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Diagnosing bipolar disorder

A diagnosis of bipolar disorder, with alternating periods of mania and depression, will be made by a mental health specialist after a referral from a GP.

What does a doctor need to know to diagnose bipolar disorder?

A bipolar disorder diagnosis is only made by taking careful note of symptoms, including their severity, length, and frequency. The most telling symptoms of bipolar disorder include mood swings (going from extreme highs to extreme lows) that don't follow a set pattern.

In making the diagnosis of bipolar disorder, the psychiatrist or other bipolar expert will ask questions about your personal and family history of mental illness and/or bipolar disorder. Because bipolar disorder has a strong genetic component, family history is important in order to make an accurate diagnosis.

Also, the doctor will ask detailed questions about your bipolar symptoms. Other questions may focus on reasoning, memory, ability to express yourself, and ability to maintain relationships.

Do other illnesses mimic symptoms of bipolar disorder?

Some serious illnesses such as lupus (SLE), HIV, and syphilis may have signs and symptoms that mimic those of bipolar disorder, causing a delay in making a diagnosis and inappropriate treatment.

In addition, numerous studies show the prevalence of anxiety disorders in those with bipolar, including generalised anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, phobic disorder, social anxiety disorder, and posttraumatic stress disorder ( PTSD). If left untreated, each of these co-occurring disorders can cause unnecessary suffering and impairment.

Other problems often confound a correct diagnosis of bipolar disorder, such as steroid medications used to treat inflammatory diseases like rheumatoid arthritis, asthma and allergy, ulcerative colitis, eczema, and psoriasis. These steroid medicines can cause mood swings of depression and mania that are sometimes mistaken for the moods of bipolar disorder.

What should I do before I see the doctor about bipolar disorder?

Before consulting your doctor about bipolar disorder, it’s helpful to write down your symptoms of depression, hypomania, or mania. It is also useful to get an in-depth family history from relatives. So often, knowing the family history is crucial for making an accurate diagnosis and prescribing effective treatment.

In addition, consider bringing your spouse (or other family member) or a close friend with you to the doctor’s consulting room. Often, a family member or friend may be more aware of a person’s unusual behaviour and be able to describe this in detail to the doctor. Before your consultation, think about and record the following:

  • Your mental and physical health concerns
  • Symptoms you’ve noticed
  • Any unusual behaviour
  • Past illnesses
  • Your family history of mental illness (bipolar disorder, depression, mania, seasonal affective disorder or SAD, or others)
  • Medicines you are taking now and in the past (take all such medicine with you to the doctor’s appointment)
  • Natural dietary supplements you are taking (take your supplements to the doctor's appointment)
  • Your lifestyle habits ( exercise, diet, smoking, alcohol consumption, recreational drug use)
  • Your sleep habits
  • Causes of stress in your life ( marriage, work, relationships)
  • Questions you may have about bipolar disorder

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