Diagnosing Bipolar Disorder (2024)

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.

Diagnosing Bipolar Disorder (2024)

FAQs

How accurate is the diagnosis of bipolar disorder? ›

Bipolar disorder, especially subtypes I and II, are difficult to diagnose. In fact, during the first year of seeking treatment, only 20% of patients are correctly diagnosed. The usual time span between a misdiagnosis and an accurate diagnosis of bipolar disorder is 5-10 years.

What is the first red flag of bipolar disorder? ›

One of the most objective symptoms to monitor is sleep needing less sleep is a huge red flag and often easier to see than the mood changes of mania.

Could my bipolar diagnosis be wrong? ›

Some researchers estimate that the misdiagnosis rate for bipolar disorder is up to 40% . Research also suggests that people with bipolar disorder may not receive an accurate diagnosis for 5–10 years and that about 20% of people with the condition receive an accurate diagnosis within 1 year of seeking treatment.

What looks like bipolar but isn't? ›

Cyclothymia symptoms alternate between emotional highs and lows. The highs of cyclothymia include symptoms of an elevated mood (hypomanic symptoms). The lows consist of mild or moderate depressive symptoms. Cyclothymia symptoms are similar to those of bipolar I or II disorder, but they're less severe.

What is most commonly misdiagnosed as bipolar? ›

Bipolar disorder and major depression

The most common misdiagnosis of bipolar disorder is major depressive disorder (MDD).

How do doctors confirm 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.

What can be mistaken for bipolar? ›

As mentioned previously, the most common misdiagnosis for bipolar patients is unipolar depression. An incorrect diagnosis of unipolar depression carries the risk of inappropriate treatment with antidepressants, which can result in manic episodes and trigger rapid cycling.

Why is it hard to accept bipolar diagnosis? ›

Stigma, Discrimination, and Denial of Bipolar. Indeed, the stigma and discrimination associated with mental illness is a huge barrier to coming to terms with bipolar, consumers and experts agree. It is because there are so many misconceptions and preconceptions about mental illness that Dr.

Why is bipolar so hard to diagnose? ›

Bipolar is often an overlooked condition, which can take years to diagnose - and more awareness is needed. One reason it can take so long to recognise is how challenging it is to obtain a full and accurate history of someone's mental health, which is a key part of any psychiatric assessment.

What is the most misdiagnosed mental illness? ›

Bipolar disorder may be the most commonly misdiagnosed mental health issue. Furthermore, treating bipolar incorrectly may have the most adverse effects. A number of studies have looked at the misdiagnosis of bipolar.

What is the hardest mental illness to live with? ›

Borderline personality disorder is one of the most painful mental illnesses since individuals struggling with this disorder are constantly trying to cope with volatile and overwhelming emotions.

What are bipolar facial features? ›

On a background of minor dysmorphologies of the upper face, maxilla, midface and periorbital region, the main features in bipolar disorder are (a) retrusion and shortening of the premaxilla, nose, philtrum, lips and mouth (the frontonasal prominences), with (b) protrusion and widening of the mandible-chin.

How often is bipolar overdiagnosed? ›

The authors concluded that 67% of patients were overdiagnosed with bipolar disorder (Goldberg et al., 2008).

What makes bipolar disorder difficult to diagnose? ›

Bipolar disorder type II is especially difficult to diagnose accurately because of the difficulty in differentiation of this disorder from recurrent unipolar depression (recurrent depressive episodes) in depressed patients.

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