How is it Diagnosed?
The diagnosis of bipolar disorder relies on comprehensive psychiatric evaluation, as
there is no specific laboratory or imaging test to confirm the condition. A psychiatrist
begins by gathering a detailed personal and family psychiatric history, focusing on
mood episodes, duration, triggers, and functional impact.
Diagnostic criteria are based on the Diagnostic and Statistical Manual of Mental
Disorders (DSM-5). To be diagnosed with bipolar I disorder, a person must have
experienced at least one manic episode, with or without depressive episodes. Bipolar II
disorder involves at least one hypomanic episode and one major depressive episode,
without any full manic episodes.
Clinicians evaluate for hallmark symptoms of mania (elevated mood, hyperactivity,
decreased need for sleep, impulsivity) and depression (persistent sadness, loss of
interest, fatigue, suicidal ideation).
Mood charting or self-reporting tools like the Mood Disorder Questionnaire (MDQ) can
help identify patterns over time.
A physical exam and lab tests (e.g., thyroid function tests, complete blood count) are
often performed to rule out medical conditions that can mimic bipolar symptoms, such
as hyperthyroidism or substance use disorders.
Neuroimaging (MRI or CT) and EEG may be conducted if there are concerns about
underlying neurological conditions, although they are not diagnostic for bipolar disorder.
Early and accurate diagnosis is crucial to initiate mood-stabilizing treatment and
prevent future episodes. Misdiagnosis with unipolar depression is common and can lead
to inappropriate treatment with antidepressants alone, which may worsen symptoms.