Bipolar diagnosis is tricky without labs, so this episode lays out a practical, semi-structured interview you can use in real clinics. We start with what many clinicians skip: a medication and substance timeline, plus medical causes, before jumping into mood symptoms. Then we map major depressive episodes, screen for hypomania with narrative follow-ups, and compare behavior to baseline instead of trusting yes/no answers. Along the way we cover classic pitfalls and mimics, including PTSD insomnia, borderline traits, psychosis-related agitation, and ADHD mislabeling. Finally, we talk about when tools like the MDQ or Rapid Mood Screener help, and why collateral history can change the case.

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