You've been doing the obligatory rounds of all the mental health websites and gathering information on your symptoms. Whatever you’ve read up on the kind of mood swings and troubled relationships that your life seems to be filled with, the signs seem to point in one direction – bipolar disorder.
You can't be sure of this, of course. Why, you’ve even read about how there is so much symptom overlap between bipolar disorder, schizophrenia, ADHD, anxiety disorder, depression and borderline personality disorder that even mental health professionals can have trouble diagnosing bipolar disorder with any degree of certainty. How do you make sure that your doctor does come to the right conclusion?
The answer lies in seeing multiple mental health professionals. It might surprise you to learn that one out of two people with bipolar disorder end up needing to see three or more psychiatrists before they find one who is able to give them the correct diagnosis.
That's what a survey done by the Depression and Bipolar Support Alliance in 1994 has found. It gets even worse. According to that survey, one out of three people with bipolar disorder complains of how their doctors never actually arrived at the correct diagnosis for the first 10 years of their treatment.
It is clear then that diagnosing bipolar disorder can be a challenge even to a seasoned psychiatrist. You can't just go to a psychiatrist and expect that he will champion your cause and do the work needed to come to the correct diagnosis. Often, even as psychiatrists are unsure of the accuracy of their diagnosis, they still declare it with a great deal of confidence; the patient might be swayed by his air of confidence alone.
When it comes to seeking psychiatric evaluation and treatment of any kind, you simply cannot sit back and trust that your psychiatrist will use every scientific method available to him and arrive at the right conclusions. You need to take some control – at least at the diagnosis stage – to make sure that your doctor gets it right.
Why Doctors Lose Their Way Diagnosing Bipolar Disorder
Mental health professionals tend to lose their way diagnosing bipolar disorder for the same reason that regular, untrained people do: many of the symptoms of the disease are there to be seen in other diseases as well. If you plan to head to a psychiatrist about your symptoms then, you need to prepare. You should probably read up on all of the ways in which doctor tend to get bipolar mixed up with other diseases. What follows now is a short introduction.
The Trouble Doctors Have Telling Bipolar Apart From Depression
Bipolar disorder is immediately recognizable for the way it puts a person through shifts between two extreme states of mind. You can swing between extreme depression, and euphoria – the technical term for which, in the context of this disease, is mania.
Much of the time, patients with bipolar disorder are incorrectly diagnosed for just one half of their disease – for the depression part. Doctors simply look at the depression side of the disease and diagnose major depression (or unipolar disorder), with no mood swings.
One reason they make this mistake is that patients may often come in only complaining about the depression part of their problem. Mood swings in bipolar disorder can be long-lived ones – lasting months at a time. These patients simply come in before their mood actually has the time to swing around.
In other cases, they only complain about the depression because that's what really bothers them. They kind of enjoy the mania part and they don't really bring it up as a problem at all. In fact, they go in wishing that they could experience the mania forever.
In some cases, patients who experience mania just feel that it's a good, normal and happy time. In other cases, these patients just don't remember that they have experienced a manic episode. They just mentally block it.
Often, the patient really hasn't experienced the mania just yet. Sometimes, it takes time for the disease to develop to its full potential.
Bipolar disorder can manifest itself sometimes in such a way that manages to truly confuse every mental health professional – it can cause patients to experience both mania and depression at the same time. People who experience bipolar in this way can complain of extreme hyperactivity, anxiety and agitation while also feeling depression and misery – both at the same time. Psychiatrists call this a “mixed episode” these days. For the longest time though, there was no name for this.
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About 40% of people with bipolar disorder do complain of mixed episodes. Since people with regular depression do experience something like this sometimes as well, doctors can have a very hard time telling a case of depression with manic thoughts apart from a case of bipolar disorder with mixed episodes.
A psychiatrist who makes a mistake diagnosing bipolar disorder this way may end up prescribing antidepressants to a patient who has bipolar. Antidepressants can send a bipolar patient into a serious manic episode.
If you need to see a doctor about symptoms that might indicate bipolar disorder, you need to be very careful making sure that the doctor makes none of these mistakes.
Borderline Personality Disorder Can Appear Quite Similar To Bipolar As Well
Bipolar disorder has quite a bit in common with borderline personality disorder. People suffering from either one of these diseases can experience inexplicable mood swings, a lack of emotional control and serious self-image issues. People can have very troubled relationships with their friends and family when they have either disease.
The difference with bipolar disorder (which is otherwise known as manic depression), is that the mania and the depression phases can last months at a time. In borderline personality disorder, the mood swings are rapid. Your manic phases can come up abruptly and could be gone in a matter of hours.
There are often symptoms like anxiety, aggression, impulsiveness and tendencies to self-harm that accompany the mood swings that borderline personality disorder comes with. These add-on symptoms aren't usually a part of bipolar disorder.
There are a couple of additional wrinkles to this situation too. To begin with, it is possible for a person to have both bipolar disorder and borderline personality disorder at the same time. These diseases are not mutually exclusive.
To add to the confusion, psychiatrists are now beginning to question the very way they define these diseases. They are beginning to argue now that perhaps bipolar and borderline personality disorders are two sides of the same coin. Perhaps they are just two different states of the same disease, they suggest.
Telling Bipolar Apart From Schizophrenia
Schizophrenia is a serious brain disorder that causes a person to act in a psychotic manner. He gets hallucinations, experiences logic disturbances, feels an illogical fear of persecution, an inability to function in life and a lack of emotional stability.
How Do Doctors Get This Disease Mixed Up with Schizophrenia?
This happens because bipolar disorder, in its earliest stages, does cause a patient to experience psychosis. Early-stage bipolar disorder can be quite like schizophrenia. The difference is that schizophrenic symptoms tend to stay on. With bipolar disorder, they are episodic.
ADHD and Anxiety Disorder
When a person has bipolar disorder, he can in his manic phases, experience feelings of agitation and be extremely energetic and restless. Unfortunately, a person who suffers from ADHD can experience symptoms that are quite similar.
There are differences, though, that doctors should pay attention to. Bipolar disorder is very rare in children, for instance; and ADHD happens to not be uncommon among that group.
Among both children and adults, doctors can tell the difference between bipolar and ADHD by how bipolar patients tend to have psychotic episodes, while ADHD patients do not.
The anxiety disorder can appear in different shapes and forms. In some people, it manifests itself as OCD. In others, it appears as generalized anxiety disorder or panic disorder. Doctors can sometimes look at the agitation that a bipolar patient experiences and incorrectly identify it as the agitation commonly seen in sufferers of anxiety disorder.
Diagnosing Bipolar Disorder Takes Time
The episodes of mania and depression that you get in bipolar disorder can last for months at a time. To help your doctor see the full picture before delivering a diagnosis, you need to make sure that you see him over an extended period of time – a full year wouldn't be a bad idea. You need to make sure that the doctor gets to hear about everything that you experience. Only then will he have the right kind of information to work with.
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