How Is Bipolar Disorder Diagnosed
Most people with bipolar disorder can be helped â but a psychiatrist or psychologist must first diagnose the disorder. Sadly, many people with the condition are never diagnosed or are not diagnosed properly. Without proper diagnosis and treatment, the disorder can become worse. Some teens with undiagnosed bipolar disorder can end up in a psychiatric hospital or residential treatment center, in the juvenile justice system, abusing drugs, or committing suicide.
Because children and teens with bipolar disorder do not usually show the same patterns of behavior as adults who have the condition, a mental health professional will observe a teen’s behavior carefully before making a diagnosis. This includes getting a complete history of the person’s past and present experiences. Family members and friends can also provide helpful insights into the person’s behavior. The doctor may also want a teen to have a medical exam to rule out other conditions.
Diagnosing bipolar disorder can be difficult. As yet, there aren’t any laboratory tests like a brain scan or blood test that will diagnose it. In teens, bipolar disorder can sometimes be mistaken for illnesses like schizophrenia and posttraumatic stress disorder, attention deficit hyperactivity disorder , and other depressive disorders. That’s why a complete, detailed history is so important.
What Are The Symptoms Of Bipolar Disorder
The symptoms of bipolar disorder can vary. An individual with bipolar disorder may have manic episodes, depressive episodes, or mixed episodes. A mixed episode has both manic and depressive symptoms. These mood episodes cause symptoms that last a week or two or sometimes longer. During an episode, the symptoms last every day for most of the day. Mood episodes are intense. The feelings are intense and happen along with changes in behavior, energy levels, or activity levels that are noticeable to others.
|Symptoms of a Manic Episode||Symptoms of a Depressive Episode|
|Feeling very up, high, elated, or extremely irritable or touchy||Feeling very down or sad, or anxious|
|Feeling jumpy or wired, more active than usual||Feeling slowed down or restless|
|Racing thoughts||Trouble concentrating or making decisions|
|Trouble falling asleep, waking up too early, or sleeping too much|
|Talking fast about a lot of different things||Talking very slowly, feeling like you have nothing to say, or forgetting a lot|
|Excessive appetite for food, drinking, sex, or other pleasurable activities||Lack of interest in almost all activities|
|Thinking you can do a lot of things at once without getting tired||Unable to do even simple things|
|Feeling like you are unusually important, talented, or powerful||Feeling hopeless or worthless, or thinking about death or suicide|
Bipolar Disorder With Impairment Among Adults
- Of adults with bipolar disorder in the past year, degree of impairment ranged from moderate to serious, as shown in Figure 2. Impairment was determined by scores on the Sheehan Disability Scale.
- An estimated 82.9% of people with bipolar disorder had serious impairment, the highest percent serious impairment among mood disorders.3
- An estimated 17.1% had moderate impairment.
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Learn To Manage Stress
Everyone needs to nd ways to manage stress but its especially important if you have Bipolar disorder because stress can trigger episodes of illness.Some suggestions:
- Going for a walk, yoga, meditation, aromatherapy, or having a long bath can all help to relieve stress find what works for you.
- Relaxing with things you enjoy whether its a movie, a book, listening to music, watching TV, meeting people or being with a pet should be a regular part of your life.
- Think about ways of reducing stress in your life. Dont try to pack too much into your day, for instance, and try to deal with one thing at a time.
- If you cant avoid stressful events, give yourself time to relax and recover afterwards. If stress is becoming a problem, ask your doctor or case manager to suggest ways of dealing with it.
How To Help Yourself
Taking positive action against an illness helps minimise the risk of another episode and reduce the effect of symptoms. It also helps people feel good about themselves because it shows they can start to take control of their lives again.
There are a number of ways in which you can take positive action, for example, relieving stress by going for a walk or meditating.
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Bipolar Disorder And Obesity
Bipolar disorder has the highest rates of co-occurring obesity for any psychiatric illness, with about 35 percent of people with bipolar disorder also living with obesity.
Researchers are uncertain about what causes the link between bipolar disorder and obesity. While the leading theory is that the medications used to treat bipolar disorder often cause weight gain, people with bipolar disorder who are not taking medication still have a higher likelihood of developing obesity than members of the general population.
The rates of diabetes and heart disease in people with bipolar disorder are also higher than average, which may also link to higher incidences of obesity in people with bipolar disorder.
Will Alternative Therapies Help
Some people nd alternative therapies such as acupuncture or herbal medicine helpful. If you decide to try an alternative therapy as well as your prescribed treatment, make sure that there will be no harmful side-effects. Some alternative therapies are not recommended for people with a mental illness so it is important to discuss using them beforehand with your doctor.Be wary of anyone who suggests they can cure your condition .
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Sinad O’connor Rebuilt Her Life After A Depression Diagnosis
The Irish singer Sinéad O’Connor often made headlines in the late 1980s and 1990s with her Grammy-winning songs and rebellious attitude. However, as her fame grew in her twenties, she began to suffer from depression.
O’Connor’s depression steadily got worse, including suicidal thoughts, until she was finally diagnosed with bipolar disorder at the age of 37. She talked openly about living with this condition on The Oprah Winfrey Show in 2007.
“Every pore of you is crying and you don’t even understand why or what,” she says. “I actually kind of died and got born again as a result of taking the meds and having a chance to, you know, build a life.”
Demi Lovato Lives Well With Bipolar Disorder
The actress and singer Demi Lovato, born in 1992, learned she had bipolar disorder after a stint in rehab in 2010 to address with depression, an eating disorder, and self-harm. She discussed her diagnosis in a 2011 interview with People magazine. “I never found out until I went into treatment that I was bipolar,” she told the magazine. During the interview, Lovato said she had battled depression from a young age.
Recently, the popular songstress talked to HuffPost Live about living with the condition. “I was dealing with bipolar depression and didn’t know what was wrong with me. Little did I know, there was a chemical imbalance in my brain,” she says. “Because I didn’t tell people what I need, I ended up self-medicating and coping with very unhealthy behaviors.”
After therapy and treatment, Lovato says she’s in a good place. “Now I live well with bipolar disorder,” Lovato says. “Happiness is a choice. Life is a roller coaster. You can make the highs as amazing as possible, and you can control how low the lows go.”
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How Is Nimh Addressing Bipolar Disorder
The National Institute of Mental Health conducts and supports research on bipolar disorder that increases our understanding of its causes and helps develop new treatments. Researchers continue to study genetics and bipolar disorder, brain function, and symptoms in children and teens who have bipolar disorder, as well as family history in health and behavior.
Learn more about NIMHs research priorities and current studies.
Bipolar Disorder: Definition And Statistics
All of us experience emotions such as anger, sadness or joy. Usually we feel that we control our emotions and we are able to manage them on a daily basis. People affected by bipolar disorder, however, experience their emotions with disproportionate intensity and often find it challenging to control them. The frequency, duration and intensity of these emotions can vary from person to person and affect how people think and function. The affected person may therefore encounter difficulties fulfilling their professional, family and social goals.
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Rapid Cycling In Bipolar Disease
The phrase rapid cycling refers to four or more cycles in a 12-month period. However, while having four or more cycles in a one-year period means meeting the criteria for a diagnosis of rapid-cycling bipolar illness, rapid cycling is not necessarily a permanent pattern. Rather, rapid cycling can present at any point in the course of the disease. And it can be transient.
While about 2.5% of Americans have bipolar disorder, only about 10% to 20% of those will develop rapid cycling.
Rapid cycling may be more likely to affect those who were young when symptoms first appeared, those who have had bipolar disorder for a longer time, and those who misuse alcohol and other substances.
In addition, the term “ultra-rapid cycling” may be applied to those who cycle through episodes within a month or less. If this pattern occurs within a 24-hour period, the person’s diagnosis could possibly be termed “ultra-ultra-rapid cycling” or “ultradian.” It is often difficult to tell ultradian cycling from a mixed episode.
Mental Health As A Risk Factor For Substance Abuse
Mental health is known to be an important risk factor for the development of substance use disorders . The increased risk of a substance use disorder varies by mental health disorder type:
- for alcohol dependency the risk is highest in individuals with intermittent explosive disorder, dysthymia, ODD, bipolar disorder and social phobia. This is discussed in our entry on Alcohol Consumption.
- for illicit drug dependency the risk is highest for individuals with intermittent explosive disorder, ADHD, and bipolar disorder. This is discussed in our entry on Substance Use.
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What Are The Long
Bipolar disorder is a life-long and often recurring illness. You may need long term support to help manage your condition.
What medication options are there?
Your doctor will look at what medication worked for you during episodes of mania or depression. They should ask you whether you want to continue this treatment or if you want to change to lithium.
Lithium usually works better than other types of medication for long-term treatment. Your doctor should give you information about how to take lithium safely. If lithium doesn’t work well enough or causes you problems, you may be offered:
- Olanzapine, or
Your doctor should monitor your health. Physical health checks should be done at least once a year. These checks will include:
- measuring your weight,
- checking your liver and heart, and
- checking your pulse and blood pressure.
What psychological treatments are recommended?
You should be offered a psychological therapy that is specially designed for bipolar disorder. You could have individual or group therapy.
The aim of your therapy is to stop you from becoming unwell again. This is known as relapse. Your therapy should help you to:
If you live with your family or are in close contact with them, you should also be offered family intervention.
Family intervention is where you and your family work with mental health professionals to help to manage relationships. This should be offered to people who you live with or who you are in close contact with.
Tips For Coping And Support
If youve noticed symptoms of bipolar disorder, a good first step involves reaching out to a doctor or therapist as soon as possible.
Similarly, if its a friend or loved one who has symptoms, consider encouraging them to connect with a therapist as soon as possible. It never hurts to remind them that they have your understanding and support, either.
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Vivien Leigh Suffered Without Bipolar Medications
Best known for her iconic Oscar-winning role as Scarlett O’Hara in Gone With the Wind, Vivien Leigh also captured the public’s attention with her marriage to fellow actor Laurence Olivier. However, Leigh was diagnosed with bipolar disorder, and her unpredictable behavior eventually ruined her professional reputation and destroyed her marriage to Olivier.
“In her day there were no pills, there were no clinics, there were no publicists, there was nobody between Vivien and an outside world which she found chilly, hostile, and sometimes, because of her mental state, could not cope with,” said her friend Sheridan Morley in a BBC documentary.
Bipolar Disorder Can Be Treated
There is hope. People with bipolar disorder can be helped by treatment. Treatment can include:
- Medication The doctor may recommend one or more medicines to find what works best.
- Counseling Often, psychotherapy or other forms of counseling are used in combination with medication.
- Peer Support The advice and support of others who have bipolar disorder can aid recovery.
- Complementary Care Some people benefit from exercise, stress reduction classes and other activities to complement their treatment and help them manage their illness.
- ECT, or electroconvulsive therapy This is used as a last resort to treat severe bouts of depression and suicidal thoughts. Its only considered when medication and therapy havent worked.
If you think that you or someone you know has bipolar disorder, talk with your primary care physician or faith leader. However, only a mental health professional can tell if a person has bipolar disorder and properly treat it. Once in treatment, it is important that the person receive the support and understanding of friends and family. Many people also find strength and support through their religious and spiritual affiliations.
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What Are The Extreme Moods People With Bipolar Disorder Experience
There are extreme moods common to Bipolar disorder that include mania, hypomania, depression psychosis.
Sometimes called a manic episode, mania means the high end of the mood scale.Symptoms include:
- Feeling extremely euphoric or very irritable.
- Needing less sleep.
- Being very talkative talking very fast, or bubbling with ideas, which arent followed through.
- Having racing thoughts people sometimes feel as if they cant keep up with their own thoughts.
- Risky behavior being in this manic stage can make people less inhibited, so they may do reckless things like drive too fast, spend too much money, make unwise business investments or gamble. They may be more sexually active than usual, sometimes with people they wouldnt normally have sex with.
- Inflated sense of condence or power acting as if theyre superior or more important than others.
Symptoms like these can cause real problems at work and in relationships. Sometimes people in this manic stage may need treatment in hospital.
This is the low end of the bipolar mood scale, but its more than normal sadness. People with depression cannot simply snap out of it. They lose motivation and interest in normal activities or things they used to enjoy.Symptoms include:
Disease Burden Of Mental Health And Substance Use Disorders
Health impacts are often measured in terms of total numbers of deaths, but a focus on mortality means that the burden of mental health disorders can be underestimated.2 Measuring the health impact by mortality alone fails to capture the impact that mental health disorders have on an individuals wellbeing. The disease burden measured in Disability-Adjusted Life Years considers not only the mortality associated with a disorder, but also years lived with disability or health burden. The map shows DALYs as a share of total disease burden mental and substance use disorders account for around 5 percent of global disease burden in 2017, but this reaches up to 10 percent in several countries. These disorders have the highest contribution to overall health burden in Australia, Saudi Arabia and Iran.
In 2017, an estimated 264 million people in the world experienced depression. A breakdown of the number of people with depression by world region can be seen here and a country by country view on a world map is here.In all countries the median estimate for the prevalence of depression is higher for women than for men.
DALYs from depression
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Depression Is Complicated This Is How Our Understanding Of The Condition Has Evolved Over Time
People often think of depression as a single, uniform condition deep sadness and a loss of interest in the activities that someone usually enjoys. But depression is complicated and its difficult to define what it means in an objective way.
This is because depression is a condition of the mind: it is diagnosed based on peoples psychological symptoms and behavior, not from a brain scan or markers in their blood or DNA.
When we diagnose depression, we have to rely on people to recall their own symptoms. We have to trust that doctors will observe and probe their symptoms reliably. We have to analyze this information to understand what people with depression experience that other people dont.
Our ability to do all of these things accurately has changed over time, and so has our understanding of depression.
This comes down to three factors.
First, many countries now screen for depression in the general population, not just in a subset of people who are seen by a small number of doctors. In many studies, researchers track patients over long periods of time to understand how the condition progresses.
Second, we use questionnaires and interviews that treat depression as a condition that can occur at different levels and change with time.
Third, we have better statistical tools to help us refine questionnaires and understand how symptoms are related to one another.
Surveying depression in the general population
Measuring depression on levels
Analyzing depression with more rigour