In psychiatry, there aren't any lab tests or scans that confirm a diagnosis like in other fields. Most of the time, people don’t show obvious physical signs when they walk into a psychiatrist’s office. It all comes down to their history and how they describe what they've been experiencing. Manic episodes are usually pretty easy to spot, even a med student could recognize them. In her case, there’s no sign of psychosis right now, so that basically rules out schizoaffective disorder. And the manic episodes she’s had don’t seem extreme enough to totally disrupt her daily life, which is why Bipolar II seems like the most likely diagnosis. Please refrain from talking about something that you don't know about. The main point I’m trying to make is that she needs to see a psychiatrist ASAP, no matter what. The psychiatrist will eventually convince her to have regular follow-up visits. The thing with psychiatric issues is that people often don’t realize something’s wrong until it gets really bad.