People with bipolar disorder
experience intense emotional changes that are distinctly different from their
usual mood and behavior, and these changes lead to problems in their daily lives. However, testing for bipolar disorder isn’t
as simple as taking a multiple-choice test or sending some blood to the lab.
While bipolar disorder does show distinct symptoms, there is no single test to
confirm the condition. Usually a combination of methods is needed for a doctor
to make a diagnosis.
If your symptoms are disrupting your
daily routine you should see your primary care doctor. Your doctor will conduct
a physical examination and may perform lab tests, such as blood or urine
analyses, to help determine if other conditions or factors could be causing
your symptoms. For example, certain thyroid issues may cause symptoms similar
to those of bipolar disorder. Perhaps your symptoms are a side effect of
another medication. Additionally, if you have used any recreational drugs you must
tell your doctor – frequent drug use could be the source of your symptoms.
After other possible
causes are ruled out, your doctor will likely refer you to a mental health
specialist for further evaluation.
A psychiatrist or
psychologist will ask a series of questions to assess your overall mental
health. Testing for bipolar disorder primarily involves questions about
symptoms, their duration, and how they are disrupting your life. You will also
be asked about certain risk factors for bipolar, which may include questions
about your family medical history and any history of substance abuse.
Bipolar disorder is a mental health
condition that is characterized by periods of both mania and depression; the
criteria for bipolar requires at least one depressive episode and one manic
episode. There will be questions about your thoughts and feelings during and
after these episodes. Your doctor will want to know if you feel in control
during the mania and how long the episodes last. The doctor might also ask your
friends and family about your behavior. Any diagnosis will take into account
other aspects of your medical history and any medications you are currently taking.
To be exact with a diagnosis, mental
health professionals use the
Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM provides a
technical and detailed description of bipolar disorder. Here is a breakdown of some
of the terms and symptoms used for this condition.
The DSM defines
mania as a “distinct period during which there is an abnormally and
persistently elevated, expansive, or irritable mood.” The episode must last at
least a week. The mood must have at least three of the following symptoms:
- inflated self-esteem
- little need for sleep
- pressure of speech (talking
- flight of ideas
- easily distracted
- excess pursuit of goal-directed
activities or psychomotor agitation (pacing, hand wringing, etc.)
- excess pursuit of pleasure with a
high risk of danger
The DSM states
that a major depressive episode must have at least four of the following
symptoms. They should be new or suddenly worse. They must last for at least two
- changes in appetite or weight,
sleep, or psychomotor activity
- decreased energy
- feelings of worthlessness or guilt
- trouble thinking, concentrating, or
- thoughts of death or suicidal plans
Bipolar I disorder involves one or
more manic episodes or mixed (mania and depression) episodes. The episodes are
not due to another medical condition or substance use.
Bipolar II disorder has one or more severe
major depressive episodes with at least one hypomanic episode. There are no manic or mixed episodes. Hypomania is a milder form of mania that is
never accompanied by delusions or hallucinations. It doesn’t disrupt the patient’s ability to
function as significantly as bipolar I disorder, but nevertheless the symptoms
must cause significant distress or impairment at work, school, or with personal
relationships. It’s common for those with bipolar II disorder to not recall
their manic episodes.
Cyclothymia is characterized by
fluctuating low-level depression along with periods of hypomania. The symptoms
must be present for at least two years before a diagnosis of cyclothymia can be
made (one year in children). Adults have symptom-free periods that last no
longer than two months. Children and adolescents have symptom-free periods that
last only about a month.
Rapid-Cycling Bipolar Disorder
This category is
a severe form of bipolar disorder, occurring when a person has at least four
episodes of major depression, mania, hypomania, or mixed states within a year.
Rapid cycling affects more women than men, and appears to be more persistent in
those who have their first bipolar episode at a young age (National Institute of Mental
Disorder Not Otherwise Specified (NOS)
This category is for bipolar
symptoms that do not clearly fit into other types. NOS is diagnosed when
multiple bipolar symptoms are present but not sufficient to meet the diagnostic
criteria for any of the bipolar subtypes described above. This category can also include rapid mood
changes that don’t last long enough to be true manic or depressive episodes. Bipolar
disorder NOS includes repeated hypomanic episodes without a major depressive
None of this information should be
used to self-diagnose bipolar disorder. This is for educational purposes only. If
you experience any of these symptoms, contact your doctor or a mental health
professional to obtain a diagnosis.