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TherapistMarryAnn, Therapist
Category: Mental Health
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Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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How is bipolar disorder diagnosed?

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How is bipolar disorder diagnosed?
Hello, I'd like to help you with your question.

Bipolar is diagnosed based on a list of symptoms, family history (Bipolar can be hereditary) and other factors. It is thought to be caused by an imbalance in brain chemistry but it cannot be diagnosed through medical testing, only a mental health evaluation. Therefore, the best way to diagnose Bipolar is to see a mental health therapist and not your regular doctor. A full evaluation is done of your symptoms then if you fit the criteria from a mental health manual called the DSM (Diagnostic and Statistical Manual of disorders) , then you are diagnosed. A course of treatment is then decided based on your individual needs and goals.

If you are experiencing symptoms, your first step should be to see your family doctor. You want to rule out any possible physical cause of your symptoms. That way, you are not being treated for a mental health issue when in fact you have a physical issue that needs medical attention.

If you are cleared by your doctor, then you can see a mental health professional. They will ask a series of questions that will provide the needed information to see if you fit the criteria for Bipolar.

Here are the DSM criteria for Bipolar disorder:

Here is more information about Bipolar and what you can do if you are diagnosed:

I hope this has helped you,
Customer: replied 4 years ago.
I was diagnosed with bipolar but only experienced one episode of mania at the beginning of an antidepressant treatment of celexa. This mania started after my family doctor increased the dose from 20- 40 mg. I have never had a mania before this nor have I experienced a mania since and it has been 11 years.
It sounds like you might have experienced a serotonin overdrive which is caused when you take more medication than you need for your situation. It is usually a one time event where your body's supply of serotonin was increased and it caused the mania.

It would be advisable for you to get a second opinion from a mental health professional such as a psychiatrist who is trained in medical and mental health, rather than your family doctor.

Customer: replied 4 years ago.
This was diagnosed by a psychiatrist. I thought that an antidepressant induced mania didn't count towards a bipolar diagnosis.
You most likely had an induced symptom through a medication increase. It is not a symptom of Bipolar per say since it was most likely induced by the medication and not part of your diagnosis. That is why it is so important for you to see a psychiatrist and have your medications looked at in detail. A psychiatrist needs to sit down with you and get all of the information about your experience so it can be determined why the episode occurred and if it was indeed the medication that caused the mania. I can only suggest that is what caused it because of the limits of our interaction but a psychiatrist can be more specific. Your family doctor is not able to do that for you because you need someone with specific mental health training who knows what to look for with your symptoms and medication.

Customer: replied 4 years ago.
I was diagnosed with bipolar by a psychiatrist. I was saying that my family doctor was the one who first gave me the antidepressant. I wasn't referred to a psychiatrist till after the mania which left me $60,000 in bankruptcy. After the mania ended I suffered a depression after I realized all the devastation I had done. I was put in the mental health center for a suicide attempt and it was there that a psychiatrist diagnosed me with bipolar. This diagnosis stuck with me for 11 years and recently I came across information on the Internet about the DSM criteria in diagnosing bipolar and how it states that a mania while on antidepressants does not count towards a diagnosis of bipolar. I brought this to my psychiatrist attention ( my third psychiatrist in 11 years) and she reviewed my records and said she could no longer treat me for bipolar and changed my diagnosis to unipolar and a few months later discharged me and said she no longer had any concerns. For 11 years I believed I had a lifetime illness and took bipolar medication for 11 years everyday.
Sorry about the confusion. I was under the impression that it was your family doctor that increased your medications recently. If so, then you might need a psychiatrist to re evaluate the situation. But if this happened in the past, that changes the situation.

It sounds like you have been through a very awful experience. You should not have even be put on anti depressants if you do have Bipolar and after 3 psychiatrists someone should have caught this. You may want to consult an attorney if you feel that you have been wrongly diagnosed and treated. You can also contact a patient advocate which would really help you sort out your situation and find the help you deserve. Here are some resources to help:

You may also want to contact your local community mental health center as well as your local government for advocates in your area.


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Customer: replied 4 years ago.
I was put on Effexor and lithium for 11 years with the bipolar diagnosis. I now suffer from OCD and have tried to go off the Effexor but relapsed into a severe depression after 6 months. I am off the lithium for a year now. I was just wondering if the psychiatrist fell below the standard of care in my situation?
And you mentioned I shouldn't have been on an antidepressant if I was diagnosed with bipolar? So I should have not been on Effexor and lithium ?
Customer: replied 4 years ago.
Incase there was some confusion I was originally put on celexa by my family doctor for depression. I experienced the mania while being treated for depression. After I was admitted to the mental Heath center I was there diagnosed with bipolar and taken off the celexa and put on Effexor and lithium.
Lithium is the best treatment option for Bipolar but if you cannot take Lithium for some reason then another medication for Bipolar is the best course of treatment for you. Just anti depressants alone however are probably not the best but anti depressants in a very small dose plus a Bipolar medication is ok.

I cannot judge whether or not your psychiatrist fell below standard of care as that is more geared towards a legal question or asking anther psychiatrist. I am not qualified in either.

In conclusion, you would benefit from an evaluation of your situation from an objective professional such as a therapist or another psychiatrist with patient advocacy involved so your care is carefully monitored.


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