 to help with understanding the condition, managing changes and dealing with everyday difficulties, alongside medicine. Some severe episodes require hospital care4.
Discuss what you want to improve with the doctor: sleep, the ability to study or work, relationships, or returning to an activity that matters to you. Tell them about side effects or difficulty taking treatment as planned. Do not increase or reduce a dose, or stop a medicine on your own2, even when you improve. Discuss medicines with the doctor if you are pregnant or planning pregnancy4. Ask about physical health checks and tests needed for your medicine; monitoring may include weight, blood pressure, blood glucose and lipids3, depending on the plan.
Make the follow-up plan practical: What early signs should prompt a call3? Who can you actually reach, and what should you do outside their working hours or if they do not answer? When will treatment benefits and side effects be reviewed? Write down the answers with the doctor and keep the available contact numbers13. Do not assume an old plan or an unreachable number will be enough when symptoms return; use the urgent-help route above9 when needed.
Treatment and follow-up can help with stability and a better life1, but the course varies from person to person2 and care may need adjusting. Improvement does not require you to return to every responsibility at once, or mean on its own that it is time to stop treatment. Ask for support with the task that is difficult for you now, and discuss it at your next visit.
Frequently Asked Questions
What is the difference between bipolar disorder and normal mood swings?
Being pleased by good news and upset by an argument on the same day does not, alone, mean bipolar disorder. Bipolar disorder can involve periods of elevated mood or irritability and increased activity, as well as periods of depression. An episode is more than moving from happiness to sadness during a day: it involves noticeable changes in energy, behavior and thinking that persist and affect life. If changes persist, recur or concern you, you can start with a family doctor or psychiatrist.
What is the difference between bipolar I and bipolar II?
The history of episodes tells them apart. Bipolar I disorder involves a manic episode; depressive episodes may occur but are not required. Bipolar II disorder involves depressive and hypomanic episodes without a full manic episode. Hypomania is a noticeable but less severe change that does not involve psychotic symptoms or the marked disruption associated with mania. The word “hypomania” does not mean that the person's suffering or depression is mild.
How is bipolar disorder diagnosed, and can a blood test show it?
A blood test or brain scan alone does not establish bipolar disorder. The doctor needs your symptoms, how they changed over time and other possible explanations, and may request tests to investigate other causes, such as thyroid disorders. Describe changes in sleep, activity and mood rather than only the word “swings”. If you seek help for depression, also mention any earlier period of unusual energy and confidence, even if you felt well then; it can change treatment decisions.
Is bipolar disorder the same as schizophrenia?
No. Bipolar disorder involves episodes of changes in mood, energy and activity. Psychotic symptoms can occur during mania or severe depression in someone with bipolar disorder, but they do not automatically change the diagnosis to schizophrenia. Schizophrenia may include psychotic symptoms and difficulties with motivation, expressing emotions and concentration. Hearing voices alone does not establish schizophrenia, and taking a medicine used for both conditions does not show that the diagnoses are identical.
When do bipolar symptoms need an urgent assessment?
Seek urgent medical assessment if mania is possible: a major change from usual with reduced need for sleep and increased activity or irritability, plus impulsive behavior or impaired judgment. Do not wait a week, or for a job loss or a stated intention to harm; no previous diagnosis is needed. New psychotic symptoms, severe depression that prevents eating, drinking or basic self-care, and suicidal thoughts, even without a stated plan, also need urgent professional help.
Contact your doctor or team through any agreed plan; if there is none or you cannot reach them, seek urgent medical assessment. While safe, 937 offers guidance in Saudi Arabia. If you cannot get assessment promptly, go to a hospital emergency department. A consultation call must not delay emergency help when there is danger.
Content writer and researcher at Tatmeen, working on Arabic and English articles across mental health and everyday life topics, including relationships, stress, work, habits, and family.
Every Tatmeen article is reviewed by care providers licensed by the Saudi Commission for Health Specialties, so what you read is accurate and trustworthy.
This article builds understanding and does not replace a licensed care provider.
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Schizophrenia may include psychotic symptoms and difficulties with motivation, expressing emotions and concentration. Hearing voices alone does not establish schizophrenia, and taking a medicine used for both conditions does not show that the diagnoses are identical.</p>"},{"question":"When do bipolar symptoms need an urgent assessment?","answer":"<p>Seek urgent medical assessment if mania is possible: a major change from usual with reduced need for sleep and increased activity or irritability, plus impulsive behavior or impaired judgment. Do not wait a week, or for a job loss or a stated intention to harm; no previous diagnosis is needed. New psychotic symptoms, severe depression that prevents eating, drinking or basic self-care, and suicidal thoughts, even without a stated plan, also need urgent professional help.</p><p>Contact your doctor or team through any agreed plan; if there is none or you cannot reach them, seek urgent medical assessment. While safe, 937 offers guidance in Saudi Arabia. If you cannot get assessment promptly, go to a hospital emergency department. A consultation call must not delay emergency help when there is danger.</p>"}],"beforeSourcesHtml":"\n","sources":[{"title":"American Psychiatric Association: What Are Bipolar Disorders?","href":"https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders","hostname":"psychiatry.org"},{"title":"National Institute of Mental Health: Bipolar Disorder","href":"https://www.nimh.nih.gov/health/publications/bipolar-disorder","hostname":"nimh.nih.gov"},{"title":"NICE: Bipolar disorder—assessment and management, CG185","href":"https://www.nice.org.uk/guidance/cg185/chapter/recommendations","hostname":"nice.org.uk"},{"title":"NHS: Bipolar disorder","href":"https://www.nhs.uk/mental-health/conditions/bipolar-disorder/","hostname":"nhs.uk"},{"title":"NHS: Psychosis","href":"https://www.nhs.uk/mental-health/conditions/psychosis/overview/","hostname":"nhs.uk"},{"title":"National Institute of Mental Health: Schizophrenia","href":"https://www.nimh.nih.gov/health/publications/schizophrenia","hostname":"nimh.nih.gov"},{"title":"NHS: Diagnosis of psychosis","href":"https://www.nhs.uk/mental-health/conditions/psychosis/diagnosis/","hostname":"nhs.uk"},{"title":"NHS: Causes of psychosis","href":"https://www.nhs.uk/mental-health/conditions/psychosis/causes/","hostname":"nhs.uk"},{"title":"NHS: Where to get urgent help for mental health","href":"https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/","hostname":"nhs.uk"},{"title":"NHS: Sudden confusion (delirium)","href":"https://www.nhs.uk/symptoms/confusion/","hostname":"nhs.uk"},{"title":"NHS: Poisoning","href":"https://www.nhs.uk/conditions/poisoning/","hostname":"nhs.uk"},{"title":"MedlinePlus: Suicide and suicidal behavior","href":"https://medlineplus.gov/ency/article/001554.htm","hostname":"medlineplus.gov"},{"title":"Saudi Ministry of Health: Contact us and 937","href":"https://www.moh.gov.sa/ministry/about/pages/contactus.aspx","hostname":"moh.gov.sa"},{"title":"Saudi Red Crescent Authority: First-aid awareness and important telephone numbers","href":"https://www.srca.gov.sa/first-aid-awareness/","hostname":"srca.gov.sa"},{"title":"National Institute of Mental Health: Bipolar Disorder in Children and Teens","href":"https://www.nimh.nih.gov/health/publications/bipolar-disorder-in-children-and-teens","hostname":"nimh.nih.gov"},{"title":"CANMAT and ISBD: 2018 guidelines for the management of patients with bipolar disorder","href":"https://pmc.ncbi.nlm.nih.gov/articles/PMC5947163/","hostname":"pmc.ncbi.nlm.nih.gov"},{"title":"National Institute of Mental Health: Adult Outpatient Brief Suicide Safety Assessment Guide","href":"https://www.nimh.nih.gov/research/research-conducted-at-nimh/asq-toolkit-materials/adult-outpatient/adult-outpatient-brief-suicide-safety-assessment-guide","hostname":"nimh.nih.gov"},{"title":"NHS: Hallucinations and hearing voices","href":"https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/hallucinations-hearing-voices/","hostname":"nhs.uk"}],"afterSourcesHtml":"\n","blocks":[{"type":"html","html":"<p>You can be pleased by good news and upset by an argument on the same day. That alone does not mean bipolar disorder. A doctor looks at a broader history: how your <a href=\"https://www.nimh.nih.gov/health/publications/bipolar-disorder\" target=\"_blank\" rel=\"noopener noreferrer\">sleep, energy and behavior changed</a>, whether you have <a href=\"https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">had similar periods before</a>, and how you were between them. Those details say more than “my mood keeps changing” when you explain what concerns you.</p>\n<p><strong>If things have changed sharply right now, start with <a href=\"https://tatmeen.sa/en/blog/Bipolar-and-relationship-with-schizophrenia/#when-do-you-need-urgent-help\">When do you need urgent help?</a>.</strong> You can seek care before you understand all the medical terms.</p>\n<h2 id=\"article-section-what-differs-from-ordinary-mood-changes\" data-toc-heading tabindex=\"-1\"><span id=\"what-differs-from-ordinary-mood-changes-1\" aria-hidden=\"true\"></span>What differs from ordinary mood changes?</h2>\n<p>Bipolar disorder can involve periods of <a href=\"https://www.nimh.nih.gov/health/publications/bipolar-disorder\" target=\"_blank\" rel=\"noopener noreferrer\">elevated mood or irritability</a> and increased activity, as well as periods of depression. An episode is more than moving from happiness to sadness during a day: it involves noticeable <a href=\"https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">changes in energy, behavior and thinking</a> that persist and affect life to different degrees. There may be <a href=\"https://www.nhs.uk/mental-health/conditions/bipolar-disorder/\" target=\"_blank\" rel=\"noopener noreferrer\">long periods of stability between episodes</a>.</p>\n<p>For example, staying up to finish important work and then feeling exhausted differs from <a href=\"https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">sleeping far less than usual</a> with an unfamiliar sense that you do not need sleep, taking on many projects, speaking rapidly or <a href=\"https://www.nhs.uk/mental-health/conditions/bipolar-disorder/\" target=\"_blank\" rel=\"noopener noreferrer\">rushing into financial decisions</a>. During depression, loss of interest and energy or difficulty concentrating can make previously ordinary tasks, such as studying or preparing a meal, difficult. These are examples of what to describe to a doctor, not a way to confirm a diagnosis.</p>\n<p>Ask what has <strong>changed from usual</strong>: <a href=\"https://www.nimh.nih.gov/health/publications/bipolar-disorder\" target=\"_blank\" rel=\"noopener noreferrer\">Has your need for sleep changed</a>? Have your activity or judgment changed? What have you or <a href=\"https://www.nice.org.uk/guidance/cg185/chapter/recommendations\" target=\"_blank\" rel=\"noopener noreferrer\">someone who knows you well</a> noticed? Have you had similar periods before? A change happening around stress or an event does not settle its cause, and one happy or energetic day does not establish an episode.</p>\n<p>If changes persist, recur or concern you, you can start with a <a href=\"https://www.nhs.uk/mental-health/conditions/bipolar-disorder/\" target=\"_blank\" rel=\"noopener noreferrer\">family doctor or psychiatrist</a>, even if you do not know what to call the problem. You do not need to lose your job or experience both depression and mania before asking for help. <a href=\"https://www.nice.org.uk/guidance/cg185/chapter/recommendations\" target=\"_blank\" rel=\"noopener noreferrer\">Some changes need urgent help</a>, as explained in the dedicated section below.</p>\n<h2 id=\"article-section-what-do-mania-hypomania-and-depression-mean\" data-toc-heading tabindex=\"-1\"><span id=\"what-do-mania-hypomania-and-depression-mean-2\" aria-hidden=\"true\"></span>What do mania, hypomania and depression mean?</h2>\n<p><strong>Mania</strong> is a severe change in mood, energy and activity that may impair judgment and disrupt life. It can involve psychotic symptoms or require hospital care. <strong>Hypomania</strong> is a <a href=\"https://www.nimh.nih.gov/health/publications/bipolar-disorder\" target=\"_blank\" rel=\"noopener noreferrer\">noticeable but less severe change</a>; it <a href=\"https://pmc.ncbi.nlm.nih.gov/articles/PMC5947163/\" target=\"_blank\" rel=\"noopener noreferrer\">does not involve psychotic symptoms or the marked disruption</a> associated with mania. The person may feel productive and well, while people close to them <a href=\"https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">notice an unusual change</a>.</p>\n<p>A <strong>depressive episode</strong> may involve <a href=\"https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">intense sadness or loss of interest</a> and pleasure, with changes in sleep, energy and concentration. Depression alone does not establish bipolar disorder, so it is also important to tell the doctor about previous periods of increased activity. Depressive symptoms can <a href=\"https://www.nimh.nih.gov/health/publications/bipolar-disorder\" target=\"_blank\" rel=\"noopener noreferrer\">occur alongside increased activity or irritability</a>, rather than as two separate states of happiness and sadness.</p>\n<p><strong>Bipolar I disorder</strong> involves a manic episode. Depressive episodes may occur, but are not required for this type. <strong>Bipolar II disorder</strong> involves <a href=\"https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">depressive and hypomanic episodes</a> without a full manic episode. The word “hypomania” does not mean that the person's suffering or depression is mild. Episodes and the <a href=\"https://pmc.ncbi.nlm.nih.gov/articles/PMC5947163/\" target=\"_blank\" rel=\"noopener noreferrer\">periods between them vary</a>; they do not have to alternate in a fixed order.</p>\n<h2 id=\"when-do-you-need-urgent-help\" data-toc-heading tabindex=\"-1\">When do you need urgent help?</h2>\n<h3>Urgent assessment, even without obvious danger</h3>\n<p><strong>Seek urgent medical assessment if mania is possible:</strong> for example, a major change from usual involving <a href=\"https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">reduced need for sleep</a> and increased activity or irritability, with impulsive behavior or impaired judgment. <a href=\"https://www.nice.org.uk/guidance/cg185/chapter/recommendations\" target=\"_blank\" rel=\"noopener noreferrer\">Do not wait a week</a>, wait to lose your job or wait for a stated intention to cause harm. You do not need a previous bipolar disorder diagnosis.</p>\n<p><a href=\"https://www.nhs.uk/mental-health/conditions/psychosis/overview/\" target=\"_blank\" rel=\"noopener noreferrer\">New psychotic symptoms</a>, <a href=\"https://www.nice.org.uk/guidance/cg185/chapter/recommendations\" target=\"_blank\" rel=\"noopener noreferrer\">severe depression that prevents eating</a>, drinking or basic self-care, and <a href=\"https://medlineplus.gov/ency/article/001554.htm\" target=\"_blank\" rel=\"noopener noreferrer\">thoughts of suicide</a> also need urgent professional help, even if no suicide plan has been stated.</p>\n<p>Contact the doctor or treatment team using any agreed contact plan, if there is one and they can be reached. If there is no plan or team, contact details are missing or you cannot reach them, <a href=\"https://www.nice.org.uk/guidance/cg185/chapter/recommendations\" target=\"_blank\" rel=\"noopener noreferrer\">seek urgent medical assessment</a>. While you are safe, you can <a href=\"https://www.moh.gov.sa/ministry/about/pages/contactus.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">call 937 for medical consultation</a> and guidance on where to seek care within Saudi Arabia; the service is available around the clock. If you cannot obtain suitable assessment promptly, <a href=\"https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/\" target=\"_blank\" rel=\"noopener noreferrer\">go to a hospital emergency department</a>. A consultation call must not delay emergency help when there is danger.</p>\n<h3>Emergency help now</h3>\n<p><strong>Seek emergency help now</strong> if there is <a href=\"https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/\" target=\"_blank\" rel=\"noopener noreferrer\">immediate danger to life</a> or you cannot keep yourself or another person safe. <a href=\"https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/hallucinations-hearing-voices/\" target=\"_blank\" rel=\"noopener noreferrer\">Voices commanding harm</a>, rapidly worsening hallucinations, severe agitation or aggression, or speech that has become incoherent also need emergency assessment, even without a stated intention to harm.</p>\n<p>Sudden confusion also <a href=\"https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/\" target=\"_blank\" rel=\"noopener noreferrer\">needs emergency medical care</a>: for example, someone suddenly <a href=\"https://www.nhs.uk/symptoms/confusion/\" target=\"_blank\" rel=\"noopener noreferrer\">does not know where they are or develops a new difficulty thinking or paying attention</a>. Do not wait for a psychiatric appointment to find out its cause.</p>\n<p>Also seek emergency care if any of the following has happened recently and has not been medically assessed: a <a href=\"https://medlineplus.gov/ency/article/001554.htm\" target=\"_blank\" rel=\"noopener noreferrer\">suicide attempt</a>, serious injury, <a href=\"https://www.nhs.uk/conditions/poisoning/\" target=\"_blank\" rel=\"noopener noreferrer\">actual or suspected poisoning</a>, or an <a href=\"https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/\" target=\"_blank\" rel=\"noopener noreferrer\">actual or suspected overdose</a>. If you suspect someone has taken a harmful substance or an overdose, do not wait for confirmation or symptoms.</p>\n<h3>Getting to care safely</h3>\n<p>Ask a trusted person who can accompany you safely for help. Do not drive if you have signs of mania, psychotic symptoms or <a href=\"https://www.nhs.uk/symptoms/confusion/\" target=\"_blank\" rel=\"noopener noreferrer\">sudden confusion</a>, or if <a href=\"https://www.nhs.uk/conditions/poisoning/\" target=\"_blank\" rel=\"noopener noreferrer\">poisoning or an overdose is suspected</a>; have someone else drive you. If you are alone or no safe companion is available, tell the medical service when you call. <a href=\"https://www.srca.gov.sa/first-aid-awareness/\" target=\"_blank\" rel=\"noopener noreferrer\">Call 997 for an ambulance</a> in Saudi Arabia if travel is unsafe or you cannot keep everyone safe. In immediate danger, call for an ambulance from a safe place.</p>\n<p>If you are helping someone who does not think they need care or refuses it, <a href=\"https://www.nhs.uk/mental-health/conditions/psychosis/diagnosis/\" target=\"_blank\" rel=\"noopener noreferrer\">seek professional advice</a> and explain what you have observed. Do not wait until you agree on the diagnosis. Do not force them to travel, restrain them or give them medicine secretly.</p>\n<h2 id=\"article-section-bipolar-disorder-psychosis-and-schizophrenia-why-do-the-names-differ\" data-toc-heading tabindex=\"-1\"><span id=\"bipolar-disorder-psychosis-and-schizophrenia-why-do-the-names-differ-4\" aria-hidden=\"true\"></span>Bipolar disorder, psychosis and schizophrenia: why do the names differ?</h2>\n<p>You may hear these terms during an assessment, but <a href=\"https://www.nhs.uk/mental-health/conditions/psychosis/overview/\" target=\"_blank\" rel=\"noopener noreferrer\">they mean different things</a>.</p>\n<div class=\"table-block\"><table>\n<thead>\n<tr>\n<th>Term</th>\n<th>What does it mean?</th>\n<th>What does the name alone not tell you?</th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>Psychosis or psychotic symptoms</td>\n<td>Experiences such as hearing voices other people do not hear, firmly held beliefs that do not match reality, or noticeably disorganized thinking and speech.</td>\n<td>This does not identify the cause or diagnosis. These experiences can occur with different disorders, physical conditions, medicines or substances.</td>\n</tr>\n<tr>\n<td>Bipolar disorder</td>\n<td>A disorder involving episodes of changes in mood, energy and activity, understood through the history of those episodes and the periods between them.</td>\n<td>Mood swings alone do not establish the diagnosis, and psychotic symptoms do not automatically change it to schizophrenia.</td>\n</tr>\n<tr>\n<td>Schizophrenia</td>\n<td>A disorder that may include psychotic symptoms and difficulties with motivation, expressing emotions and concentration, which vary from person to person.</td>\n<td>Hearing voices alone does not establish schizophrenia. The diagnosis does not mean having multiple personalities or being permanently out of touch with reality.</td>\n</tr>\n</tbody>\n</table></div>\n<p>Psychotic symptoms can <a href=\"https://www.nimh.nih.gov/health/publications/bipolar-disorder\" target=\"_blank\" rel=\"noopener noreferrer\">occur during mania or severe depression</a> in someone with bipolar disorder. The clinician therefore asks when they occurred, <a href=\"https://www.nice.org.uk/guidance/cg185/chapter/recommendations\" target=\"_blank\" rel=\"noopener noreferrer\">how they relate to mood</a>, what happened before and between those periods, and <a href=\"https://www.nhs.uk/mental-health/conditions/psychosis/causes/\" target=\"_blank\" rel=\"noopener noreferrer\">what other causes may be involved</a>. Taking a medicine used for both conditions does not show that the diagnoses are identical; a medicine may treat symptoms they share.</p>\n<p><a href=\"https://www.nimh.nih.gov/health/publications/schizophrenia\" target=\"_blank\" rel=\"noopener noreferrer\">Schizophrenia does not make violence inevitable</a>; most people with it are not violent. Treatment can help symptoms and everyday life, and the amount of support someone needs varies. Describing the person's actual experience is more useful for assessment than judging them by a diagnostic label.</p>\n<h2 id=\"article-section-what-causes-bipolar-disorder\" data-toc-heading tabindex=\"-1\"><span id=\"what-causes-bipolar-disorder-5\" aria-hidden=\"true\"></span>What causes bipolar disorder?</h2>\n<p>No single cause is known; genetic and environmental factors contribute to the likelihood of developing it. <a href=\"https://www.nimh.nih.gov/health/publications/bipolar-disorder\" target=\"_blank\" rel=\"noopener noreferrer\">Having an affected relative</a> can increase that likelihood without making it inevitable. Life stress, <a href=\"https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">disrupted sleep and some substances</a> may trigger an episode in a susceptible person, but none of these alone fully explains the condition. This information can help you discuss your history and care plan; it is not a reason to blame yourself or your family.</p>\n<h2 id=\"article-section-how-do-you-get-an-assessment-that-clarifies-the-picture\" data-toc-heading tabindex=\"-1\"><span id=\"how-do-you-get-an-assessment-that-clarifies-the-picture-6\" aria-hidden=\"true\"></span>How do you get an assessment that clarifies the picture?</h2>\n<p>If the situation <a href=\"https://www.nimh.nih.gov/health/publications/bipolar-disorder\" target=\"_blank\" rel=\"noopener noreferrer\">is not urgent, arrange an assessment with a psychiatrist</a>, or <a href=\"https://www.nhs.uk/mental-health/conditions/bipolar-disorder/\" target=\"_blank\" rel=\"noopener noreferrer\">start with a family doctor</a> who can assess general health and guide you to appropriate care. When booking, describe changes in sleep, activity and mood, rather than using only the word “swings”.</p>\n<p>You might seek help for depression now and leave out an earlier period of unusual energy and confidence because you felt well at the time. Mention it too. Bipolar depression can resemble depression in someone who has never experienced mania or hypomania, but knowing about those earlier periods can change treatment decisions. <a href=\"https://www.nimh.nih.gov/health/publications/bipolar-disorder\" target=\"_blank\" rel=\"noopener noreferrer\">Antidepressants taken alone can trigger mania</a> in some people with bipolar disorder. Ask the prescriber how your history affects the plan, and do not change medication on your own.</p>\n<p>The clinician will ask about the periods you have experienced, including:</p>\n<ul>\n<li>When the change began, how sleep, energy and behavior differed from usual, and its effect on study, work and relationships.</li>\n<li>Previous periods and what happened between them, family history, and treatments that helped or caused problems.</li>\n<li><a href=\"https://www.nice.org.uk/guidance/cg185/chapter/recommendations\" target=\"_blank\" rel=\"noopener noreferrer\">Medicines and supplements</a>, <a href=\"https://www.nhs.uk/mental-health/conditions/psychosis/causes/\" target=\"_blank\" rel=\"noopener noreferrer\">alcohol or drugs</a>, any recent change in their use, and <a href=\"https://www.nhs.uk/mental-health/conditions/psychosis/diagnosis/\" target=\"_blank\" rel=\"noopener noreferrer\">physical symptoms or illnesses</a>.</li>\n</ul>\n<p>You can note a few examples or bring someone you trust if you wish. You do not need a complete record before the visit, and should not delay seeking help to prepare one. The doctor may request an examination or tests to investigate other causes, such as <a href=\"https://www.nimh.nih.gov/health/publications/bipolar-disorder\" target=\"_blank\" rel=\"noopener noreferrer\">thyroid disorders</a>. A blood test or brain scan alone does not establish bipolar disorder; symptoms, their course and other possible explanations are <a href=\"https://www.nice.org.uk/guidance/cg185/chapter/recommendations\" target=\"_blank\" rel=\"noopener noreferrer\">essential parts of assessment</a>.</p>\n<p>Clarifying a diagnosis can take time, especially when little is known about previous periods or symptoms overlap with other conditions. If you are told the diagnosis is provisional, or it changes later, ask what the doctor has learned and what remains unclear, together with a <a href=\"https://www.nice.org.uk/guidance/cg185/chapter/recommendations\" target=\"_blank\" rel=\"noopener noreferrer\">plan for care and follow-up</a>. Useful questions include: “What makes this explanation more likely? What else could explain it? What information do we need? When will we review the assessment?” You can ask for an explanation or another opinion without changing treatment on your own.</p>\n<p><strong>For children and teenagers:</strong> unusual changes need an assessment suited to their age. A pediatrician or family doctor can be a starting point for reaching a professional experienced in working with children and teenagers. Signs may <a href=\"https://www.nimh.nih.gov/health/publications/bipolar-disorder-in-children-and-teens\" target=\"_blank\" rel=\"noopener noreferrer\">overlap with development and other conditions</a>. Do not try to diagnose a child using descriptions for adults or give them medication prescribed for someone else.</p>\n<h2 id=\"article-section-what-does-care-after-assessment-involve\" data-toc-heading tabindex=\"-1\"><span id=\"what-does-care-after-assessment-involve-7\" aria-hidden=\"true\"></span>What does care after assessment involve?</h2>\n<p>Treatment for the current episode may differ from a plan for longer-term stability. <a href=\"https://www.nice.org.uk/guidance/cg185/chapter/recommendations\" target=\"_blank\" rel=\"noopener noreferrer\">Medicines and care are chosen</a> according to symptoms and their severity, physical health, previous response, side effects and the person's priorities. The plan may include <a href=\"https://www.nimh.nih.gov/health/publications/bipolar-disorder\" target=\"_blank\" rel=\"noopener noreferrer\">psychological therapy</a> to help with understanding the condition, managing changes and dealing with everyday difficulties, alongside medicine. Some <a href=\"https://www.nhs.uk/mental-health/conditions/bipolar-disorder/\" target=\"_blank\" rel=\"noopener noreferrer\">severe episodes require hospital care</a>.</p>\n<p>Discuss what you want to improve with the doctor: sleep, the ability to study or work, relationships, or returning to an activity that matters to you. Tell them about side effects or difficulty taking treatment as planned. Do not increase or reduce a dose, or <a href=\"https://www.nimh.nih.gov/health/publications/bipolar-disorder\" target=\"_blank\" rel=\"noopener noreferrer\">stop a medicine on your own</a>, even when you improve. Discuss medicines with the doctor if you are <a href=\"https://www.nhs.uk/mental-health/conditions/bipolar-disorder/\" target=\"_blank\" rel=\"noopener noreferrer\">pregnant or planning pregnancy</a>. Ask about physical health checks and tests needed for your medicine; monitoring may include weight, <a href=\"https://www.nice.org.uk/guidance/cg185/chapter/recommendations\" target=\"_blank\" rel=\"noopener noreferrer\">blood pressure, blood glucose and lipids</a>, depending on the plan.</p>\n<p><a href=\"https://www.nhs.uk/mental-health/conditions/bipolar-disorder/\" target=\"_blank\" rel=\"noopener noreferrer\">Regular sleep, meals and activity</a>, <a href=\"https://www.nimh.nih.gov/health/publications/bipolar-disorder\" target=\"_blank\" rel=\"noopener noreferrer\">avoiding alcohol and drugs</a>, and continuing follow-up can support everyday care. These steps are not enough on their own to treat a possible episode. A safe person you choose can help with appointments or <a href=\"https://www.nice.org.uk/guidance/cg185/chapter/recommendations\" target=\"_blank\" rel=\"noopener noreferrer\">noticing early changes</a>, with a clear agreement about what you want to share with them.</p>\n<p>Make the follow-up plan practical: What <a href=\"https://www.nice.org.uk/guidance/cg185/chapter/recommendations\" target=\"_blank\" rel=\"noopener noreferrer\">early signs should prompt a call</a>? Who can you actually reach, and what should you do outside their working hours or if they do not answer? When will treatment benefits and side effects be reviewed? Write down the answers with the doctor and <a href=\"https://www.moh.gov.sa/ministry/about/pages/contactus.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">keep the available contact numbers</a>. Do not assume an old plan or an unreachable number will be enough when symptoms return; use the <a href=\"https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/\" target=\"_blank\" rel=\"noopener noreferrer\">urgent-help route above</a> when needed.</p>\n<p>Treatment and follow-up can help with <a href=\"https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">stability and a better life</a>, but the <a href=\"https://www.nimh.nih.gov/health/publications/bipolar-disorder\" target=\"_blank\" rel=\"noopener noreferrer\">course varies from person to person</a> and care may need adjusting. Improvement does not require you to return to every responsibility at once, or mean on its own that it is time to stop treatment. Ask for support with the task that is difficult for you now, and discuss it at your next visit.</p>\n"}],"inlineCtaSignatures":[],"_experienceAliases":{"v":1,"fields":["html","bodyHtml"],"faqs":[0,1,2,3,4]}},"createdAt":"2024-01-08T21:00:00.000Z","updatedAt":"2026-10-30T19:35:10.180Z","disorderGroups":[{"id":"1e82772d-a1a7-4d29-b475-be9d6b67ae02","slug":"common-mental-issues","arName":"اضطرابات نفسية شائعة","enName":"Common Mental Issues"}],"reviewer":{"arFullName":"فريق تطمين","enFullName":"Tatmeen 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