News | Published February 12, 2014 | Written by Timothy Derstine, MD, medical director, behavioral health services, Mount Nittany Medical Center

Diagnosing bipolar disorder

Bipolar disorder, sometimes referred to as manic-depressive illness, is an illness in which a person has unusual shifts in mood that range from feeling the lows of depression to the highs of mania. Prior to treatment, the illness often impairs a person’s ability to carry out day-to-day tasks.

In the depressive phase of bipolar disorder, the symptoms may include sadness, loss of interest in previously enjoyed activities, problems concentrating, fatigue, irritability, excessive guilt and suicidal thoughts and behavior. In the manic phase of the illness, the range of symptoms includes prolonged periods of feeling “high,” being in an overly happy or outgoing mood, extreme irritability, poor judgment, rapid speech, racing thoughts, easily distractible, not feeling tired with little or no sleep, exhibiting impulsive or high-risk behaviors and having an unrealistic belief in one’s abilities. At times, people with bipolar disorder may experience depression and mania symptoms concurrently.

Healthcare providers diagnose bipolar disorder using criteria guidelines in the Diagnostic and Statistical Manual of Mental Disorders, which outlines specific criteria defining manic, hypomanic, major depressive and mixed episodes to help diagnose the three different subtypes of bipolar disorder. In Bipolar I disorder, a person has manic episodes along with depressive episodes. Bipolar II disorder includes depressive and hypomanic episodes (less severe than manic episodes). Cyclothymic disorder is a less severe variation of the bipolar spectrum where the symptoms of mania and depression are not as bothersome or as impairing of daily functioning. An exam and diagnostic testing is performed to rule out other illnesses that can mimic the symptoms of bipolar disorder.

It is the depressive phase of the illness that usually motivates someone to get help, and oftentimes family and friends play an important role in assisting the person to seek treatment as they may not see a need. The illness typically responds positively to medication therapy and psychotherapy. As with most illnesses, early diagnosis and treatment promote better outcomes, and many people with bipolar disorder function quite well. 

(Please note that this article was originally published in the February issue of State College Magazine.)