Diagnosing Bipolar Disorder

Bipolar disorder, also known as manic–depressive illness, is a medical condition that causes a person to experience intense mood swings that alternate between depression and mania. These mood swings can last for hours, days, or even weeks.

Mental health specialists at NYU Langone Psychiatry Associates, such as psychiatrists, psychologists, and licensed clinical social workers, can help determine if a person has bipolar disorder and, if so, how best to manage symptoms.

Symptoms of Bipolar Disorder

During a depressive episode, a person may experience irritability, persistent sadness, or frequent crying. He or she may have thoughts of death or suicide and lose interest in activities that were previously enjoyable. Other signs include a low energy level, fatigue, poor concentration, and a change in eating or sleeping habits.

During a manic episode, a person may seem unusually happy or excited. He or she may also talk too much and too fast or appear distracted or overly confident and ambitious.

Mania may also involve psychosis, or being out of touch with reality. This symptom can be characterized by hallucinations, which involve hearing or seeing things that aren’t there, or delusions, which involve believing things that aren’t supported by evidence.

Other symptoms of mania include experiencing increased energy despite a lack of sleep, driving recklessly, being sexually promiscuous, and engaging in risky behavior, such as abusing drugs or alcohol.

Types and Causes of Bipolar Disorder

There are two different types of bipolar disorder. People with bipolar disorder I have severe manic episodes, whereas those with bipolar disorder II experience milder episodes.

Bipolar disorder tends to run in families, and research suggests that certain genes may increase the risk. The condition is usually diagnosed before age 25, although some people experience symptoms for the first time later in life.

Some people with bipolar disorder also have attention deficit hyperactivity disorder, which usually develops before bipolar disorder. Other psychological conditions, including anxiety disorders, may accompany bipolar disorder.

It can be difficult to distinguish between depressive episodes that occur due to regular, or unipolar, depression, and those that occur due to bipolar disorder. NYU Langone is home to nationally renowned psychiatrists who specialize in identifying bipolar disorder. A correct diagnosis is essential to the appropriate management of bipolar disorder. Medications to ease symptoms of unipolar depression can actually trigger manic episodes in people with bipolar disorder.

To diagnose bipolar disorder, a doctor performs a physical exam, asks about your symptoms, and recommends blood testing to determine if another condition, such as hypothyroidism, is causing your symptoms.

If the doctor does not find an underlying cause of your symptoms, he or she performs a psychological evaluation.

Psychological Evaluation

During a psychological evaluation, a specialist asks if you have a family history of bipolar disorder, depression, or anxiety disorders. He or she asks about your symptoms—when they started, how long they have lasted, how severe they are, whether they have occurred before, and, if so, how they were treated.

The specialist asks if you are using alcohol or drugs and if you are thinking about death or suicide. In addition, he or she may ask you to complete a questionnaire to clarify how your symptoms affect your life.

Speaking with your partner or close friends or relatives about your symptoms and history also helps an NYU Langone mental health specialist obtain a better picture of your health and determine if bipolar disorder is causing your symptoms.

After the specialist assesses your symptoms and family history, he or she conducts a feedback session, during which you discuss the diagnosis and most appropriate treatment options.