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Diagnosis

Medical Diagnosis. Diagnosis in the field of medicine. Determination of which disease or condition is causing a person’s signs and symptoms.

Lots of People don`t Know they are Bipolar

It seems to be a lot of people that don`t know what bipolar disorder is

There are people that I know that probably are bipolar, but they just don`t know it.
They have never been to counseling at a mental health professional to get diagnosed, because no one has told them that their problems, in fact, can be a mental illness.

Mental Mind SpiralOften-lot, grown-up people (age from 30 years and up) are not informed about what bipolar disorder is all about. They don`t know what it means, what it includes, how to get help and where to get help. Often-lot, not always.
The whole thing started probably when they were young, when bipolar disorder and all other mental illnesses were hush-hush and taboos’.

Of course, taboos and lack of information are not only a concern for those who might be bipolar, but for all kinds of mental illnesses that I know about.

If one suspects that a family member, a close friend or a coworker, has a mental illness, it is not easy to tell the person about what one believe/suspect.

Some people might suspect (themselves) that they have a mental illness, but are too proud to admit it, and for that reason not seek help from a counselor. They will probably never take any advice from others either regarding such sensitive personal things, having all taboos’ fresh in mind.

So, how do we approach these people – what are we supposed to do to let them know about our thoughts? Letting them know that there might be a “solution” to their problems. That it is somehow treatable – using medications. Tell them that it`s not their fault – they have an illness. They may at least feel better just by knowing.

Since IBipolar Mental Illnness suspect that a friend of mine is bipolar, should I contact a mental health professional just to ask for advice about how to approach my friend? I must admit; the thought has crossed my mind in several occasions related to some friends of mine, and especially in the case of member of my family.

I didn`t expect it to happen, but not long ago I got an opportunity to ask this special person in my life (my family member) how he felt about me asking a psychologist questions.

Just to get sorted things out. His answer was: don`t!
He didn`t want me to ask because he meant he had everything under control, and wanted to “mind his own business”. It wasn`t said in a rude way, he wasn`t angry with me, so, since he is an adult, I had to let it go.

Was that the right decision to make? I don`t have an answer to that question right now, so if anyone out there have an input to come with, please do – right here on this site, or on our Facebook page.

Lots of people that don`t know what bipolar disorder is

Bipolar Disorder – Euphoria vs. Dysphoria or Mixed Episode

Most symptoms of Manic Episodes appear to be positive

Manic-depression or Bipolar disorder is usually perceived on of two ways – a person who alternates between depression and euphoria – or a person who alternates between depression and craziness.

Often a person who is told that they are bipolar will identify one of those two states – and will object based on the fact that they have never been “euphoric“, and they have never been actually psychotic or “crazy”.

Bipolar disorder or Manic-Depression is defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) – “the Bible” of psychiatric disorders – as “…clinical course that is characterized by the occurrence of one or more Manic Episodes…”

7 “points” retrieved from: DSM IV Criteria for Manic Episode – Food and Drug Administration

A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least one week. With three or more of:

1. Inflated self-esteem or grandiosity
2. Decreased need for sleep (e.g., feels rested after only three hours of sleep)
3. More talkative than usual or pressure to keep talking
4. Flight of ideas, or subjective experience that thoughts are racing
5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
6. Increase in goal-directed activity (either socially, at work or school or sexually) or psychomotor agitation
7. Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

There is another specifier – “The symptoms do not meet criteria for a Mixed Episode” which is left out in a lot of thought processes.

Bipolar - EuphoricOne problem that is often encountered when diagnosing Bipolar disorder – or when trying to convince someone who has Bipolar disorder that they do, indeed have the illness – is that most of the “symptoms” of a Manic Episode appear to be “positive” or “happy.”  If you examine the wording – it looks on the surface and is often described as periods of “Euphoria” or extreme happiness.

In truth, many people with Bipolar disorder don’t have periods of “euphoria,” they don’t have what is perceived as “inflated self-esteem or grandiosity“, and they don’t seek out “excessive involvement in pleasurable activities.”  They may have “dysphoria,” they may believe that they have to do everything themselves, they may experience psychomotor agitation…they may be in a really active bad mood.

This is a state of “dysphoria.”  It is also called a “mixed state” where the Manic Episode and the Depressive Episode occur at the same time.  Features may include the racing thoughts, irritability, lack of sleep, psychomotor agitation of a Manic Episode but also include anhedonia or lack of enjoyment, inappropriate guilt, or suicidal thoughts which are symptoms of depression.

Unfortunately, this disconnects in presentation, and lack of awareness of mixed states (in both the patient and some professionals) often gives the bipolar patient an “easy out” in acceptance of the diagnosis.

Melissa Lind

Mixed Episode or Manic Episode with Mixed Features is given too little attention!

Diagnosis and Symptoms of Bipolar Disorder

Bipolar disorder is difficult to diagnose.

The average bipolar patient will see three mental health professionals before getting the right diagnosis. In fact, one-third of bipolar patients will not be diagnosed with the disorder until more than 10 years after they first seek treatment.

There is a lot of similarity between the symptoms of bipolar disorder and other psychiatric conditions, but that isn’t the only reason why it is so difficult to diagnose. Here are some of the complicating factors:

Bipolar Disorder PatientThe patient only talks about depression – as bipolar disorder is a condition that has periods of depression alternating with manic episodes, many patients present when they are depressed. This is particularly true when a patient seeks treatment for themselves. Manic patients feel good or at least energized and are unlikely to believe that anything is wrong. Either they feel terrific, or they are in a heightened “bad” mood – and likely to blame that on other people or life circumstances. Consequently when they first seek treatment – they only profess to the depression as that is most bothersome.

Bipolar disorder looks like anxiety – in actuality, many, if not most bipolar patients also have some type of anxiety disorder. Consequently it may be very difficult for mental health professional to root out bipolar disorder. If patients are seen as agitated, hyperactive or fidgety, they may be only asked about anxiety or given a self-rating scale for anxiety. This would immediately lead the practitioner to diagnose an anxiety disorder – unless careful investigations were done.

Substance abuse can be complicating the issue – many bipolar patients spend years self-treating with substances of abuse. This includes prescription medications, recreational drugs and alcohol. There is not any particular drug that is more often abused by bipolar people as a whole – some will choose alcohol, some will prefer stimulants, some will choose pain medications – all of which will mask the symptoms to some extent. In some cases, the substance abuse appears to be more problematic than anything else and in cases of addiction; the substance abuse must be treated before an accurate evaluation can occur.

Denial is very common – Denial is a nice way of saying dishonesty. That would be lying. This sounds very harsh but in many cases, bipolar patients will not be honest about difficulties that they have had. It may be subconscious dishonesty in that they, themselves do not really know what the problem is. Lack of awareness is common but outright denial is also common. Many bipolar patients absolutely refuse to accept the diagnosis when it is first presented – even after years of not being treated properly. Oddly, this may make it more likely that the practitioner believes that the patient has bipolar disorder but such outright denial delays treatment.

These are just a few of the reasons why bipolar disorder is so difficult to pin down and, unfortunately, delayed treatment can have huge life implicationsBipolar disorder is one of the riskiest psychiatric illnesses to have and can have severe consequences for the patient who is not properly diagnosed and medicated – including job losses, family disturbance, institutionalization, jail and even death.

Bipolar disorder affects not only the patient himself – but family and loved ones as well.

Why is it so difficult to diagnose bipolar disorder?

Counseling for Depression

Depression does require medication.

If you suffer from depression, and your doctor has prescribed an antidepressant for you, you will find that, in about three weeks, you are able to function in your life again — even while taking the medication.

Depression MedicationUnfortunately, this gives people a sense of “I’m all better now” that isn’t quite true. You see; depression does require medication, but it also requires counseling. Without proper counseling, you will never get to the root of the problem — what is causing the depression. The medication will not make that go away — it only deals with the symptoms of depression.

Counseling is needed to deal with the cause of the depression.

Counseling for depression may have two parts. The first part may be traditional therapy so that the counselor can help you to discover what the problem is, in the event that you do not already know. Sometimes depression has no visible cause. Other times, it may be caused by a physical condition that does not need any counseling at all — the depression lifts when the condition is treated.

So, traditional therapy may be needed, but that will usually be followed with Cognitive Behavioral Therapy, or CBTCognitive Behavioral Therapy essentially teaches you a new way of thinking — a new way of looking at or approaching a problem, — something that enables you to deal with the problem in a more constructive, timely manner. Once the problem that is causing the depression is taken care of, the depressed state lifts.

CBT can take anywhere from 12-20 weeks. Furthermore, depending on the severity of your depression, your doctor may not feel that counseling should be sought until the medication prescribed has a chance to work. On the other hand, he (or she) may think that the depression warrants immediate counseling. This varies from one individual to another.

Note that most therapists are not licensed to prescribe medication. That requires a medical doctor or a psychiatrist.

Diagnosing Depression

Often the cause of depression is easily discovered.

Diagnosing depression is easy in some cases, and extremely difficult in others. If you find that you have been suffering from the symptoms of depression for more than two weeks, it is vital that you visit your doctor to find out what the problem is. Only a doctor can determine whether or not clinical depression exists, and whether or not treatment is required.

Depression - One Lonely ManYou should start with your medical doctor. He or she will perform a physical exam to see if there is a health problem that could be causing your depressed feeling. He will not only inquire about your physical state, but also he may also ask about medications that you are taking, your consumption of caffeine, your consumption of nicotine, your consumption of alcohol, and your consumption of illegal drugs. He or she may perform a blood test as there are certain viruses and other illnesses that can cause one to experience symptoms of depression, as well.

Once the physical exam is complete, your doctor may or may not refer you to a counselor for further diagnostic testing. They may also prescribe you an antidepressant; however, this is usually just for the short term, to see if the problem causing the depression passes. If the depression continues, however, the doctor will need to refer you for counseling.

The cause of depression is often easily discovered. If it isn’t a health problem, there may be something going on in your life that causes the depression. For this reason, your doctor and/or counselor may ask personal questions concerning your life or lifestyle. It is vital that you are totally honest with your health care professionals so that they can accurately diagnose and treat the problem. For this reason, it is noteworthy that you talk with your doctor alone. Have family members wait at home or in the waiting room.

Also read; Anxiety and Depression

Understanding Mental Illness and Diagnosis

Many people are confused by mental illness and many will claim that they simply do not exist.

Mental Illness - Sad TeenagerThey mean that such conditions are caused by the persons experiencing it. However, every day there are counselors who are diagnosing people as having a mental illness conditions. The disease is difficult to determine because of this, whether or not a diagnosis is correct. Also because of this, there are many controversies surrounding these conditions.

Mental health is essential for everyday life. Most people are fit to go through life without glitches in their mental activity, but others seem to have constant interruptions. It`s these interruptions that show us that there is something going wrong in the brain of these individuals and that there is an existing problem.

To understand interruptions that occur in the brain we need to look at different diagnoses and symptoms. We could use bipolar depression for this example. Bipolarity is one of the most common disorders diagnosed in today`s society. In fact, you probably know someone with bipolar depression you just don`t know that they have it. Bipolar disorder is extremely common, but many people do not fully understand the condition.

Bipolar is a chemical imbalance in the brain. Meaning; the brain is denied of vital nutrients that it needs to maintain a stable mindset. Since lots of people are diagnosed bipolar, they do not have their whole life experiences taken into consideration; this can be an enormous problem for them.

We all experience stress, trauma and excitement in our lives. However, not everybody deals with these stressors the same way as somebody else would do. No one should be expected to cope with such stressors the same way as everybody else would do. There is a process that takes place that brings on the condition of bipolar depression.

The first thing we must consider is that all have some “triggers” in life. That triggers might be traumatic events that occur in one’s life. Now, everybody deals with these differently.

Some people will react negatively, and others ignore. Those individuals who ignore these issues are generally not hearing the messages in between. This is how we can separate a mentally ill mind from a so called “normal” way of thinking.

The mentally ill mind tends to consume everything in life that is said. They get it all, and they fell all of that process in their heads until this begins to cause confusion. The “normal” mind tends to listen only to what it wants to listen to, and they do not have these conflicting thoughts to cause the mental confusion.

To better understand this process, it helps also to understand cognitive mental health disorders and how these are related to the confusion that occurs in the mind.