Bipolar Diagnosis

Diagnosing Bipolar Disorder

Doctors have come a long way in fully understanding different moods in bipolar disorder and in making an accurate diagnosis. It wasn’t that long ago when bipolar disorder was lumped together with other disorders such as schizophrenia, a serious mental illness with symptoms of incoherent speech, delusions, and hallucinations. With the greater understanding of mental disorders today, doctors can identify the signs and symptoms of bipolar depression, hypomania, and mania and most cases can be treated effectively and safely with bipolar medications.

Most of us have become used to specialized blood tests or other expensive laboratory tests to help our doctors make an accurate diagnosis. However, most lab tests or imaging tests are not useful in diagnosing bipolar disorder. In fact, the most important diagnostic tool may be talking openly with the doctor about your mood swings, behaviors, and lifestyle habits.

While a physical examination can reveal a patient’s overall state of health, the doctor must hear about the bipolar signs and symptoms from the patient in order to effectively diagnose and treat bipolar disorder.

What does a doctor need to know to diagnose bipolar disorder?

A bipolar disorder diagnosis is made only by taking careful note of symptoms, including their severity, length, and frequency. The most telling symptoms of bipolar disorder include mood swings (going from extreme highs to extreme lows) that don't follow a set pattern. The patient’s symptoms may then be assessed using specific criteria from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders or DSM-IV.

In making the diagnosis of bipolar disorder, the psychiatrist or other bipolar expert will ask you questions about your personal and family history of mental illness and/or bipolar disorder. Because bipolar disorder has a strong genetic component, family history is important to making an accurate diagnosis.

Also, the doctor will ask detailed questions about your bipolar symptoms. Other questions may focus on reasoning, memory, ability to express yourself, and ability to maintain relationships.

Do other illnesses mimic symptoms of bipolar disorder?

Some serious illnesses such as lupus, HIV, and syphilis may have signs and symptoms that mimic those of bipolar disorder, causing a delay in making a diagnosis and improper treatment.

In addition, numerous studies show the prevalence of anxiety disorders in those with bipolar, including generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, phobic disorder, social anxiety disorder, and posttraumatic stress disorder (PTSD). If left untreated, each of these co-occurring disorders can cause unnecessary suffering and impairment.

Other problems often confound the proper diagnosis of bipolar disorder such as steroid medications used to treat inflammatory diseases such as rheumatoid arthritis, asthma and allergy, ulcerative colitis, eczema, and psoriasis. These steroid drugs can cause mood swings of depression and mania  that are sometimes mistaken for the moods of bipolar disorder.