How Is Bipolar Disorder Diagnosed?
DIagnosis criteria mentioned
Detailed Answer:
Thank you for asking!
Bipolar disorder, or manic-depressive illness (MDI), is one of the most common, severe, and persistent mental illnesses. It constitutes one pole of a spectrum of mood disorders that includes bipolar I (BPI), bipolar II (BPII), cyclothymia (oscillating high and low moods), and major depression. The pathophysiology of bipolar disorder has not been determined, but studies indicate that it has a substantial genetic component.
The diagnosis of BPI requires the following:
A manic episode of at least 1 week’s duration that leads to hospitalization or other significant impairment in occupational or social functioning
The episode cannot be caused by another medical illness or by substance abuse
Manic episodes also must include at least 3 of the following symptoms:
Grandiosity
Diminished need for sleep
Excessive talking or pressured speech
Racing thoughts or flight of ideas
Clear evidence of distractibility
Increased level of goal-focused activity at home, at work, or sexually
Excessive pleasurable activities, often with painful consequences
Hypomanic episodes are characterized by an elevated, expansive, or irritable mood of at least 4 days’ duration, along with at least 3 of the following symptoms:
Grandiosity or inflated self-esteem
Diminished need for sleep
Pressured speech
Racing thoughts or flight of ideas
Clear evidence of distractibility
Psychomotor agitation at home, at work, or sexually
Engaging in activities with a high potential for painful consequences
For major depressive episodes, the person experiences 5 or more of the following symptoms for the same 2 weeks, with at least 1 of the symptoms being either of the first 2 listed:
Depressed mood
Markedly diminished pleasure or interest in nearly all activities
Significant weight loss or gain or significant loss or increase in appetite
Hypersomnia or insomnia
Psychomotor retardation or agitation
Loss of energy or fatigue
Decreased concentration ability or marked indecisiveness
Preoccupation with death or suicide; patient has a plan or has attempted suicide
The symptoms cause significant impairment and distress
The mood is not the result of substance abuse or a medical condition
Mixed episodes are characterized by the following:
Persons must meet the criteria for both mania and major depression; the depressive event is required to be present for 1 week only
The mood disturbance results in marked disruption in social or vocation function
The mood is not the result of substance abuse or a medical condition
Evaluation should address the following:
Appearance
Affect/mood
Thought content
Perceptions
Suicide/self-destruction
Homicide/violence/aggression
Judgment/insight
Cognition
Physical health
Complications (eg, suicide, homicide, and addictions)
Laboratory studies that may be helpful include the following:
Complete blood count (CBC) with differential
Erythrocyte sedimentation rate (ESR)
Fasting glucose level
Serum electrolyte concentrations
Serum calcium concentration
Serum protein levels
Thyroid tests
Serum creatinine and blood urea nitrogen (BUN) levels
Substance and alcohol screening
Other laboratory tests: Urine copper levels, antinuclear antibody (ANA) testing, HIV testing, or Venereal Disease Research Laboratory (VDRL) testing
Other diagnostic modalities that may be helpful include the following:
Magnetic resonance imaging
Electrocardiography
Electroencephalography
Management
Treatment of bipolar disorder is directly related to the phase of the episode and the severity of that phase. It may involve inpatient care, outpatient care, or partial hospitalization or day treatment. Indications for inpatient treatment include the following:
Danger to self
Danger to others
Total inability to function
Total loss of control
Medical conditions that warrant medication monitoring
Pharmacologic agents approved by the FDA for use in treating bipolar disorder are as follows:
Valproate (manic)
Carbamazepine, extended-release (manic, mixed)
Lamotrigine (maintenance; risk of aseptic meningitis[2] )
Lithium (manic, maintenance)
Aripiprazole (manic, mixed, maintenance)
Ziprasidone (manic, mixed)
Risperidone (manic, mixed)
Asenapine (manic, mixed)
Quetiapine (manic, depression)
Chlorpromazine (manic)
Olanzapine (manic, mixed, maintenance)
Olanzapine-fluoxetine (depression)
Electroconvulsive therapy (ECT) has proved to be highly effective in the treatment of acute mania. Other measures that may be considered include the following:
Diet: Unless the patient is on monoamine oxidase inhibitors (MAOIs), no special diet is required; no significant changes should be made in salt intake; adjunctive use of omega-3 may improve bipolar depressive symptoms, though not bipolar mania
Regular exercise
Prevention (medication and psychoeducation)
I hope it helps. Get to a psychiatrist for further management. Don't forget to close the discussion please.
Regards
Two days later i had a full blown mania and i am doubting that the mania is due to nutrient imbalance and not due to mental illness. Is it possible that mania may develop due to physiological reasons such as shock from the treatment for severe dehydration rather than a mental illness.
I went to check several psychiatrists some said i am bipolar other said i am not and that the mania developed due to severe dehydration. How can i be sure?
Then you are not, odds are least likely
Detailed Answer:
Thank you for asking!
That ambiguity is due to you don't fill the criteria for BP disorder. Re read the criteria for diagnosis. That is pretty strict. getting an anxiety panic attack from a dehydration issues is more a psychological issue. mania is too thicker label for such scenario. I think the later proposition of diagnosis is good. Every pathology to simple correctable electrolytes disturbance and dehydration can explain that.
But the final diagnosis needs to established after a comple psychiatric evaluation. If the work up was all that normal as you mentioned , you already dont qualify the criteria so you are not bipolar. just some psychiatric rehab is all you need.
Cheers up and stop getting overwhelmed.
Take care