Making the assessment of bipolar disorder can seem difficult, and, following the onset of symptoms, may take years to properly diagnose. Other conditions are typically ruled out before considering bipolar disorder as there are no specific brain scans or blood tests that can definitively identify the illness. Diseases such as hypothyroidism or medication side effects must be ruled out to effectively treat any symptoms. During our initial assessment, we ask questions surrounding the overall mental health of the patient. We will cover the length of symptoms, how much they disrupt everyday life, and any risk factors for developing bipolar disorder.

Our diagnosis for bipolar disorder requires at least one episode of depression and one episode of mania or hypomania. We will ask patients what their thoughts are during these episodes, if they feel in control and how they feel. We may need to interview family and friends to better understand our patient’s history.

This condition shares symptoms with many other conditions, making it tricky to diagnose. Anxiety, depression, OCD, ADHD, eating disorders and personality disorders can all mimic bipolar disorders, causing diagnosis to be unclear. However, if patients give a strong family history and history of symptoms, diagnosis can become easier and treatment can begin faster.

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There are different types of bipolar disorder that require different levels of treatment. These types are determined by the pattern and severity of symptoms during both highs and lows. 

Bipolar I Disorder- characterized by one or more manic episodes, lasting at least a week or requiring hospitalization. These manic episodes are either preceded or followed by hypomanic or major depressive episodes. Behavior during the mania can lead to severe financial, family and social disruptions or trigger a break from reality (called psychosis).

Bipolar II Disorder- characterized by one or more depressive episodes accompanied by at least one hypomanic episode, but never a true manic episode. Hypomanic episodes mimic manic symptoms but don’t last as long and are not as severe. 

Cyclothymic Disorder- characterized by chronic mood fluctuations but does not reach the levels of full mania or full depression. This does not mean that symptoms don’t cause serious distress in personal relationships, work or school and other areas of life. Symptoms are considered more mild than bipolar I and II, but, if left untreated, someone with cyclothymic disorder may go on to develop a more serious case of bipolar disorder.

Other- there are other types of bipolar disorder. These include other related disorders induced by certain drugs, alcohol, or medical conditions, such as Cushing’s disease or a stroke.