Dr Victoria Lukats is a psychiatrist and an expert on relationships and dating. Today, she offers advice to a woman who wonders if her boyfriend is bipolar.

Dear Dr Victoria,

This year I had great expectations for Valentine’s. I have been with my partner for 12 years and really thought a romantic dinner and proposal was on the cards.

While everyone else was celebrating Valentine’s with a romantic dinner I spent my alone watching television while my partner went to bed at 7pm claiming he was too depressed to go out.

My partner has always been reserved, quiet and a man of few words, however over the last three months his behaviour has changed significantly.

One week he's really positive, upbeat, enthusiastic and even adventurous, then the next he’ll become extremely withdrawn, spend days in bed and refuse to communicate. Both of these personas are completely uncharacteristic of his normal behaviour.

The week before Valentine’s he had been talking about marriage and commitment and that we should really go out this Saturday and celebrate our 12 years of being together. So with this in mind I booked a table at our local Italian and was really looking forward to the evening.

Then on Friday before his mood changed I prayed that he’d pull himself together and it was just a blip, but unsurprisingly, four days on he’s still withdrawn.

So far he’s refused to go and see the doctor. Initially I thought it was a touch of depression, then I’d read an article about bi-polar and the similarities seem so apparent, extreme highs and lows.

Being a psychiatrist I thought you might be able to advise what to do and if this sounds like bi-polar.

Dr Victoria replies:

It sounds like the last few months have been very difficult for you and naturally you're concerned about your partner.

There's not really enough information in your email to be clear about a diagnosis and in any case, a doctor would have to see him to make a diagnosis.

It can be difficult to know where to look on the internet for good quality information about medical problems as there are so many different websites out there, often with contradictory information.

Bipolar disorder is now the name of the condition that used to be called manic depression.

To make a diagnosis, the individual will have suffered at least one manic episode (or the milder version, called a hypomanic episode) plus he or she will have also suffered at least one other episode of either clinical depression, mania or hypomania.

So what counts as a manic episode? If someone is suffering a full-blown manic episode, it will be obvious to friends, family and colleagues that there is something seriously wrong.

An individual manic episode typically goes on for weeks or months on end, rather than a few days.

The symptoms of a manic episode include elated mood (feeling really high or unusually happy, cheerful, or even ecstatic - or sometimes even just appearing that way to others even if they don't feel it), being unable to sleep much, increased energy levels, irritability and rapid speech.

During a manic episode, individuals may become uncharacteristically disinhibited, reckless or impulsive.

The result can be varied but will often involve overspending, taking on all maner of new projects and there may be an increase in sex-drive.

At its most severe, manic individuals can become delusional, with grandiose delusions (firmly believing things that are not based on fact such as believing they are God or believing they have special powers).

The difference between a manic episode and a hypomanic episode is the severity and the disruption to normal functioning.

With hypomania, the individual may be unusually cheerful, sleeping a few hours less each night, full of energy and may even be much more productive at work - especially if they work in academia or a creative field.

They may struggle but be able to continue with ordinary day to day life - going to work and getting housework and paperwork done. A manic episode is much more disruptive and work would be almost impossible.

So to clarify, bipolar disorder is characterised by discrete episodes of being unwell - with either mania, milder hypomania or depression and the individual returns to their normal self when they've recovered from one of these episodes.

These episodes usually go on for weeks, often months at a time so it's definitely different from mood swings.

When people say they feel up for a few hours then feel normal or miserable for a few hours or a day or two, this is unlikely to be bipolar disorder.

But whether this is bipolar disorder or not, you're right to be concerned about your partner.

You've known him for 12 years and if this is the first time you've known him like this then something's up.

Such rapid swings from being cheerful and adventurous to being so depressed he can't get out of bed for days aren't the typical presentation of bipolar disorder but there is a more unusual form of bipolar disorder with more rapid swings between mania or hypomania and depression. This is a possibility.

Alternatively it may be depression but it's important that he sees a doctor for an accurate assessment and proper treatment as sometimes this condition can sometimes be difficult to diagnose and it's important to consider other medical conditions which can present with similar symptoms.

If your partner doesn't want to see a doctor then there's nothing stopping you going to see your doctor yourself to explain the problems. Your doctor won't be able to share confidential information about your partner's medical history without his permission but you will be able to give your doctor information and get some advice and support for yourself. Your doctor may be able to visit your partner at home if necessary.

In the short term, the priority is getting a medical assessment for your partner. Try to stay supportive and sympathetic even though this must be worrying or even frustrating. Let him know that you're there for him.

If you become concerned that your partner may have become so depressed that he's mentioning self-harm or suicide then get help and advice urgently by phoning for your out of hours GP or taking him to the local A&E if necessary.

If you want to ask Dr Lukats's advice send an email to drvictoria@independent-digital.com . Please bear in mind she cannot enter into private correspondence and cannot answer all questions. Any advice given will be published on the website (personal details will not be published).

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