How Is Bipolar Disorder Diagnosed
A psychiatrist or other mental health professional typically diagnoses bipolar disorder. The diagnosis will include a review of both your medical history and any symptoms you have that are related to mania and depression. A trained professional will know what questions to ask.
It can be very helpful to bring a spouse or close friend with you during the doctors visit. They may be able to answer questions about your behavior that you may not be able to answer easily or accurately.
If you have symptoms that seem like bipolar 1 or bipolar 2, you can always start by telling your doctor. Your doctor may refer you to a mental health specialist if your symptoms appear serious enough.
A blood test may also be part of the diagnostic process. There are no markers for bipolar disorder in the blood, but a blood test and a comprehensive physical exam may help rule out other possible causes for your behavior.
Mood stabilizers are often the first drugs used in treatment. You may take these for a long time.
Lithium has been a widely used mood stabilizer for many years. It does have several potential side effects. These include low thyroid function, joint pain, and indigestion. It also requires blood tests to monitor therapeutic levels of the drug as well as kidney function. Antipsychotics can be used to treat manic episodes.
Characteristics Of Bipolar I Disorder
There are a few different types of bipolar disorder, distinguished by the pattern of manic and depressive episodes, and the severity and duration of those episodes. The two main types are called bipolar I and bipolar II. Bipolar I is the disorder that is most often associated with the bipolar characteristic of mood shifting between depression and mania.
The main characteristic of bipolar I is the presence of manic episodes. These are mood episodes that last for at least one week and cause an elevated, often irritable mood. Mania often causes euphoria, but it can also make someone more irritable than euphoric. It may also cause someone to alternate between feeling irritable or angry and feeling euphoric. Other symptoms of a manic episode include:
- An inflated sense of self-esteem, or a feeling of grandiosity. This may be expressed as very high self-confidence but can also take the form of delusions, like expertise in a particular area the person doesnt actually have experience with.
- Racing thoughts, or thoughts jumping quickly from one topic to the next, accompanied by fast talking
- Sleeping less than normal, but feeling energized nonetheless
- An unusually high level of activity
- Irritability and angry outbursts
- Psychotic episodes
Bipolar I Vs Bipolar Ii
Bipolar I disorder and bipolar II disorder are two of the three major forms of bipolar disorder. While both involve shifts in mood, energy, activity levels and concentration, BP-I and BP-II have two key differences. These differences include the intensity of manic episodes and the prevalence of major depressive episodes.
One major difference between BP-I and BP-II is the intensity of manic episodes. BP-I involves periods of severe mania whereas BP-II involves periods of less severe hypomania.
Mania and hypomania are both marked by persisting elevated, expansive or irritable mood that is uncharacteristic of the person at baseline. These periods may also involve abnormally elevated self-esteem, decreased need for sleep, increased talkativeness, flight of ideas or racing thoughts, abnormal distractibility, increased energy or goal-directed activity and abnormally risky behaviors.
Mania lasts for at least one week and is considered a medical emergency, often requiring psychiatric hospitalization. Its effects on ones personal life and ability to work are debilitating. Hypomania lasts for at least four days. It does not cause impairment in functioning, require hospitalization, or have psychotic features.
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Bipolar Disorder Type Ii Prognosis
Those with bipolar disorder can have repeated relapses throughout the lifespan. This can even happen when on medication as for many, medications do stop working and have to be evaluated at one or more points. Nonetheless, those who stay on medication do have the brightest prognosis. Psychotherapy and social support also improve the prognosis of those with bipolar disorder.
While the initial diagnosis of bipolar disorder type II can be very scary, learning about bipolar disorder, working with qualified mental health professionals and staying adherent to treatment can make managing the illness quite possible.
Causes Of Bipolar Disorder
The exact cause of Bipolar Disorders is not precisely understood. It seems to be a combination of 3 things:
2. Chemical imbalances in the brain.
3. Stress and triggering events that somehow activate an inherited or genetic predisposition to the disorder.
When you go for an assessment, just like with any other illness, you will be asked about family history. A close relative such as a parent with suspected or diagnosed bipolar disorder greatly increases the likelihood other family members also having the illness.
So far, there does not seem to be any way to prevent the illness, but you can prevent some episodes of mania or depression once a doctor establishes that you do in fact have Bipolar I Disorder.
Bipolar I almost always requires the person to take medication for effective management. Dont worry stability and sanity is SO worth it!3
The key factor is stabilization. Regular therapy, a healthy diet, exercise and MOST OF ALL mood stabilizing medications such as lithium can greatly reduce the frequency and severity of Bipolar I episodes.
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Bipolar 1 Diagnostic Criteria
A 2018 study published in Therapeutic Advancements in Psychopharmacology found that about 0.6% of all people have bipolar type 1, making it more commonly diagnosed than bipolar type 2.
Criteria for a diagnosis of bipolar 1 include:
- At least one lifetime manic episode
- The manic episode was not the result of medication, substances, or another medical illness
- A depressive episode may be present, but is not required for diagnosis
Symptoms Specific To Bipolar Ii
For bipolar II a person must experience at least one of major depressive episode lasting two-weeks, and one experience of hypomania that lasts at least four days.
Similar to mania, a hypomanic episode features an elevated, persistent or irritable mood, with increased energy, and three or more symptoms of:
- Inflated self-esteem or grandiosity
- Increased goal-directed activity
- Excessive involvement in activities that have high potential for painful consequences.
Unlike mania, an episode of hypomania is not considered severe enough to impact social functioning or to require hospitalisation. It does not include psychosis and the impact of an episode is not considered a significant impairment. In fact, it is possible for people who experience hypomania to continue to operate within their regular, although modified, routine.
This is not to say bipolar II is a milder disorder. The impact and trauma associated with hypomania is just as real and just as debilitating. The experience of depression and the impulsivity associated with bipolar II can also contribute to suicide attempts.
Because someone may not consider their highs to be out of the ordinary, symptoms of hypomania are not always easy to identify. Therefore, friends and relatives, those who witness someone’s symptoms, offer important information required for diagnosis.
‘Many people believe that bipolar II is a lesser condition, but having more frequent yet less ‘high’ episodes is extremely debilitating.’
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Help Is Available For All Types Of Bipolar Disorder
Treatment is available for all types of bipolar disorder. The first step to recovery is to seek help from a medical doctor or licensed mental health care provider such as a psychiatrist. The professional will likely provide you with a psychological assessment for bipolar disorder and work with you to create a treatment plan specifically for you. You might also be asked to monitor your daily moods and sleep patterns through a mood chart to help with diagnosis.
Treatment for this disorder usually includes a variety of strategies to manage the condition over the long term such as psychotherapy and medication. Since bipolar disorder is a chronic illness, treatment must be ongoing.
Medications are typically an important part of treatment and might include mood stabilizers, antipsychotic medications, or antidepressants. Such medications usually need to be taken regularly to be effective. If you have been diagnosed with bipolar disorder, you and your doctor will work together to find the right medication or combination of medications for your unique needs. As everyone responds to medication differently, you may have to try several different medications before you find one that relieves your symptoms.
With treatment and through an individuals own efforts, people with all types of bipolar disorder can live rich, rewarding lives.
Treatment For Bipolar I & Bipolar Ii Disorders
Many different fears can hold people back from seeking proper treatment. These include concerns about medications and difficulty accepting a lifelong mental illness. Many people with bipolar often fear giving up the great feelings that accompany a manic or hypomanic episode. As a result, the defense of denial is an expected aspect of bipolar disorder. Its especially important for people with bipolar to feel in control of the energetic and hyper-creative parts of mania as an offset to the desperate, hopeless feelings of their depressive episodes.
For these reasons, it can be helpful to understand the treatment choices available and what to expect under the different circumstances in each individual situation.
Bipolar disorder treatment can take place in a variety of settings depending on the needs of the individual, especially when considering the possible imminent threat of harm or extent of any co-occurring substance abuse. Although hypomania in Bipolar II Disorder doesnt usually require hospitalization, the level of depression in Bipolar II can certainly create the need for intensive psychiatric care. And for that matter, neither Bipolar I or II is automatically safe from suicidal feelings or actions that require a higher level of professional supervision.
Causes Of Bipolar 1 And Bipolar 2
Scientists don’t know exactly what causes bipolar 1 or 2. They think several factors may contribute to both disorders, including:
If you have a parent or sibling with bipolar disorder, you have a greater chance of developing it. However, many people with a family history of bipolar never develop it themselves. There are even cases of identical twins where one twin has bipolar and the other doesn’t.
A stressful event can trigger a manic or depressive episode. If you’re going through an event like a difficult divorce, having financial problems, or an illness, it can play a role in developing bipolar disorder.
Brain structure and function
Researchers have discovered subtle differences in the average size or activation of certain brain structures. You can’t tell if someone has bipolar by looking at brain scans, though.
Diagnosis Of Bipolar 2 Disorder
There are no tests that can tell whether someone has bipolar disorder. Doctors canât diagnose it very well because of this. Doctors do not know how to diagnose bipolar disorder. They look at your symptoms and ask you questions.
The following checklist may help guide clinicians in their diagnosis:
- Feelings of mania/hypomania
- The decreased need for sleep
- Increased activity levels both mentally as well as physically
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What Are The Symptoms Of Bipolar Disorder
The changing mood states do not always follow a set pattern, and depression does not always follow manic phases. A person may also experience the same mood state several times before experiencing the opposite mood. Mood changes can happen over a period of weeks, months, and sometimes even years.
An important aspect of the mood changes are that they are a departure from the persons regular self and that the mood change is sustained for a long period of time. It may be many days or weeks in the case of mania and many weeks or months in the case of depression. Shorter periods of mania or depression may be an indicator of more severe episodes in the future but are usually not enough to diagnose a person with bipolar disorder.
The severity of the depressive and manic phases can differ from person to person and in the same person at different times. Symptoms of mania include:
- Excessive happiness, hopefulness, and excitement
- Sudden changes from being joyful to being irritable, angry, and hostile
- Rapid speech and poor concentration
- Increased energy and less need for sleep
- High sex drive
Patients with depression can also become psychotic and hear things or have delusions.
Can You Have Both Bipolar Disorder And Schizoaffective Disorder
No, but you can have schizoaffective disorder bipolar type.
In schizoaffective disorder, you experience symptoms of psychosis at the same time as a mood episode like mania or depression. These symptoms are preceded or followed by at least 2 weeks of hallucinations and delusions without any mood episodes.
In schizoaffective disorder bipolar type, the mood episodes you experience are mainly mania, and you may or may not experience symptoms of depression.
Bipolar disorder involves intense mood episodes that include mania, hypomania, and depression. In some cases, some people experiencing mania can also show symptoms of psychosis. There are, however, no symptoms of psychosis when youre not experiencing a mood episode.
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition has established the following criteria for diagnosing schizoaffective disorder bipolar type:
- hallucinations: perceiving something that others cant feel, hear, or see
- delusions: firm beliefs that dont change despite being shown evidence to the contrary
- disorganized and incoherent speech
- reduced emotional expression: or negative symptoms
At least one of the two symptoms required for diagnosis must be from the first three items on the list.
2. Experiencing positive symptoms like delusions and hallucinations for at least 2 weeks without symptoms of depression or mania.
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Beyond Treatment: Things You Can Do
Regular Exercise: Regular aerobic exercise, such as jogging, brisk walking, swimming, or bicycling, helps with depression and anxiety, promotes better sleep, and is healthy for your heart and brain. There is also some evidence that anaerobic exercise such as weightlifting, yoga, and Pilates can be helpful. Check with your health care provider before you start a new exercise regimen.
Keeping a Life Chart: Even with proper treatment, mood changes can occur. Treatment is more effective when a patient and health care provider work together and talk openly about concerns and choices. Keeping a life chart that records daily mood symptoms, treatments, sleep patterns, and life events can help patients and health care providers track and treat bipolar disorder over time. Patients can easily share data collected via smartphone apps including self-reports, self- ratings, and activity data with their health care providers and therapists.
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Differences Between Bipolar I And Bipolar Ii
Bipolar I and II are similar in that periods of elevated mood and symptoms of depression can occur in both types of the condition.
The main difference between the two types is the degree to which mania presents.
In bipolar I disorder, a person experiences a full manic episode, which causes extreme changes in mood and energy. Symptoms are severe enough that they may interfere with a person’s functioning at home, school, or work.
Less severe symptoms occur during a hypomanic episode, which are present in bipolar II disorder. In hypomania, a person experiences an elevated mood, but it isn’t as intense and doesn’t last as long as a manic episode.
Ultimately, these types share similar symptoms, but the way in which they are experienced can be different.
- Thoughts of death or suicidal thoughts
What Is The Outlook
Bipolar disorder isnt curable. But with proper treatment and support from family and friends, you can manage your symptoms and maintain your quality of life.
Its important that you follow your doctors instructions regarding medications and other lifestyle choices. This includes:
Including your friends and family members in your care can be especially helpful.
Its also helpful to learn as much as you can about bipolar disorder. The more you know about the condition, the more in control you may feel as you adjust to life after diagnosis.
You may be able to repair strained relationships. Educating others about bipolar disorder may make them more understanding of hurtful events from the past.
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Diagnosis Of Bipolar I
Bipolar I Disorder is marked by severe manic episodes, what some people call full-blown mania. This is generally considered the worst form of bipolar disorder, but a better understanding of bipolar II may challenge that idea. In many cases, Bipolar I Disorder can be easier to diagnose than Bipolar II. Why? Because only one manic episode in a persons historycurrent or pastis required for the diagnosis.
However, finding that manic episode in the persons history and making sure its not indicative of another type of mental disorder may indeed be a challenge. But again, only one episode is needed for the diagnosis and depression, though evident in many people with Bipolar I, is not needed for the diagnosis.
Although Bipolar I may be easier to diagnose, its often harder to treat over the course of the illness. Someone with Bipolar I will suffer longer or sometimes more intense episodes of manic symptoms than with Bipolar II, and therefore will experience more consequences in a shorter stretch of time.
Psychotic symptoms, such as hallucinations or delusional thinking, can only be present in Bipolar I. And because of the often wild, impulsive behaviors, mania in Bipolar I tends to get more attention than hypomania in Bipolar II. However, people with Bipolar I may avoid or be denied care for any number of reasons, despite the obvious need.