Diagnosing Bipolar Disorder
In order to avoid an incorrect mental health diagnosis, diagnosing bipolar disorder can be a lengthy, involved process. After taking your medical history and listening to your symptoms, your doctor may first do a physical exam with lab tests to check for physical problems that might be causing your symptoms. However, no one test can provide a definitive bipolar disorder diagnosis.
Bipolar disorder is often characterized by both manic (or less severe “hypomanic”) episodes of high activity and depressive episodes of sadness and hopelessness. Some people experience a combination of mania and depression symptoms, called a “mixed state.”
Because people are more likely to see a doctor during bipolar depression than during mania, a doctor must look beyond diagnosing depression. For a complete picture of your mental state, a doctor will talk to you about your thoughts, feelings and behavior patterns.
Among other things, your doctor may:
- Ask you to fill out a psychological self-assessment.
- Ask you to keep a daily record of your moods, sleep patterns, or other factors that could help with diagnosis and finding the right treatment.
- With your permission, talk to family members or close friends who might provide information about your symptoms and possible manic or depressive episodes.
Types of Bipolar Disorder
A mental health diagnosis of bipolar disorder generally falls into one of three categories:
- Bipolar I disorder: You’ve had at least one manic or one mixed episode. You may or may not have had a major depressive episode. Bipolar I differs from person to person, and has specific subcategories based on specific signs and symptoms.
- Bipolar II disorder: You’ve had at least one major depressive episode and at least one hypomanic episode (but not a fully manic or mixed episode). Bipolar II disorder also has subcategories.
- Bipolar disorder not otherwise specified (BP-NOS): Your symptoms are clearly out of your normal range of behavior, but they don’t meet diagnostic criteria for either bipolar I or II.
- Cyclothymic disorder (cyclothymia): You’ve had many hypomanic episodes and experienced periods of mild depression, but you’ve never had a full manic episode, a major depressive episode or a mixed episode. For a bipolar disorder diagnosis of cyclothymic disorder, your symptoms must have been present for two years or more.
Diagnosing Bipolar Disorder in Children
Although a bipolar disorder diagnosis in children follows the same official criteria as adult diagnosis, bipolar symptoms in children and adolescents often have different patterns that may not fit well into the diagnostic categories. Diagnosing bipolar disorder in children under the age of six is often particularly difficult.
Adults usually have distinct episodes of mania and depression, but children and adolescents may have erratic, rapid changes in mood, behavior and energy levels that may also fit another mental health diagnosis, including attention deficit hyperactivity disorder (ADHD).
Because of potential overlapping diagnoses in children and the possibility of disagreement even among experts, if your child is suffering from emotional problems, you may want to get a second and even third opinion.
Resources
Mayo Clinic Staff. (2010). Bipolar disorder: Tests and diagnosis. Retrieved May 14, 2010, from the Mayo Clinic website: www.mayoclinic.com/health/bipolar-disorder/DS00356/DSECTION=tests-and-diagnosis.
National Institute of Mental Health Staff. (n.d.). Bipolar disorder. Retrieved May 14, 2010, from the National Institute of Mental Health website: www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml.
HealthyPlace.com Staff Writer. (2008). Diagnosing Bipolar disorder in children. Retrieved May 19, 2010, from the HealthyPlace website: www.healthyplace.com/bipolar-disorder/children/diagnosing-bipolar-disorder-in-children/menu-id-67/.