Table of Contents
Diagnosis
Doctors diagnose bipolar disorder based on criteria of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM). These criteria include the presence of manic, depressive, or mixed episodes, how frequently these symptoms occur, and how often they last.
Ruling out Similar Conditions
When making a diagnosis of bipolar disorder, it is important that the doctor rule out other conditions that may be causing symptoms of bipolar disorder.
Distinguishing Mania from Normal Euphoria or Joy. A major difficulty with a diagnosis of bipolar disorder is the tendency for a patient to be unable to recognize his or her own condition, particularly when in the manic state. Patients often deny their symptoms, which may be perceived as positive feelings. The doctor should take a careful and complete history of any and all episodes of depression, mania, or both.
Hypomania, the less severe variant of mania, may be particularly difficult to distinguish from normal joy or euphoria. It can often be distinguished by the following characteristics:
- Hypomania persists for at least 4 days
- Patients with hypomania are easily distracted and overly talkative
- Patients with hypomania have difficulty functioning
Distinguishing Unipolar from Bipolar Depression. It is often difficult to differentiate between unipolar (the depression associated with major depressive disorder) and bipolar depression. This is especially true for patients with bipolar II disorder. Bipolar depression and major depressive disorder may differ in the following ways:
- Bipolar depression typically lasts 2 - 3 months -- not as long as in major depression (although left untreated some bipolar disorder episodes can last 6 - 12 months or longer).
- People with unipolar depression can still experience a variety of other moods, but none meet the criteria for a manic state.
- Bipolar depressive episodes tend to develop more gradually than do those caused by major depression.
An accurate diagnosis is important because patients with bipolar disorder who are inappropriately medicated solely with antidepressants have an increased risk of rehospitalization.
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Review Date: 01/28/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School; Physician, Massachusetts General Hospital.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
