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 confused with other disorders such as unipolar depression or with 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 laboratory measures 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. "Mood swings" from day to day or moment to moment do not necessarily indicate a diagnosis of bipolar disorder. Rather, the diagnosis hinges on having periods of unusual elevation or irritability in mood that are coupled with increases in energy, sleeplessness, and fast thinking or speech. The patient’s symptoms are fully 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 mental health expert will ask you questions about your personal and family history of mental illness and bipolar disorder. Because bipolar disorder sometimes has a genetic component, family history can be helpful in making a diagnosis. Most people with bipolar disorder, though, do not have a family history of bipolar disorder.
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.