Depression

There are no hard and fast proven tests for bipolar diagnosis. The very basis for a bipolar diagnosis will be the self-reported incidences and observations of the patient himself or herself. A bipolar diagnosis can also be achieved through any abnormal or irregular behavior reported by the family members of the patient, his or her friends and co-workers. However, both reports, individual and external, have to be confirmed through an observation made by a psychiatrist, a nurse, a clinical psychologist or any medical practitioner with background in psychiatry or psychology, before a bipolar diagnosis can be reached. They will be looking for secondary signs in behavior and asses those using special criteria made especially for bipolar diagnosis. The time and duration of the observation can vary, although they are almost always done in an outpatient basis. The bipolar diagnosis can only be achieved if the signs and symptoms are present in during the observation. If none are observed, then a bipolar diagnosis will not be given and the patient will be released. Actually, patients who will receive a bipolar diagnosis will only be admitted if the medical practitioner considers the patients to a risk to himself or to his immediate environment.

The criteria that these medical practitioners use to determine a bipolar diagnosis is based primarily on the American Psychiatric Association’s Diagnostic and Statistical Manual for Mental Disorders, or DSM. The most current version of this piece of literature is DSM-IV-TR. Another reference material that they use as secondary literature is the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems, and most current edition published is the ICD-10. DSM is used more often in the United States and the ICD is more often used in Europe

The initial examination and observation to determine bipolar diagnosis almost always include a physical examination. As mentioned, there are no biological tests to confirm bipolar disorder but the physical examinations are done to eliminate the possibility that the reported mania or depression is not caused by any medical or organic illness. Possible ailments that can hinder a bipolar diagnosis include thyroidism, whether hyper- or hypo- and any form of metabolic abnormalities.

A bipolar diagnosis will be suspended if the doctor finds a systemic infection or immune disease like syphilis or HIV. After the physical exam, an EEG will be conducted to eliminate the possibility of epilepsy. If the patient has any brain lesions or other brain damages, bipolar diagnosis will be interrupted since any form of brain damage will disqualify the patient from getting a bipolar diagnosis. Therefore, to eliminate this possibility, a CT scan will be performed. These tests and procedures will be done once only, unless something happens after the tests that call for a re-testing, like a seizure or perhaps bleeding.

After ruling out any physical cause which may disqualify a bipolar diagnosis, the doctor will start eliminating the possibility of other mental illnesses. A bipolar diagnosis will only be given if the patient will not exhibit other symptoms of other mental illnesses like schizophrenia or schizoaffective disorder, which can sometimes be confused with bipolar disorder because of the similar symptoms these illness have.