How is bipolar disorder diagnosed?
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Bipolar Disorder is diagnosed by either a psychiatrist, (medical doctor) or a psychotherapist (psychologist or psychiatric social worker).
Bipolar Disorder comes in 2 forms, Bipolar I and Bipolar II. Bipolar I is the type most people think of where someone experiences shifts between depression, mania and/or mixed episodes. Bipolar II is most like recurrent major depressive episodes interspersed with hypomanic episodes (which do not reach the level of a mania).
The following is a general description of some of the criteria for depression and mania, but you should not attempt diagnosis yourself. You can check the exact criteria in a DSM IV and a thorough history needs to be taken for accurate diagnosis and assessment.
Criteria for Depression are five of the following during a 2 week period:
1) depressed mood more days than not, can be just irritable in adolescents and children and frequently men show more irritability
2) decreased or increased appetite accompanied by weight gain or loss
3) hypersomnia or insomnia
4) recurrent thoughts of death or dying, suicidal ideation
5) observable psychomotor retardation or agitation
5) anhedonia (loss of interest in previous pleasurable activities)
6) subjective feelings of restlessness or being slowed down
7) Difficulty concentrating and/or making decisions
Criteria for a Mania:
1) Decreased need for sleep without feeling tired despite only several hours per night or no sleep
2) Pressured speech that is difficult to interrupt(talking very rapidly and loudly with pressure to keep talking)
3) Flight of Ideas or "racing thoughts"
4) Increased energy
5) Engaging in a flurry of goal-directed activity-either impulsive behavior that has a high potential for damaging consequences-spending money, reckless driving, sexual promiscuity, etc. or excessively overproductive with respect to work
6) a consistently elevated or "high" mood or a consistently irritable mood
7) grandiose delusions-seeing oneself as more important or powerful than they truly are but in delusional proportions, not simply inflated self-esteem
Bipolar II is similar but the manic symtoms are less severe and rarely warrant hospitalization as they do not reach psychotic levels.
Additionally there is a condition called cyclothymia where a person cycles between hypomania and dysthymia (milder depression).
The condition most often has a genetic component and often there are first degree relatives with the disorder. there is also a higher prevalence of other mood disorders and eating disorders and alcoholism among relatives.
If you suspect someone is Bipolar take them to a psychiatrist for evaluation. Primary MD's are not qualified to diagnose or treat the condition and it is often misdiagnosed, especially in children as the symptoms look different and the cycling tends to be more rapid.
It absolutely requires medication for treatment to be effective.
It is done by psychiatrist after evaluating the symptoms.
Symptoms of depression and mania persist for certain period of time...diagnosis is made.
Thus there is no blood test or other tests to make diagnosis. It is how long symptoms persisted and their severity is used for diagnosis
Unfortunately no laboratory test can detect bipolar disorder. However, a simple questionnaire can help a doctor determine if someone has common symptoms of bipolar disorder.4 This questionnaire is called the Mood Disorder Questionnaire, or MDQ. The MDQ is a checklist that helps a doctor identify bipolar-related symptoms.4 Remember, only a doctor can provide an accurate diagnosis.
You have terrible changes in your mood, and you have a lack of litium in your brain, so they prescribe you litium in order to change the mood swings.
It can be diagnosed by a psychiatrist or a clinical social worker. The criteria are found in the DSM IV-TR. For a patient to be diagnosed, they must have a history of episodes meeting the criteria. To be diagnosed with Bipolar I the person must have experienced at least one episode of mania, for a diagnosis of Bipolar II the individual must have experienced at least one episode of hypomania (a less severe form of mania). These episodes can occur anytime over an individual's lifetime and must only have one episode to meet the diagnosis.
Although a depressive episode is not required to be diagnosed with Bipolar disorder it is highly likely that the individual has experience at least one depressive episode in his or her life time.
Primarily, the diagnosis is made based on the individual's self-report and personal history. It is advised to get input from family members if that is an available option.
Madison is wrong.there is NO lithium in your brain. Lithium is not in the human body unless you take it.
Bipolar is diagnosed by a trained expert using your symptoms and perhaps a questionnaire.
Sometimes family history gives a clue, as it is believed that Bipolar is genetic.
Most Bipolar patients have a family history of a mood disorder such as Bipolar or major depression.
Also, responses to medication can tell. For example, many Bipolar 1 patients DO NOT respond to Lamictal and will continue to show symptoms until put on amother medication. Sometimes depressed people may not respond correctly to anti-depressants...this may be indictive of Bipolar disorder.
there are a number of different types of bipolar disorder and milder forms of bipolar, you must fall into some of the following symptoms to say you are bipolar.
Signs and symptoms of mania (or a manic episode) include:
Increased energy, activity, and restlessness
Excessively "high," overly good, euphoric mood
Extreme irritability
Racing thoughts and talking very fast, jumping from one idea to another
Distractibility, can't concentrate well
Little sleep needed
Unrealistic beliefs in one's abilities and powers
Poor judgment
Spending sprees
A lasting period of behavior that is different from usual
Increased sexual drive
Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
Provocative, intrusive, or aggressive behavior
Denial that anything is wrong
A manic episode is diagnosed if elevated mood occurs with three or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, four additional symptoms must be present.
Signs and symptoms of depression (or a depressive episode) include:
Lasting sad, anxious, or empty mood
Feelings of hopelessness or pessimism
Feelings of guilt, worthlessness, or helplessness
Loss of interest or pleasure in activities once enjoyed, including sex
Decreased energy, a feeling of fatigue or of being "slowed down"
Difficulty concentrating, remembering, making decisions
Restlessness or irritability
Sleeping too much, or can't sleep
Change in appetite and/or unintended weight loss or gain
Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury
Thoughts of death or suicide, or suicide attempts
A depressive episode is diagnosed if five or more of these symptoms last most of the day, nearly every day, for a period of 2 weeks or longer.
A mild to moderate level of mania is called hypomania. Hypomania may feel good to the person who experiences it and may even be associated with good functioning and enhanced productivity. Thus even when family and friends learn to recognize the mood swings as possible bipolar disorder, the person may deny that anything is wrong. Without proper treatment, however, hypomania can become severe mania in some people or can switch into depression.
Sometimes, severe episodes of mania or depression include symptoms of psychosis (or psychotic symptoms). Common psychotic symptoms are hallucinations (hearing, seeing, or otherwise sensing the presence of things not actually there) and delusions (false, strongly held beliefs not influenced by logical reasoning or explained by a person's usual cultural concepts). Psychotic symptoms in bipolar disorder tend to reflect the extreme mood state at the time. For example, delusions of grandiosity, such as believing one is the President or has special powers or wealth, may occur during mania; delusions of guilt or worthlessness, such as believing that one is ruined and penniless or has committed some terrible crime, may appear during depression. People with bipolar disorder who have these symptoms are sometimes incorrectly diagnosed as having schizophrenia, another severe mental illness.
It may be helpful to think of the various mood states in bipolar disorder as a spectrum or continuous range. At one end is severe depression, above which is moderate depression and then mild low mood, which many people call "the blues" when it is short-lived but is termed "dysthymia" when it is chronic. Then there is normal or balanced mood, above which comes hypomania (mild to moderate mania), and then severe mania.
Bipolar I and Mania
Most people with bipolar I have episodes of both depression and mania. In very rare cases, they experience only mania. Bipolar I is distinguished from bipolar II by the severity and duration of the manic phase, which can last anywhere from a week to several months, and the experience of delusions. Risky behavior is common in manic episodes and patients often require hospitalization for their own safety.
The symptoms of mania can include rapid speech, insomnia, disconnected thoughts, grandiose ideas, hallucinations, extreme irritability, feelings of omnipotence, paranoia, violent behavior, a marked increase in strength, and openly promiscuous activity. (see Bipolar Screening)
Bipolar II and Hypomania
People with bipolar II suffer primarily from episodes of severe depression with occasional episode of "mild" mania, called hypomania. Hypomania differs from mania in that no delusions are experienced.
Like mania, hypomania can cause severely impaired functioning. The hypomanic episode often feels so good that bipolar patients often discontinue their medication in quest of a hypomanic episode. This is especially problematic because symptoms that come back after stopping drug treatment are often much harder to get back under control a second time.
While Bipolar II has sometimes been described as a "milder" form of bipolar disorder than Bipolar I, the suicide rate among people suffering form Bipolar II is actually higher than that for those suffering from Bipolar I.
Cyclothymic Disorder
People with cyclothymic disorder alternate between hypomania and mild depression. It is not as severe as bipolar I and II, but persists for longer periods with no break in symptoms. Cyclothymic disorder can later become full-blown bipolar disorder in some people, or can continue as a low-grade chronic condition.
Rapid Cycling
Most people with bipolar disorder have an average of 8 to 10 manic or depressive episodes over a lifetime. Some, however, experience much more severe symptoms called rapid cycling. They can swing (cycle) between "highs" and "lows" many times in one day. To be considered a rapid cycler, you must have at leat 4 mood swings in a year.
Mixed Episode
During a Mixed Episode, symptoms of both mania and depression occur at the same time. The excitability and agitation of mania is coupled with depression and irritability. This combination of high energy and agitation along with depression makes the mixed episode the most dangerous for risk of suicide.
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