Bipolar disorder is commonly diagnosed based upon the criteria found within the latest edition of the Diagnostic and Statistical Manual for Mental Disorders, which is the professional manual for diagnosing mental disorders. These criteria include symptoms and the amount of time you’ve experienced these symptoms, as well as any family history and the degree the symptoms affect your daily life and functioning.
Like other mental illnesses, bipolar disorder does not have a blood test or a brain scan. A diagnosis of bipolar disorder is made on the basis of symptoms, course of illness, and, when available, family history. Like most mental disorders, it is usually best to receive a reliable diagnosis from a mental health professional, not your family physician or general practitioner. While such general practice doctors can help spot and refer such problems, they are not experts in the area of mental disorders (which often have their own challenging diagnostics issues).
When bipolar disorder is diagnosed, it is often done through a common process:
Initial Assessment. A mental health professional will ask about your symptoms — when they started, how long they have lasted, how severe they are, whether you have had them before, and if so, whether the symptoms were treated and what treatment was given. You will also be asked about your medical and family history. If the person with the disorder is a child or teen, the professional may also wish to interview your family members and/or other persons close to you.
Psychological Evaluation. A mental health professional is probably the best person to evaluate your symptoms, after you see your regular health care provider. Diagnosis of bipolar disorder is based on:
- Presence of symptoms over time
- Absence of medications and medical or neurological illness that may look like bipolar disorder
- Family history of bipolar disorder
Mania is diagnosed if abnormally elevated mood (lasting at least one week) occurs with three or more of the other symptoms of mania. If your mood is irritable, four additional symptoms must be present.
Depression is diagnosed if depressed mood or loss of interest in pleasure occurs every day (or nearly every day) over the last two weeks, and is accompanied by five or more of the symptoms.
A diagnostic evaluation may include a mental status exam to determine if your speech or thought patterns or memory have been affected, as sometimes happens in the case of bipolar disorder.
You may also be evaluated for other psychiatric conditions such as anxiety disorders and alcohol or drug abuse.
Physical Examination. If you are first seeing a doctor or general practitioner, they often may want to conduct a physical exam. You may be given several laboratory tests to rule out other causes for your moods and behavior such as hypothyroidism. If a physical cause for your symptoms is ruled out, you may be referred to a psychiatrist for a psychological evaluation.