How do I find out if I have bipolar disorder?

Cycling between the poles of high-high (mania) and low-low (depression) is the very essence of the diagnosis of bipolar disorder, which contrasts with major and mild-to-moderate depression -- disorders characterized by lows without intervening manic highs (hence the name unipolar depression used sometimes for depression).

To be diagnosed as having a manic episode, a person must experience manic symptoms -- feeling unusually high, euphoric, elevated or expansive -- for at least one week and also experience three or more of the following symptoms:
  • inflated self-esteem and grandiosity
  • marked decrease in the need for sleep
  • talkative with rapid, pressured speech
  • flight of ideas (rapidly racing thoughts)
  • distractibility
  • increase in goal-directed activity
  • excessive involvement in pleasurable activity with a high risk of painful consequences (buying sprees, sexual indiscretions or foolish investments
Doctors use several different tools to learn about your condition and make a diagnosis:
  • Questionnaires. Your doctor may use questionnaires to check for bipolar disorder and other mental health problems. The questionnaires ask about your symptoms at different times. They may also ask about stress, your coping style, and the support you have in your life.
  • Medical history. Your doctor asks about your past and present illnesses and your family history.
  • Family input. Your doctor may ask if he or she can talk with family members or close friends to get their insights on your symptoms.
  • Physical exam. An exam helps your doctor know if your symptoms come from something other than bipolar disorder.
  • Guidelines for diagnosis. Your doctor compares your information to the standard medical definition for bipolar disorder.
Bipolar Disorder, like depression, has been part of the human condition since the dawn of humankind. In fact it can be persuasively argued that people with bipolar disorder have shaped the course of human history via influence in many fields, including the arts, religion, politics, medicine and economics. At the same time, bipolar disorder and its associated conditions (e.g., drug and alcohol abuse, divorce etc.) can extract a great toll in terms of human suffering and mortality (e.g., cardiovascular disease, suicide).

Determining whether one has the disorder requires a very careful longitudinal history, multigenerational family history and collection of collateral history directly from family members. While the incidence of depression seems to be clearly rising, the incidence of bipolar disorder remains stable at 1-2 % of the population. Thus it is not surprising that the genetic influence in identical twins (separated at birth) is stronger in the case of bipolar disorder, than it is in depression.
Dr. Michael Roizen, MD
Internal Medicine
Typically, if you or your family or friends suspect that something is not right with how you’ve been acting and feeling compared to normal, you will be referred to a doctor to rule out physical problems that may be causing your symptoms. If nothing comes up abnormal, you may be referred to a specialist who will ask you about your feelings, thoughts, and behavior. He may do a psychiatric assessment, or ask you to fill out a questionnaire. Your family and friends may also be asked about changes in your mood or behavior.
Bipolar disorder is a complex diagnosis to make. The symptoms of bipolar disorder overlap with many other disorders including unipolar depression, borderline personality disorder, schizophrenia and attention deficit disorder. Diagnosis is critical as it implies the need and potential benefit from specific therapies. The diagnosis needs to be made by a skilled mental health professional. If the diagnosis is unclear, it can often take some time for the full picture to evolve. A second opinion is often a very helpful strategy if there is uncertainty.  
Your doctor can help you figure out whether you have bipolar disease. Medical doctors will usually ask you questions, give you a physical exam and use tests to tell if you have this disorder. The tests might include analyzing a sample of your blood or making an image of your brain. These tests cannot tell for sure whether you have bipolar disorder, but they can rule out other problems, such as a stroke, which could cause similar symptoms. If your doctor thinks you have bipolar disorder, or is having trouble deciding, he or she may refer you to a mental health expert, such as a psychiatrist.
Keith Star
Only a licensed psychologist or psychiatrist can diagnose bipolar disorder. It is recommended if you feel you may have bipolar disorder to seek medical attention for evaluation.
Charles J. Sophy, MD
Adolescent Medicine

The best and only true way to if you may be suffering from Bi-Polar D/O is to have a mental health assessment from a qualified mental health professional. You will be able to access one from your medical provider asking for a referral, or from your insurance carrier. There are several criteria that must be in line to diagnose Bi-Polar D/O. You may also look at this criteria in the Diagnostic Statistical Manual (DMS) that is sold in most bookstores and also on line. It is a book listing all the criteria for all mental health disorders.

Mona A. Schulz, MD
Bipolar disorder is a psychiatric diagnosis given to you by a licensed mental health professional when your problems with depression and moodiness fit the strict criteria of a profile listed in the American Psychiatric Association guidebook called the Diagnosis and Statistical Manual of Mental Disorders.

After your mental health provider interviews you, they will see if the characteristics of your depression and moodiness fit the criteria of bipolar I or bipolar II. In order to have either type of bipolar disorder you must have episodes of major depression for at least two weeks long, which must include five or more of the following features:
  • A depressed mood, with sadness, emptiness and tearfulness.
  • No pleasure or satisfaction from daily activities.
  • A significant gain or loss of weight.
  • Inability to sleep at night or stay awake during the daytime.
  • Slow-motion thoughts and movements.
  • Fatigue and loss of energy.
  • You innermost thoughts turn against you - you think you are worthless and you blame yourself for everything.
  • You can't concentrate, you feel your memory is "going" and you can't make decisions.
  • You think about death, or you want to die, or you want to kill yourself.
Next, the practitioner determines whether you have moodiness and elevated mood states that are either true mania (bipolar I) where you lose touch with reality, or hypomania (bipolar II) where you simply get out of control but "not out of touch." Bipolar I, where your mood elevates to such heights that it causes you to lose touch with reality, have bizarre, frenzied thoughts, speech and behavior. A manic episode lasts at least a week, where the individual won't sleep and will lose absolute restraint over sex, spending and other choices.

Your mental health provider may give you the diagnosis bipolar II where your moodiness is called "hypomania," a term used to describe those "moods" lasting at least four days where you are in an expansive "high" or irritable state. In bipolar II, your moods don't cause you to lose touch with reality. Depending upon how strict a practitioner follows the Diagnosis and Statistical Manual of Mental Disorders criteria, more people in the 21st century are receiving the bipolar II disorder diagnosis than ever before.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.