View Full Version : How were you diagnosed with Bipolar disorder?

05-16-13, 11:49 AM
I'm highly suspecting that I will be/could be diagnosed with some form of Bipolar disorder. I'm trying to educate myself the best I can, but there are some questions below that would be helpful to me along the way.

Thank you for taking the time to read and give your answers/experiences...

What did the process consist of?

Is there a "standard" method of diagnosis that I should be aware of?

What tests or assessments did you have to complete (if any)?
> If you completed more than one, how many did it take before the results were clear?
> What did it/they consist of?
> Was it/were they effective in providing accurate feedback for your situation?

Are there any warnings you would give or red flags I should be on the look out for when speaking with my psychologist?

05-17-13, 01:07 PM
I've always had bad mood swings but I never suspected I was bipolar (strange because I was always convinced that my mom is bipolar). I've been suffering from depression for the last 10 years but it was only when I suspected that I might have ADHD that I saw a professional. None of them believed I had ADHD, neither my GP, nor any of the psychiatrists saw. They all said that my ADHD like symptoms were caused by severe depression.

I started taking anti depressants and though they helped with depression they made my mood swings worse. I kept complaining to my GP about mood swings and finally she suggested that I see a psychiatrist, who specialises in bipolar disorder. The specialist diagnosed me with bipolar disorder type II.

The standard method of diagnosis is a detailed interview with a psychiatrist. Some might ask you to fill in a questionnaire. I didn't. I wasn't given any tests either.

05-17-13, 03:19 PM
Hi there! Here was my history/diagnostic process in a nutshell:

First major depressive episode at age 12. First hypomanic episode at 15. Pediatrician at the time had a god complex and never referred me to a psychiatrist (not sure I would have been cooperative at that age anyway though). She gave me antidepressants which made me wildly manic. Mom thought I was on drugs, I never received treatment, nobody thought anything about it and the episode died down on its own.

I had further major depressive episodes at 14, 16, 17, and 19. I had manic episodes at 15, 17, and 20 (the last one turning into a mixed episode). It was the major depressive episode at 19 that made me seek help from a psychiatrist at the university I was doing my undergrad studies at. She diagnosed me tentatively with bipolar disorder NOS, aware that something was wrong but not having witnessed any of my manic episodes yet and unsure of what "type" of bipolar we were dealing with.

The next year I had a phenomenal manic episode that turned mixed, and at 20 received the diagnosis of bipolar I disorder. I did not believe her, so I went to a second psychiatrist, who also diagnosed me with bipolar I disorder. I did not believe him, so I went to a third psychiatrist, one who is very highly esteemed and specializes in bipolar disorder... and (no surprise) he also diagnosed me with bipolar I disorder.

After 3 separate doctors diagnosed me with the same illness, I decided it was probably time to accept my diagnosis and figure out how to treat it and live the best life possible with this illness. I've gone through about a dozen antidepressants and mood stabilizers, in varying combinations, trying to find the right cocktail that, along with therapy and lifestyle adjustments, keeps my moods under wraps. I haven't had a manic episode in a while (the last one having been triggered by Ritalin). I have hypomanic episodes here and there, but nothing too expensive. I am currently having a pretty fantastic depressive episode (try not to drown in the sarcasm there), but I'll get through it. I always do.

The actual diagnostic process usually consists of a lengthy interview (mine have been from 45-90 minutes) with the psychiatrist. During that interview they ask you questions about why you're there. They have you detail your current symptoms and give a history of your symptoms over time - when the problem started, how many episodes have you had, of what types, etc. They will ask you just how serious the symptoms were - was it bothersome but ultimately tolerable, or did it completely destroy your life?

They will also ask you about your family history of mental illness - do you have any relatives who also have depression, bipolar disorder, schizophrenia, anxiety disorders, substance abuse issues, suicide attempts, etc. A lot of these disorders are strongly genetic, so family history can help shed light on diagnosis. They will ask you if you've been using drugs or alcohol to try and self-medicate, because it is not possible to make a diagnosis in the presence of current substance abuse.

They may have you take a questionnaire or two to help quantify your type and severity of symptoms. Psychiatry is, ultimately, a subjective science, but there are a few different questionnaires that help scale the type and severity of symptoms. Those tools might help your psychiatrist figure out just how bad things are.

For example, the PHQ-9 is a survey on a 0-3 scale where you are asked a series of questions and you rate how often it applies to you. It is scored on a 0-20 scale, with 5 being mild, 10 being moderate, 15 being moderate-severe, and 20 being severe. There is no "cut off" for depression, but the results of something like that can help the psychiatrist see just how much the symptoms are impacting your daily life.

The MDQ is another survey that is sometimes given when bipolar disorder is suspected. Unlike the PHQ, the MDQ screens for both depressive and manic type symptoms. But again, there is no "cut off" for scoring in such a way that definitely means yes or no. And to be honest, your psychiatrist should be asking you all these questions themselves anyway, not throwing a stack of paperwork at you and diagnosing you based on the results of a few questionnaires.

When you're at your intake appointment, I would say to be wary of any doctor who makes definite statements. Anyone who says, "Oh, you definitely have this" or "People like you always have this." Anyone who operates in black and white like that is not a good psychiatrist, because mental health isn't black and white. I would also encourage you to look for a professional who seems to be genuinely listening to you, who asks probing questions, and most of all, who wants you to be an active part of your treatment.

If your doctor doesn't like you asking questions about your treatment, LEAVE. Run, don't walk. Find a doctor who wants you to be an active part of your treatment, because that is how you're going to get better. Not as a passive pill-popper, but as part of a team achieving wellness.