Health Advice



How is bipolar disorder diagnosed?

By Keith Roach, M.D. on

DEAR DR. ROACH: How do you diagnose bipolar disorder? Do you need a blood test, or can it be diagnosed by a person's actions? -- A.Y.

ANSWER: Bipolar affective disorder, formerly called manic-depressive illness, is a psychiatric condition that is frequently misdiagnosed. Over a third of people diagnosed with bipolar disorder waited at least 10 years between seeking treatment for their symptoms and receiving a correct diagnosis.

The diagnosis is made clinically, meaning based on a thorough psychiatric history and exam, but also includes a medical evaluation to be sure there is not a medical condition underlying (or mimicking) the diagnosis.

The major criteria for making the diagnosis of bipolar disorder include depressive symptoms or symptoms of elevated mood. Elevated mood comes in two closely related clinical types: mania and hypomania. With both of these, people have high levels of energy and activity, and an elated or irritable mood. The person must have several of these defining symptoms:

-- Inflated self-esteem (grandiosity)

-- Decreased need for sleep


-- More talkative than usual

-- Racing thoughts

-- Distractibility

-- Increase in activity (such as work or school; or sexual activity)


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