Diagnosis Guide For Bipolar Disorder
Testing for bipolar disorder
People with bipolar disorder go through intense emotional changes that are very different from their usual mood and behavior. These changes affect their lives on a day-to-day basis.
Testing for bipolar disorder isnt as simple as taking a multiple choice test or sending blood to the lab. While bipolar disorder does show distinct symptoms, theres no single test to confirm the condition. Often, a combination of methods is used to make a diagnosis.
Before We Get Into Mixed Episodes Lets Go Over What Constitutes A Standard Episode Of Mood Elevation Versus A Depressive Episode
Bipolar historically was known as manic depression, and some people will still call it that. So it makes sense to me that many people only associate it with two sort of categories of mood, those being mania and depression, Wendy Marsh, M.D., director of the Bipolar Disorders Specialty Clinic and an associate professor in the department of psychiatry at the University of Massachusetts Medical School, tells SELF.
Symptoms associated with an episode of bipolar depression include lower energy and/or activity levels, difficulty concentrating, loss of interest in things, and changes in appetite and sleep, among others. And to classify as having an episode of depression, you need to be experiencing a gateway symptom of either a sad mood or loss of interest in life pervasively, in addition to at least five of the other symptoms for two weeks, Dr. Marsh says.
To classify an episode as a mood elevationmeaning mania or hypomaniayou must exhibit a prolonged, unusual, high-energy mood, while also showing at least three additional symptoms of mood elevation, including feeling a sense of euphoria, having increased energy and/or self-esteem, racing thoughts, reduced sleep, and others.
Bipolar Disorder And Other Conditions
Some bipolar disorder symptoms are similar to those of other illnesses, which can make it challenging for a health care provider to make a diagnosis. In addition, many people may have bipolar disorder along with another mental disorder or condition, such as an anxiety disorder, substance use disorder, or an eating disorder. People with bipolar disorder have an increased chance of having thyroid disease, migraine headaches, heart disease, diabetes, obesity, and other physical illnesses.
Psychosis: Sometimes, a person with severe episodes of mania or depression may experience psychotic symptoms, such as hallucinations or delusions. The psychotic symptoms tend to match the persons extreme mood. For example:
- People having psychotic symptoms during a manic episode may have the unrealistic belief that they are famous, have a lot of money, or have special powers.
- People having psychotic symptoms during a depressive episode may falsely believe they are financially ruined and penniless, have committed a crime, or have an unrecognized serious illness.
As a result, people with bipolar disorder who also have psychotic symptoms are sometimes incorrectly diagnosed with . When people have symptoms of bipolar disorder and also experience periods of psychosis that are separate from mood episodes, the appropriate diagnosis may be schizoaffective disorder.
Anxiety: It is common for people with bipolar disorder to also have an anxiety disorder.
How Do Doctors Treat It
Although there’s no cure for bipolar disorder, treatment can help stabilize moods and help the person manage and control symptoms. Like other teens with long-lasting medical conditions , teens with bipolar disorder need to work closely with their doctors and other medical professionals to treat it.
This team of medical professionals, together with the teen and family, develop what is called a treatment plan. Teens with bipolar disorder will probably receive medication, such as a mood stabilizer, from a psychiatrist or other medical doctor. A psychologist or other type of counselor will provide counseling or psychotherapy for the teen and his or her family. Doctors will watch the symptoms closely and offer additional treatment advice if necessary.
How Do I Get Help If I Think I Have Bipolar Disorder
The usual first step to getting help is to speak to your GP.
It can help to keep a record of your moods. This can help you and your GP to understand your mood swings. Bipolar UK have a mood diary and a mood scale on their website. You can find their details in the Useful contacts section at the bottom of this page.
Your GP cant diagnose bipolar disorder. Only a psychiatrist can make a formal diagnosis. Your GP may arrange an appointment with a psychiatrist if you have:
- depression, and
- ever felt very excited or not in control of your mood or behaviour for at least 4 days in a row.
They might refer you to a psychiatrist at your local NHS community mental health team .
Your GP should make an urgent referral to the CMHT if they think that you might have mania or severe depression. Or there is a chance that you are a danger to yourself or someone else.
Your GP should refer you to your local NHS early intervention team if you have an episode of psychosis and its your first one.
Bipolar disorder can be difficult to diagnose because it affects everyone differently. Also, the symptoms of bipolar disorder can be experienced by people who have other mental illness diagnoses. It can take a long time to get a diagnosis of bipolar disorder.
You can find more information about:
- NHS mental health teams by clicking .
How Can I Help My Child Or Teen
Help begins with the right diagnosis and treatment. Talk to your family health care provider about any symptoms you notice.
If your child has bipolar disorder, here are some basic things you can do:
- Be patient.
- Encourage your child to talk, and listen to your child carefully.
- Pay attention to your childs moods, and be alert to any major changes.
- Understand triggers, and learn strategies for managing intense emotions and irritability.
- Help your child have fun.
- Remember that treatment takes time: sticking with the treatment plan can help your child get better and stay better.
- Help your child understand that treatment can make life better.
Treatment For Manic Episodes
Mania can sometimes be hard to identify and understand. Doing so, however, can be detrimental to your mental health and overall wellbeingas a misunderstanding of manic episodes can lead to additional harm: Sometimes I felt invincible, and it was these moments when my mind would go all over the place, Demi Lovato said of her manic episodes. When you dont know whats happening, why youre feeling certain ways, and you dont have the answers yet, people tend to self-medicate, which is exactly what I did. But once Demi saw the mania for what it was, she was able to seek proper treatment and cope with itas well as other issuesappropriately. Now I know that when I focus on my treatment plan with my team and my support system, Im able to not only maintain a healthy mind, but Im able to maintain my sobriety, she told Womens Health Magazine.
Because manic episodes can vary in presentation, treatment plans can vary as well. You may find that antipsychotics, such as olanzapine or risperidone, or mood stabilizers, such as lithium or carbamazepine, , adequately relieve your symptoms. Or sometimes simply avoiding triggers can do the jobor at least further efforts; triggers can include alcohol, illegal drugs, and certain mood-altering prescription drugs. Furthermore, introducing structure into ones every day can also stabilize mood and prevent the onset or reduce the severity of manic episodes.
What Can Children And Teens Expect From Treatment
With treatment, children and teens with bipolar disorder can get better over time. Treatment is more effective when health care providers, parents, and young people work together.
Sometimes a childs symptoms may change, or disappear and then come back. When this happens, your childs health care provider may recommend changes to the treatment plan. Treatment can take time, but sticking with the treatment plan can help young people manage their symptoms and reduce the likelihood of future episodes.
Your childs health care provider may recommend keeping a daily life chart or mood chart to track your childs moods, behaviors, and sleep patterns. This may make it easier to track the illness and see whether treatment is working.
What Are The Symptoms Of Bipolar Disorder In A Teen
Teens with bipolar disorder often have abnormal mood swings. They shift between depression and mania. These episodes often last 1 or 2 weeks. But symptoms may be different for each teen.
Symptoms of depression may include:
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Lasting feelings of sadness
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Heightened energy level
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Uncharacteristically poor judgment
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Seeing or hearing things that are not there , or believing things that are not true
Symptoms of bipolar disorder, especially in a teen, may look like other problems. Make sure your teen sees his or her healthcare provider for a diagnosis.
The Keys To Bipolar Disorder Self
Get educated. Learn as much as you can about bipolar disorder. The more you know, the better youll be at assisting your own recovery.
Get moving. Exercise has a beneficial impact on moodand may reduce the number of bipolar episodes you experience. Aerobic exercise that activates arm and leg movement such as running, walking, swimming, dancing, climbing or drumming may be especially beneficial to your brain and nervous system.
Keep stress in check. Avoid high-stress situations, maintain a healthy work-life balance, and try relaxation techniques such as meditation, yoga, or deep breathing.
Seek support. Its important to have people you can turn to for help and encouragement. Try joining a support group or talking to a trusted friend. Reaching out is not a sign of weakness and it wont mean youre a burden to others. In fact, most friends will be flattered that you trust them enough to confide in them, and it will only strengthen your relationship.
Stay closely connected to friends and family. Nothing is as calming to the nervous system as face-to-face contact with caring supportive people who can just listen to you talk about what youre experiencing.
Make healthy choices. Healthy sleeping and eating habits can help stabilize your moods. Keeping a regular sleep schedule is particularly important.
Monitor your moods. Keep track of your symptoms and watch for signs that your moods are swinging out of control so you can stop the problem before it starts.
What Is A Manic Episode What Do Manic Episodes Feel Like
Manic episodes are a period of extremely elevated mood and are required for a diagnosis of bipolar disorder type 1. Bipolar manic episodes are not just feeling “good” or “high,” they are moods that are beyond reason and cause major distress and life impairment. Some of the symptoms of a manic episode include:
- Extreme, grandiose self-esteem; a perceived connection with god; belief in god-like powers
- Extreme elation or irritability
- Spending or gambling sprees, drug use, dramatic increase in sexual behavior
- A rapid stream of ideas thought to be brilliant
- Either behavior with extreme focus on goals or complete distractibility
- Not sleeping, or sleeping very little
This mood must be present for at least one week and not be explainable bydrug abuse or any other illness in order to be diagnosed as a manic episode. Manic episodes may be brought on by stressful life events, lack of sleep, drug use, medication changes or nothing at all.
Bipolar Disorder In Children And Teens
Does your child go through extreme changes in mood and behavior? Does your child get much more excited or much more irritable than other kids? Do you notice that your child goes through cycles of extreme highs and lows more often than other children? Do these mood changes affect how your child acts at school or at home?
Some children and teens with these symptoms may have bipolar disorder, a brain disorder that causes unusual shifts in mood, energy, activity levels, and day-to-day functioning. With treatment, children and teens with bipolar disorder can get better over time.
What Are Your Treatment Options
Treatment will depend on which type of bipolar disorder you have, and what your symptoms are. Most of the time, youll need medication to manage your symptoms, along with therapy. that may be used include:
Antidepressants Antipsychotics Mood stabilizers Anti-anxiety medications
Sometimes traditional medication therapy isnt enough. At Boston MindCare, our doctors offer a unique treatment option when nothing else has worked. Ketamine infusion therapy can help the symptoms of depressive episodes associated with bipolar disorder. It works by inhibiting glutamate in your brain to stabilize your mood.
Like many of the other medications used to treat this disorder, ketamine comes with some side effects, so its important to talk to our doctors to see if this treatment is right for you.
You dont need to deal with bipolar disorder on your own. If youre looking for help, call our office at 701-207-9841 or book an appointment online today.
Bipolar Disorder And Suicide
The depressive phase of bipolar disorder is often very severe, and suicide is a major risk factor. In fact, people suffering from bipolar disorder are more likely to attempt suicide than those suffering from regular depression. Furthermore, their suicide attempts tend to be more lethal.
The risk of suicide is even higher in people with bipolar disorder who have frequent depressive episodes, mixed episodes, a history of alcohol or drug abuse, a family history of suicide, or an early onset of the disease.
Suicide warning signs include:
- Talking about death, self-harm, or suicide.
- Feeling hopeless or helpless.
Treatments For Bipolar Disorder
The high and low phases of bipolar disorder are often so extreme that they interfere with everyday life.
But there are several options fortreating bipolar disorder that can make a difference.
They aim to control the effects of an episode and help someone with bipolar disorder live life as normally as possible.
The following treatment options are available:
- medicine to prevent episodes of mania and depressionthese are known as mood stabilisers, and you take them every day on a long-term basis
- medicine to treat the main symptoms of depression and mania when they happen
- learning to recognise the triggers and signs of an episode of depression or mania
- psychological treatmentsuch as talking therapy, which can help you deal with depression, and provides advice about how to improve your relationships
- lifestyle advicesuch as doing regular exercise, planning activities you enjoy that give you a sense of achievement, as well as advice onimproving your diet and getting more sleep
It’s thought using a combination of different treatment methods is the best way to control bipolar disorder.
Help and advice for people with a long-term condition or their carersis also availablefrom charities, support groups and associations.
This includes self-help and learning todeal with the practical aspects of a long-term condition.
Find out more about living with bipolar disorder
The More Severe Symptoms Of Mania
Unlike hypomanic episodes, manic episodes can lead to serious consequences. When the mania subsides, you may be left with remorse or depression for things youve done during the episode.
- visual or auditory
- alcohol use
- drug use
The exact cause of bipolar disorder is unclear. Family history may play a role. Youre more likely to develop bipolar disorder if you have a family history of the illness. Bipolar disorder may also involve a chemical imbalance in the brain.
What Do Bipolar Manic Episodes Look Like
The energy felt inside a manic episode is seen on the outside too. People in bipolar manic episodes are often “buzzing” about the room, moving and talking quickly, often going from one idea, or one person, to another. They can be seen laughing and smiling without cause.
Three-quarters of manic episodes involve delusions wherein the person truly believes in ideas beyond reason or logic. This is often seen as they brag about impossible abilities, god-like power or creative genius. They may be so sure of their grandiose powers that they demand others follow and obey them, and become enraged, even violent, if they don’t. They may defend themselves violently if they feel threatened. Manic episodes may even, very rarely, result in homicide.
Other outward cues of a manic episode include:
- Clothes put on in haste, disheveled
- Unusual clothing that attracts attention
- May be openly combative and aggressive with no tolerance for anyone
- Hyper-vigilance
Diagnosing Bipolar Disorder In Children
Bipolar disorder isnt only an adult problem, it can also occur in children. Diagnosing bipolar disorder in children can be difficult because the symptoms of this disorder can sometimes mimic those of attention-deficit hyperactivity disorder .
If your child is being treated for ADHD and their symptoms havent improved, talk to your doctor about the possibility of bipolar disorder. Symptoms of bipolar disorder in children can include:
- impulsiveness
- emotional outbursts
- periods of sadness
The criteria for diagnosing bipolar disorder in children is similar to diagnosing the condition in adults. Theres no particular diagnostic test, so your doctor may ask a series of questions about your childs mood, sleep pattern, and behavior.
For example, how often does your child have emotional outbursts? How many hours does your child sleep a day? How often does your child have periods of aggression and irritability? If your childs behavior and attitude are episodic, your doctor may make a bipolar disorder diagnosis.
The doctor may also ask about your family history of depression or bipolar disorder, as well as check your childs thyroid function to rule out an underactive thyroid.
This Is What A Mixed Bipolar Episode Feels Like
Bipolar disorder is a condition in which a person experiences dramatic shifts in mood and energy, but at severities that are different from the mood changes the average person goes through. But a common misconception about bipolar disorder is that a person with the diagnosis only experiences two distinct moods: either really high highs , or really low lows . For starters, people with bipolar disorder are not always experiencing symptoms, known as bipolar episodes. Plus, these episodes aren’t always as simple as high or low.
Many episodes that people with a bipolar diagnosis experience are considered mixed episodes, sometimes also described as switching episodes, or manic/hypomanic or depressive episodes with mixed features. A mixed episode signals that the person is experiencing both aspects of mania or hypomania as well as symptoms of bipolar depression.
What Does A Person With Bipolar Disorder Experience
Bipolar disorder does not have a set pattern and differs from individual to individual. Patients may feel a particular emotion several times before switching to another state.
Symptoms of mania are:
- Patients may feel that they are on the top of the world
- Highly irritable
When medication therapy is ineffective, electroconvulsive therapy might be considered.During electroconvulsive therapy, an electric current is passed through the brain to treat the disorder. In some, talk therapy has proven to be beneficial in treating mood episodes. Another part of treatment is psychoeducation where patients and their families are educated regarding symptoms and importance of medication compliance.
How Does Bipolar Disorder Affect Caregivers And Families
Caring for a child or teenager with bipolar disorder can be stressful for parents and families. Coping with a childs mood episodes and other problemssuch as short tempers and risky behaviorscan challenge any caregiver.
It is important that caregivers take care of themselves, too. Find someone you can talk to or consult your health care provider about support groups. Finding support and strategies for managing stress can help you and your child.
Types Of Bipolar Disorder
Bipolar disorder is a complex condition that affects your mental health. If youre newly diagnosed with this condition, youre probably wondering what it is, why you have it, and what you can do about it. There are four different kinds of bipolar disorder, and finding out which one is affecting you will help you get your life back on track.
At Boston MindCare, our are committed to helping you figure out which category of bipolar disorder fits you bbest. They can help you navigate your new diagnosis and find the best treatment option.
Does Bipolar Disorder Look Different In Men Vs Women
Both men and women are affected equally and have similar symptoms. However, men usually experience mania first while women typically start with depressive episodes. Women and people with bipolar II disorder are significantly more likely to experience periods of rapid cycling than men with the same condition. Other research findings indicate that women with bipolar disorder may have more depressive episodes and more mixed episodes than do men with the illness.
What Is Bipolar Disorder
We all have our ups and downs, but with bipolar disorder these peaks and valleys are more severe. Bipolar disorder causes serious shifts in mood, energy, thinking, and behaviorfrom the highs of mania on one extreme, to the lows of depression on the other. More than just a fleeting good or bad mood, the cycles of bipolar disorder last for days, weeks, or months. And unlike ordinary mood swings, the mood changes of bipolar disorder are so intense that they can interfere with your job or school performance, damage your relationships, and disrupt your ability to function in daily life.
During a manic episode, you might impulsively quit your job, charge up huge amounts on credit cards, or feel rested after sleeping two hours. During a depressive episode, you might be too tired to get out of bed, and full of self-loathing and hopelessness over being unemployed and in debt.
The causes of bipolar disorder arent completely understood, but it often appears to be hereditary. The first manic or depressive episode of bipolar disorder usually occurs in the teenage years or early adulthood. The symptoms can be subtle and confusing; many people with bipolar disorder are overlooked or misdiagnosedresulting in unnecessary suffering. Since bipolar disorder tends to worsen without treatment, its important to learn what the symptoms look like. Recognizing the problem is the first step to feeling better and getting your life back on track.
What Is Bipolar Disorder In Teens
Bipolar disorder is a type of depression.
There are 3 main types of depression:
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Major depression
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Bipolar disorder
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Persistent depressive disorder
A teen with bipolar disorder often has extreme mood swings. These mood swings go beyond the days normal ups and downs. A teen may have times of great elation, happiness, elevated mood, or irritability. This is called mania. These episodes are countered by periods of major depression. That is why this disorder has two poles or symptoms.
Other Bipolar Disorder Treatment
Most patients respond very well to medication and various psychotherapies but there are some outliers who dont respond as well, points out Dr. Narasimhan. In this case, you may want to explore other options.
Transcranial Magnetic Stimulation
Medication-resistant patients can benefit from other treatments such asTranscranial magnetic stimulation . This non-invasive treatment works by using magnetic fields to stimulate nerve cells in the brain and improve depressive symptoms. The treatment delivers repetitive magnetic pulses via an electromagnetic coil placed against your scalp. Though the mechanism for how it works isnt well understood, its thought to impact how the brain works, which in turn can alleviate depressive episodes. TMS is well tolerated, doesnt include much downtime, and has only some side effects such as headache, tingling, and lightheadedness. There are some rare side effects such as seizure and hearing loss.
Electroconvulsive Therapy
Lifestyle and Integrative Treatments
What Can I Do To Manage My Symptoms
You can learn to manage your symptoms by looking after yourself. Selfcare is how you take care of your diet, sleep, exercise, daily routine, relationships and how you are feeling.
What lifestyle changes can I make?
Making small lifestyle changes can improve your wellbeing and can help your recovery.
Routine helps many people with their mental wellbeing. It will help to give a structure to your day and may give you a sense of purpose. This could be a simple routine such as eating at the same time each day, going to bed at the same time each day and buying food once per week.
Your healthcare professionals should offer you a combined healthy eating, exercise and sleep programme.
You can find more information about wellbeing any physical health at:.
What are support groups?
You could join a support group. A support group is where people come together to share information, experiences and give each other support.
You might be able to find a local group by searching online. The charity Bipolar UK have an online support group. They also have face to face support groups in some areas of the country. Their contact details are in the Useful contacts at the bottom of this page.
What are recovery colleges?
Unfortunately, recovery colleges arent available in all areas. To see if there is a recovery college in your area you can use a search engine such as Google.
What is a Wellness Recovery Action Plan ?
You can find more information about Recovery by clicking .