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Old 12-12-05, 08:58 AM
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Diagnosing Bipolar Disorder: Ruling Out Other Psychiatric Conditions

from Kimberly Bailey
Ask almost any individual with bipolar disorder about how they were diagnosed and you will invariably hear of a long and difficult journey through many wrong turns and misdiagnoses, numerous dead ends and new doctors, abundant changes of direction and differing medications before arriving at the correct diagnosis of bipolar disorder. This is so often the case because the list is rather long of psychiatric conditions with symptoms similar to those of bipolar disorder. To further complicate the picture, most of these disorders can also occur concomitantly with bipolar disorder.

Psychiatric conditions that can manifest symptoms similar to bipolar disorder include:

Attention Deficit Hyperactivity Disorder (ADHD)
Hyperactivity and distractibility are two of the hallmark symptoms of ADHD. However, they are also quite predominant in bipolar disorder, most especially as it relates to children. Recent research seems to indicate that bipolar disorder does occur even in very young children. Many children diagnosed with ADHD are later diagnosed with bipolar disorder often as a co-occurring disorder.

Alcohol/Substance Abuse
It is very common for those with bipolar disorder to struggle with alcohol and substance abuse issues. This is often an attempt, even on an unconscious level, to self-medicate. Additionally, the effects of these drugs (such as hallucinations or the inability to sleep) can be confused with the symptoms of bipolar disorder.

Borderline Personality Disorder
The diagnostic criteria for this disorder include impulsivity, suicidal behavior, reactivity of mood, inappropriate anger, and paranoia. All of these are also associated with bipolar disorder. It is possible for an individual to be diagnosed with both of these disorders.

Delusional Disorder
The hallmark of this disorder is nonbizarre (the situations are possible) delusions. Mood episodes can be a symptom but they are brief in duration and part of the delusion. If a practitioner is not aware of the delusion, the mood may appear to be incongruent to current circumstances and therefore confused as bipolar disorder.

Depression
The one thing that distinguishes unipolar depression from bipolar disorder is mania/hypomania. If a patient with depression swings into an episode of mania, the diagnosis becomes bipolar disorder.

Eating Disorders
It is not uncommon for those with bipolar disorder to experience eating disorders. Moreover, depression, anxiety and irritability often result from eating disorders. Anorexia nervosa is an eating disorder characterized by an extreme fear of gaining weight or getting fat. Those with this disorder often have a body weight of less than 85% of that expected. Bulimia Nervosa is typified by periods of binge eating followed by purging (purposely vomiting).

Panic Disorder
This disorder is characterized by recurrent, spontaneous panic attacks. In that these attacks are traumatic, they do create instability of mood which may be confused with the mood episodes of bipolar disorder. Furthermore, panic attacks are common in those with bipolar disorder.

Schizophrenia
Schizophrenia is a major mental disorder that causes intense disturbances in both cognition (thinking) and emotions (feeling). It consists of two classifications of symptoms positive and negative. Positive symptoms include delusions, hallucinations, disorganized speech and thinking, disorganized behavior, catatonic behavior, and inappropriate moods. Negative symptoms are flattened emotions, lack of speech and a reduction in goal-directed behavior. The symptoms of schizophrenia are easily confused with those of bipolar disorder.

Schizoaffective Disorder
A diagnosis of schizoaffective disorder is given when the symptoms of both schizophrenia and bipolar disorder (predominantly mania) are both present occurring simultaneously. If the symptoms alternate or are not present throughout an episode, a diagnosis of schizophrenia or bipolar disorder (perhaps with psychotic features) is more likely depending on the dominant symptoms. As you would expect, there is a great deal of confusion and controversy surrounding this disorder.

Reference
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IV-TRTM).

http://bipolar.about.com/cs/menu_dia...hcond.htm?nl=1
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Old 06-21-10, 10:03 PM
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Re: Diagnosing Bipolar Disorder: Ruling Out Other Psychiatric Conditions

It's difficult to take good care of a bipolar patient but I learned that you just have to give him maintenance drugs. Maintenance drugs are always important to be taken faithfully.
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Old 01-02-13, 06:32 PM
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Re: Diagnosing Bipolar Disorder: Ruling Out Other Psychiatric Conditions

For women, I think PMDD ought to be added to this list as well, along with other hormonal imbalances.
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Old 01-02-13, 06:47 PM
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Re: Diagnosing Bipolar Disorder: Ruling Out Other Psychiatric Conditions

Thats a hard one because for some women menstration can be a trigger for their Bipolar. Though, I suppose if the only time they expirience an episode is before/durring menstration then Bipolar could be ruled out.
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