Bipolar disorder cannot be identified through a single blood test, X-ray or brain scan. To allow a proper diagnosis it should be based on current symptoms, the course of the illness, the patient's history and the family history (when available).
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At the start of the diagnostic process the person should get a physical examination to rule out any other illnesses that might cause the mood changes. The person often denies that anything is wrong or blames the problems on some cause other than mental illness. Therefore the role of family members or friends is crucial to a correct diagnosis because they can explain when and how the person started acting very differently from usual. Because bipolar disorder is a cyclical mood disorder it is extremely important that the doctor has an overview of the patient's psychiatric history and does not overlook previous episodes. In addition, information about family history can be extremely valuable, because it is known that bipolar disorder runs in families.
Why is it so difficult to make a correct diagnosis?
People with bipolar disorder can suffer for years before they are properly diagnosed and treated. The great diversity in bipolar disorder (variable severity, type, frequency and duration of episodes) makes it difficult to recognize the illness, even for physicians.
People may not seek treatment during a hypomanic or manic episode because they do not always recognize how unwell they are. On the other hand if they seek help during the depressive episode they are often misdiagnosed as having depression. An additional difficulty in diagnosing bipolar disorder is that many of the symptoms may appear to be part of another illness such as major depression, schizophrenia or other mental disorders. Finally, in the early stages bipolar disorder may seem to be a problem other than mental illness. It may at first look like alcohol or drug abuse, or poor school or work performance.
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Item code: NPR/08-0048
Date of Preparation: July 2009
