Bipolar Disorder Diagnosis What You Need to Know

If you or a loved one have recently been diagnosed with bipolar disorder, you are likely experiencing a mix of relief and uncertainty. It can be incredibly burden-lifting to have a name and definition for the struggle you’ve been experiencing.

At the same time, you may be asking questions like “What does this mean?”, “Is this the right diagnosis?”, or “Now what?” While it is always best to seek answers directly from your healthcare team, this article aims to start answering some of the many questions you or your loved ones may have about a bipolar disorder diagnosis.

What is bipolar disorder?

Bipolar disorder is a mood disorder that is characterized by extreme emotional highs and lows. These manic highs and depressive lows far surpass the natural ups and downs most people experience. While it is possible to have bipolar symptoms as early as childhood, most people are diagnosed in their late teens or early twenties.

Only a small percentage of the U.S. population is believed to be affected by bipolar disorder. However, of those who receive a diagnosis, the vast majority present with severe cases. This makes evaluation, diagnosis, and continuous treatment efforts incredibly important for people showing signs of this condition.

How is it diagnosed?

Individuals who have experienced at least one episode of extremely elevated mood, with uncomfortably high energy and uncontrollable euphoria, should be evaluated by their primary care physician.

In order to ensure that you receive the proper care, your doctor will likely perform an overall health evaluation, run tests, and try to identify any physical conditions that may explain your symptoms. If and when other medical conditions have been ruled out, your physician will likely refer you to a mental health professional for further evaluation and, possibly, a bipolar disorder diagnosis.

Recognize the symptoms

The first step toward receiving a bipolar disorder diagnosis is recognizing the patterns of moods, thoughts, and behaviors in your life that resemble bipolar disorder symptoms. People with this condition experience episodes of highly elevated mood and energy, called mania or hypomania depending on the intensity of symptoms, followed by periods of depression.

While the frequency and severity of these episodes can vary from person to person, they typically include many of the following symptoms. During a manic or hypomanic episode, you may experience:

• Feeling unusually upbeat, wired, or tense.
• Increased energy, productivity, or agitation.
• A euphoric sense of well-being, confidence, or “untouchability”.
• Decreased sleep requirements.
• Excessive or rapid speech.
• Racing thoughts.
• Increased distractibility.
• Decreased inhibitions and poor decision making (engaging in risky behaviors).

A full-blown episode of mania can lead to dangerous behaviors, trigger a psychotic break from reality, and, sometimes require hospitalization. Hypomania is a less extreme form of mania that does not feature symptoms of psychosis and may allow the sufferer to function more normally in their personal, professional, and academic life.

At the opposite end of the emotional spectrum, a depressive episode may cause you to experience:

• Feeling sad, numb, irritable, hopeless, or low.
• A loss of interest in activities you used to enjoy.
• Significant changes in appetite and sleeping habits.
• Decreased concentration and difficulty completing tasks.
• Lowered energy and fatigue.
• Feelings of worthlessness or self-hatred.
• Thoughts of death or suicide.

While it is common for some people with bipolar disorder to go long periods of time without any symptoms, it is also possible to have only short periods between episodes or to rapidly cycle between mania and depression. To be diagnosed with bipolar disorder, you must have experienced at least one episode of mania or hypomania, with or without an episode of depression.

Receive a psychiatric evaluation

When you meet with your psychiatrist or therapist for evaluation, you will likely be asked a series of questions about your symptoms, health history, family history, and the frequency of your episodes. Some questions you may be asked during your initial screening include:

• Has anyone in your family been diagnosed with bipolar disorder?
• What symptoms are you experiencing?
• Do you feel in control during your episodes?
• When did your symptoms first begin?
• What are your thoughts and feelings like during a manic episode?
• Do you ever think about suicide or harming yourself?
• What is your history with drugs and alcohol?

As your therapist works to get a complete picture of your symptoms and the severity of your most extreme episodes, they may also ask to speak with your family or close friends. Since memory formation and retention can sometime be impaired during a manic episode, all additional information that your support system can provide will help you receive the most accurate diagnosis possible.

What happens after a bipolar disorder diagnosis?

After receiving a diagnosis of bipolar disorder, the first order of business is finding the right treatment plan to manage your symptoms. Sometimes hospitalization, in-patient care, or out-patient care is necessary to help keep you safe while your healthcare team works to stabilize your moods and solidify an effective treatment plan.

Starting Treatment

Medication is an important part of treating bipolar disorder. Any combination of mood stabilizers, antipsychotics, antidepressants, and/or anti-anxiety medications may be used to help manage your symptoms and prevent severe episodes.

The process of finding the right dosages of the right medications with the lowest amount of side effects and be a slow and frustrating process. Still, is important to be patient and stick with it. Never stop taking your medication without speaking to your healthcare team, as this can lead to withdrawal symptoms and extreme bipolar episodes.

Therapy is another important tool in the treatment of bipolar disorder. Cognitive behavioral therapy, or CBT, can help you to identify unhealthy and unhelpful patterns of thoughts, beliefs, and behaviors, empowering you to identify and cope with triggers.

Family-focused therapy may also be beneficial in helping you get the support you need to stay consistent with your treatment plan. Interpersonal and social rhythm therapy, or IPSRT, can help you focus on creating sustainable routines and daily rhythms that may help you better manage your bipolar disorder symptoms.

Education about bipolar disorder can be another extremely useful treatment approach. The goal is to learn to recognize the signs and symptoms of your manic or depressive episodes before they really take hold. Ultimately, the hope is that identifying symptoms early on in an episode will allow you to seek treatment and support in time to prevent episodes from becoming severe.

Other treatments such as electroconvulsive therapy, or ECT, may be used in cases where symptoms are unresponsive to medication, there is a reason that medications can’t be taken, or there is a need to rapidly control severe bipolar symptoms in order to prevent suicide or physical harm.

Another newer, more experimental treatment called transcranial magnetic stimulation, or TMS, is currently being explored as a potential option for people whose symptoms haven’t responded well to antidepressants. Additionally, holistic remedies and faith-based prayer and meditation have only proven effective in conjunction with proper medical treatment and should not be used to replace medication or therapy.

Living with Bipolar Disorder

Bipolar disorder isn’t a condition that gets better on its own. Without proper diagnosis and treatment, individuals with bipolar disorder are at significant risk for negative outcomes. However, when proper treatment plans are established and maintained, bipolar disorder can be well-managed and patients are frequently able to live normal, fulfilling lives.

Regular routines, healthy relationships, meditation, stress-management, and mood charts, in combination with medication and therapy, can all help you reduce the frequency and severity of episodes. It may also be helpful to note that, since bipolar disorder is listed as a disability under the Americans with Disabilities Act, you are entitled to receive reasonable accommodations for your condition from educational institutions, government entities, and employers.

Ultimately, it’s important to remember that a bipolar disorder diagnosis is nothing you should be ashamed. Instead, you can choose to allow this diagnosis to mark the beginning of a new, healthier chapter of your life story.

Next Steps

If you are struggling to come to terms with your bipolar disorder diagnosis, it may be helpful to speak with a counselor. Talking in session with a mental health professional can help you process through your emotions concerning the diagnosis.

Counseling may also help you develop strategies to cope with stress, provide you a safe place to speak about past or current struggles, or enable you to improve your view of the future. Don’t hesitate to reach out to a local counselor for support today.