Bipolar Disorder Treatment: When to Go to the ER
Updated: Nov 9, 2025.
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Emergency Room Bipolar Disorder Treatment: TL;DR
Go to the ER for bipolar disorder treatment if you are experiencing severe bipolar symptoms, psychosis, or suicidal thoughts.
Severe bipolar disorder symptoms are medical emergencies that may require bipolar disorder treatment in a hospital setting.
If your symptoms are serious but not life-threatening, you can visit a walk-in clinic, contact your provider’s crisis line, or reach out to the 988 Suicide & Crisis Lifeline for support.
If you are in the midst of a mental health crisis, it can be difficult to know when to go to the hospital, especially if you are in a crisis.
As someone living with bipolar disorder, I’ve been hospitalized several times for bipolar disorder, and I’ve also worked in an emergency room conducting psychiatric assessments, so I’ve experienced mental health crises from both sides. I know how crucial timely bipolar disorder treatment can be.
It’s a good idea to think ahead about when you might need emergency psych help. If symptoms are severe or you pose a threat to yourself or others, getting urgent help is necessary. So, how do you know if this is happening? Let’s take a closer look at bipolar disorder hospitalization.
Therapy can sometimes help prevent the need for hospitalization by providing consistent support and early intervention. If you’re considering getting started, online therapy is a convenient option. You can connect with a licensed professional from home.
What Is a Bipolar Emergency?
A psychiatric emergency is a serious situation that requires urgent care. It may require bipolar disorder hospitalization. In these situations, seeking help can be lifesaving. Here are some signs that a trip to the emergency room (ER) might be necessary.
Suicidal or Homicidal Thoughts
If you are having thoughts of harming yourself or someone else and have thought about how you would do it, or have a plan to act on these thoughts, it’s an emergency. Call or text the 988 Lifeline in the U.S. for free, confidential support.
If someone close to you is threatening to harm themselves or others and refusing to go to the hospital, then you can call 911 (in the U.S.) for help. Request a mental health or crisis response team to respond if one is available in your location.
Unable To Take Care of Your Basic Needs
When severe, bipolar disorder can make it extremely difficult to take care of your basic needs. For example, severe mania can make it hard to eat or stay hydrated. If there is a question of your ability to care for yourself, seeking a mental health evaluation at the emergency room is vital.
Impulsive or Dangerous Behavior
Sometimes, while in a manic episode, people with bipolar disorder can engage in impulsive behaviors, such as unsafe driving, reckless spending, and hypersexuality. These can put you or someone else in danger.
Psychotic Symptoms
If you are experiencing psychosis, you might have trouble knowing what is real and what isn’t. Psychotic symptoms in bipolar disorder indicate severe mania and require urgent care. Symptoms of psychosis include:
Delusions - A delusion is a false belief. For example, believing that a celebrity is in love with you, even though you have never even spoken to the person.
Paranoia - Feelings that others are out to harm you or are secretly watching you.
Auditory or visual hallucinations - These involve seeing or hearing things that are not real.
Disorganized thinking: - Confused, jumbled thoughts are a sign of disorganized thinking.
Severe Sleep Loss
During manic episodes, you may not feel a need to sleep. You may have bipolar insomnia or be unable to sleep even if you want to because of manic symptoms. After several days of not sleeping, you may begin to experience hallucinations and psychosis. This is an emergency. It’s best to go sooner rather than wait. The longer you go without sleep, the worse these symptoms get.
If you are experiencing any of the above things, it’s best to go to the ER. The doctors and nurses there can determine whether or not you need immediate bipolar disorder treatment
What to Expect at the ER
It can be intimidating to visit an emergency room for a psychiatric emergency. But they are there to keep you safe. Once there, you will be evaluated first medically. Later, you will meet with a doctor, nurse, or social worker from the psychiatric team for an evaluation.
It is a good idea to come with a loved one, if possible. Bring a list of your current medications and the names of your doctors.
What Options Are There if You Don’t Need an ER?
Perhaps you have run out of your medication and have no way to reach your psychiatrist because it’s the weekend. Right now, your symptoms aren’t severe enough to warrant an ER trip, but they might be if you wait to get medications. Or, you have just experienced the death of someone close and you need help right away to keep from spiraling. What can you do then? Here are some options:
Contact your mental health provider’s on-call crisis number - Most therapists and psychiatrists offer after-hours support. Call the regular number to see if there is an option to reach someone.
Visit a walk-in crisis clinic - Many larger cities have crisis clinics that offer walk-in psychiatric services. You can find these by doing a Google search for crisis clinics.
Reach out to a psych helpline - You can call or text the 988 Lifeline for confidential, free support 24/7.
Not ready for an ER visit but need support soon? You can explore evidence-based online therapy from licensed professionals.
Perspective From Someone Who’s Been There
It can feel confusing and scary to go to the ER when you are in a psychiatric crisis, but it can also be a turning point toward recovery. Hospitalization is a tool for safety and stabilization. If you’re struggling, you deserve appropriate care.
The Bottom Line
If you are in the midst of a bipolar episode and are worried about safety, you should go to the emergency room for urgent bipolar disorder treatment. The medical staff can determine if you need bipolar disorder hospitalization. There are other options available if you need urgent help, but it’s not an emergency, such as calling your outpatient provider for urgent help.
Frequently Asked Questions
Here are some of the most common bipolar disorder treatment questions that people have.
When does someone with bipolar need to be hospitalized?
A person may need urgent bipolar disorder treatment if they are a harm to themselves or others. Examples of this include experiencing psychosis (delusions or hallucinations) or if they are unable to care for themselves. This. may occur if a person hasn’t slept for several days because of mania.
What are common bipolar disorder therapies used in the hospital?
Bipolar disorder treatments usually involve medications, such as mood stabilizers and antipsychotics. A person may receive therapy in the hospital as well. Group and individual therapies are both common in the hospital setting.
What percentage of bipolar patients are hospitalized?
Some research indicates that as many as 75 percent of people with bipolar disorder are hospitalized at some point in their lives. So, it is a bipolar disorder treatment that many people have experienced.
References
Swann, A. C. (July 1, 2007 ). Psychiatric emergencies in bipolar and related disorders. Psychiatric Times, 24(6). https://www.psychiatrictimes.com/view/psychiatric-emergencies-bipolar-and-related-disorders
Waters, F., Chiu, V., Atkinson, A., & Blom, J. D. (July 2018). Severe sleep deprivation causes hallucinations and a gradual progression toward psychosis with increasing time awake. Frontiers in Psychiatry, 9, Article 303. https://doi.org/10.3389/fpsyt.2018.00303 Frontiers
Kim, E., You, M., Pikalov, A., Van-Tran, Q., & Jing, Y. (January 2011). One-year risk of psychiatric hospitalization and associated treatment costs in bipolar disorder treated with atypical antipsychotics: A retrospective claims database analysis. BMC Psychiatry, 11, Article 6. https://doi.org/10.1186/1471-244X-11-6
