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What Is The Diagnosis Of Bipolar Disorder

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What Are The Complications Of Bipolar Disorder

What is Bipolar Disorder?

If left untreated, bipolar disorder can lead to longer and more severe mood changes. For example, episodes of bipolar-related depression can last up to 6 months, while manic episodes can last up to 4 months without ongoing treatment.

Someone living with bipolar disorder may also have a higher risk of the following:

  • unhealthy weight
  • suicidal thoughts

Some of these problems may need to be managed at the same time as bipolar disorder.

With the right treatment and support, most people with bipolar disorder can live productive and fulfilling lives.

What Is The Typical Age Of Onset For Bipolar Disorder

The average age of bipolar onset is around 25 years old, although it can vary.

Sometimes bipolar symptoms start in childhood or later in life. However, the most frequent range of onset is between the ages of 14 to 21 years.

Childhood bipolar is relatively rare, with only of children receiving this diagnosis.

According to the National Institute of Mental Health , about 4.4% of adults in the United States will experience bipolar disorder at some point in their lives. It affects men and women equally.

NIMH estimates that nearly 2.9% of adolescents those who are between 13 and 18 years old will experience bipolar disorder at some point, with the highest prevalence (

Despite common belief, bipolar disorder doesnt just occur in young people. In recent years, research has shown an increase in the diagnosis of late onset bipolar disorder .

According to a 2015 report from the International Society for Bipolar Disorders Task Force on Older-Age Bipolar Disorder , up to 25% of people with bipolar disorder are 60 years of age and older. Its estimated that between 5% and 10% of people start showing symptoms of bipolar disorder after the age of 50 years old.

People diagnosed with LOBD differ from those with early onset BD in several ways.

In addition, people with LOBD have vascular changes in their right brain hemispheres that have been

Ruling Out Other Conditions

If you experience extreme shifts in your mood that disrupt your daily routine, you should see your doctor. There are no specific blood tests or brain scans to diagnose bipolar disorder. Even so, your doctor may perform a physical exam and order lab tests, including a thyroid function test and urine analyses. These tests can help determine if other conditions or factors could be causing your symptoms.

A thyroid function test is a blood test that measures how well your thyroid gland functions. The thyroid produces and secretes hormones that help regulate many bodily functions. If your body doesnt receive enough of the thyroid hormone, known as hypothyroidism, your brain may not function properly. As a result, you may have problems with depressive symptoms or develop a mood disorder.

Sometimes, certain thyroid issues cause symptoms that are similar to those of bipolar disorder. Symptoms may also be a side effect of medications. After other possible causes are ruled out, your doctor will likely refer you to a mental health specialist.

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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.

Bipolar Disorder Symptoms In Women Vs Men

What should we know about Bipolar Disorder?

Men and women are diagnosed with bipolar disorder in roughly equal numbers. However, the main symptoms of the disorder may vary, depending on both sex you were assigned at birth and your gender.

Women with bipolar disorder tend to receive diagnoses later in life, often in their 20s or 30s. In some cases, they might first notice symptoms during pregnancy or after childbirth. Theyre also more likely to be diagnosed with bipolar II than bipolar I.

Additionally, women with bipolar disorder tend to experience:

  • milder episodes of mania
  • more depressive episodes than manic episodes
  • rapid cycling, or 4 or more episodes of mania and depression in 1 year
  • more co-occurring conditions

Women with bipolar disorder may also experience relapse more often, which may happen in part due to hormone changes related to menstruation, pregnancy, and menopause. In terms of bipolar disorder, relapse means having a mood episode after not having one for some time.

Men with bipolar disorder, on the other hand, may:

  • get a diagnosis earlier in life
  • experience less frequent but more severe episodes, especially manic episodes
  • be more likely to also have a substance use disorder
  • show more aggression during episodes of mania

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Can Brain Scans Or Imaging Tests Help With The Bipolar Diagnosis

While doctors donât rely on brain scans or imaging tests for making a bipolar diagnosis, some high-tech neuroimaging tests may help doctors make specific neurologic diagnoses that can account for psychiatric symptoms. An MRI or CT scan is therefore sometimes ordered in patients who have had a sudden change in thinking, mood, or behavior to assure that a neurological disease is not the underlying cause.

According to the National Institute of Mental Health, studies are underway to examine whether electroencephalograms and magnetic resonance imaging studies of the brain can reveal differences between bipolar disorder and related behavioral syndromes. But bipolar disorder remains a clinical diagnosis, and no imaging study or other lab test has yet been established to confirm its diagnosis or guide its treatment.

Women Of Childbearing Age

Women are at high risk of BD recurrence during pregnancy, especially if medications are discontinued, as well as during the postpartum period. Balancing the risk of medications against the need to prevent a mood episode requires active collaboration between the healthcare providers and the patient . Teratogenicity is a potential risk with most of the mood stabilizers lamotrigine may be an exception, but there are no wellcontrolled studies in humans to confirm this. Atypical antipsychotics, with the exception of lurasidone, are rated FDA pregnancy category C, meaning that they have not been shown to be either safe or unsafe for use during pregnancy lurasidone is classed in pregnancy category B based on current data.

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A Careful History Is Critical

This case illustrates many typical features of bipolar depression that are revealed only by taking a thorough history. Although the patient is high-functioning, having attained a professional career, she has serious problems with sexual and financial impulsivity and at her job. She has a strong family history of mood disorder. And she describes episodes of depression and mania in the past.

A Note On Bipolar Disorder Other Specified

What is Bipolar Disorder?

The DSM-5 also describes the four classifications as:

  • short-duration hypomanic episodes and major depressive episodes
  • hypomanic episodes and major depressive episodes
  • hypomanic episode without a prior major depressive episode
  • short-duration cyclothymia

No, unspecified bipolar disorder is not the same as mixed features.

Bipolar disorder with mixed features is present when someone is experiencing mania and depression simultaneously.

Bipolar disorder NOS means that you meet some but not all criteria to be diagnosed with bipolar disorder.

Diagnosis of unspecified bipolar disorder often occurs when symptoms are consistent with the depressive and hypomanic or manic phases typically seen in bipolar disorder.

Still, there isnt enough information to make a full diagnosis.

According to the DSM-5, a clinician may choose not to specify why the full criteria arent met.

Sometimes this may be due to not having enough information, such as in short-term treatment settings like the emergency room.

The symptoms of bipolar disorder can vary from one individual to another.

Most people experience periods of depressive episodes followed by mania.

A period of mania with fewer severe symptoms is called hypomania. Hypomania may be more common with bipolar disorder NOS.

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Starts In Young Adulthood Strong Heritability

Bipolar disorder can be a devastating condition with lifelong consequences, especially as it typically starts when patients are getting an education or embarking on a career. It usually first manifests in the late teenage years and progresses in the patients early 20s., The first hospitalization can occur soon thereafter.,

Bipolar disorder is one of the most heritable conditions in psychiatry, and about 13% of children who have an afflicted parent develop it. In identical twins, the concordance is about 50% to 75%, indicating the importance of genetics and environmental factors.,

Only Adults Can Develop It

It is heard in everyday life that bipolar disorder is a disorder that affects only the adult world. That one can not manifest these symptoms before adulthood and that it is a serious disorder that is impossible to hurt children. Bipolar disorder can occur during adolescence or even in childhood. As would be expected, the risk is greater for children whose parents have bipolar disorder.

Unlike adults, who experience distinct periods of mania or depression, children and adolescents usually experience rapid mood swings, even over a day. In phases of mania, a child becomes supple, destructive, and has many outbursts. In contrast, in phases of depression the symptoms take a more organic form and are experienced as a headache or stomachache.

The disorder usually presents with mixed symptoms in adolescents, while the signs in older adolescents are similar to those of adults. However, it is more challenging to diagnose young people. There are several times where there’s a misdiagnosis is given, and children with bipolar disorder are diagnosed with depression or Attention Deficit Hyperactivity Disorder.

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Manic Symptoms In Children

Symptoms of mania in children can include:

  • acting very silly and feeling overly happy
  • talking fast and rapidly changing subjects
  • having trouble focusing or concentrating
  • doing risky things or experimenting with risky behaviors
  • having a very short temper that leads quickly to outbursts of anger
  • having trouble sleeping and not feeling tired after sleep loss

Other Elements Of The Patient Interview

Bipolar disorder symptoms, risk factors, and interesting ...

Physical examination.

Physical examination cannot confirm a diagnosis of bipolar disorder, but it can, in combination with the medical history, help exclude the diagnosis by identifying illnesses that mimic bipolar symptoms., For example, a physical examination may identify hypothyroidism or hyperthyroidism, which are associated respectively with depressive and manic symptoms.

Laboratory tests and imaging.

No laboratory test is required to establish the diagnosis of bipolar disorder. However, in conjunction with the physical examination, laboratory tests can help to exclude alternative etiologies for mood symptoms. Laboratory tests may include a urine toxicology screen and a complete blood count . Fasting glucose and lipid assessments are important for establishing the presence of diabetes or hyperlipidemia and for determining baseline values before initiation of treatment. MRI or other neuroimaging techniques are rarely indicated, but in selected cases can be valuable to exclude an organic etiology for mood symptoms, such as a brain tumor or multiple sclerosis in cases of recent-onset mania.

Treatment response.

Differential diagnosis.

A number of common psychiatric disorders may mimic the symptoms of bipolar disorder and should be considered in the differential diagnosis. These disorders are summarized in .

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Conditions That Can Co

Many people with bipolar disorder also may have other mental health disorders or conditions such as:

  • Psychosis. Sometimes people who have severe episodes of mania or depression also have psychotic symptoms, such as hallucinations or delusions. The psychotic symptoms tend to match the persons extreme mood. For example:
  • Someone having psychotic symptoms during a manic episode may falsely believe that he or she is famous, has a lot of money, or has special powers.
  • Someone having psychotic symptoms during a depressive episode may believe he or she is financially ruined and penniless or has committed a crime.
  • Anxiety Disorders Deficit/Hyperactivity Disorder . Anxiety disorders and ADHD often are diagnosed in people with bipolar disorder.
  • Misuse of Drugs or Alcohol. People with bipolar disorder are more prone to misusing drugs or alcohol.
  • Eating Disorders. People with bipolar disorder occasionally may have an eating disorder, such as binge eating or bulimia.
  • Some bipolar disorder symptoms are like those of other illnesses, which can lead to misdiagnosis. For example, some people with bipolar disorder who also have psychotic symptoms can be misdiagnosed with schizophrenia. Some physical health conditions, such as thyroid disease, can mimic the moods and other symptoms of bipolar disorder. Street drugs sometimes can mimic, provoke, or worsen mood symptoms.

    What Are Causes And Risk Factors For Bipolar Disorder And Schizophrenia

    Like most mental disorders, neither bipolar disorder nor schizophrenia is directly passed down genetically. Rather, each is the result of a complex group of genetic, psychological, and environmental factors. These two illnesses share a number of the same risk genes but also have some unique genetic risk factors. Stress has been found to be a significant contributor to the development of most mental health conditions, including both of these disorders.

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    Surprising Symptoms Of Bipolar Disorder

    Bipolar disorder symptoms will last for days, weeks, and even months at a time. Unlike ordinary mood swings, the depressive and manic symptoms associated with bipolar disorder can get so intense that they interfere with a persons everyday activities.

    Symptoms of bipolar disorder are dysfunctional. The problem is many people dont understand the actions and manic and depressive behaviors associated with bipolar disorder sufferers. It may surprise you to learn that bipolar symptoms can be mistaken for bad decision making, when in fact the persons behavior is a sign of the mental illness. The following are 12 major bipolar disorder signs and symptoms.

    1. Having a great mood: As mentioned, a person with bipolar disorder experiences uncontrollable highs and lows. During the high times, the person is in a manic or hypomanic state. This is where the person feels good and has a lot of energy. They will appear highly enthusiastic, cheerful, and high-spirited by nature. At the same time, the person still has their grip on reality.

    In this state, they also have a lot of creativity and they feel an intense euphoric state of excitement and happiness. The person also has an exaggerated self-esteem, which can be described as a superiority or God complex. In other words, the person will have too great of a mood.

    When To Suspect Bipolar Disorder

    What Is Bipolar Disorder?

    Patients who first present to primary care with bipolar disorder may show a wide range of mood-related symptoms, including depression, anxiety, mood swings, irritability, fatigue, difficulty in sleeping, and inability to focus and concentrate. Certain psychiatric and medical comorbidities are also extremely common and, by their presence, raise a suspicion of bipolar disorder. The patients social history will often show characteristic sequelae of the illness, such as relationship and marital problems, erratic occupational histories, financial troubles, and recurrent legal issues.

    Diagnosing bipolar disorder in the face of the diverse symptoms and sequelae is a challenge that requires a high index of suspicion.

    Suspicion of a manic episode.

    A full-blown manic episode that includes the cardinal symptoms may be readily identifiable in most patients with bipolar I disorder, but the symptomatology can be variable . Particular attention should be paid to the symptomatology of mania in patients with comorbidities , as these symptoms can further complicate or mask the diagnosis. Patients experiencing a manic episode should receive urgent specialist investigation and treatment because of the high risk of harm to self or others. Manic episodes frequently require intensive outpatient treatment or admission to a psychiatric facility to provide a safe environment during treatment induction.

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    Depression And Mania: Two Sides Of The Same Coin

    Symptoms of depression and mania are frequently viewed as opposite mood states, though many times patients report a mixture of them., For both states, the features of a distinct change from the patients normal condition and the sustained nature of the symptoms are important diagnostically and indicate a likely underlying biological cause.

    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.

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    Physical Symptoms Associated With Depressive Episodes

    During depressive episodes, individuals may experience a variety of physical symptoms, including unexplained aches and pains.

    Changes in weight are also common. While some people struggle to eat when they’re feeling down, others turn to food for comfort. Thus, both weight loss and weight gain can be symptoms of a depressive episode.

    Psychomotor agitation, an increase in activity caused by mental rather than physical tension or psychomotor retardation, slowing of both thought and physical activities, may also occur.

    Case : A Television Anchors Dream Turns To Nightmare

    Bipolar Disorder Symptoms Infographic Stock Illustration ...

    According to a famous news anchors autobiography, the steroids prescribed for her hives revved her up. The next course left her depressed. Antidepressant medications propelled her into a manic state, and she was soon planning a book, a television show, and a magazine all at once. During that time, she bought a cottage online. Her shyness evaporated at parties. I was suddenly the equal of my high-energy friends who move fast and talk fast and loud, she wrote. I told everyone that I could understand why men felt like they could run the world, because I felt like that. This was a new me, and I liked her! She was soon diagnosed with bipolar disorder and admitted to a psychiatric clinic.

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