Psychofarm Podcast How to Diagnose Bipolar Disorder: The Interview Framework That Beats Screening Questions
Feb 10, 2026
A practical, semi-structured interview for diagnosing bipolar in clinic is outlined step by step. They stress starting with medication, medical, and substance timelines before mood questions. The conversation covers screening methods for hypomania and mania, anchoring timelines to life events, and common diagnostic mimics like PTSD, ADHD, and borderline traits.
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Patients Deny Screens But Tell Mania Stories
- Dr. Fu recounts patients who deny screeners yet tell clear mania narratives on narrative probing.
- Collateral often reveals mania when patients underreport due to poor recall or anosognosia.
Anchor Timelines To Stable Life Events
- Anchor timelines to a consistent life marker (jobs, school, relationships) if patients can't narrate episodes.
- Use that anchor to place medication, substance, and mood events chronologically.
Ask Substance And Medication History As Timeline
- Ask substance and medication history as timeline questions: when, how long, responses, and sobriety windows.
- Specifically ask about stimulants, antidepressant-induced mania, steroids, and supplements.
