When is bipolar usually diagnosed

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Currently, they believe several factors may contribute, including: Genetics. But the role of genetics is not absolute: A child from a family with a history of bipolar disorder may never develop the disorder. Studies of identical twins have found that, even if one twin develops the disorder, the other may not. A stressful event such as a death in the family, an illness, a difficult relationship, divorce or financial problems can trigger a manic or depressive episode. Brain structure and function.

Brain scans cannot diagnose bipolar disorder, yet researchers have identified subtle differences in the average size or activation of some brain structures in people with bipolar disorder.

Diagnosis To diagnose bipolar disorder, a doctor may perform a physical examination, conduct an interview and order lab tests. Four Types of Bipolar Disorder Bipolar I Disorder is an illness in which people have experienced one or more episodes of mania. Most people diagnosed with bipolar I will have episodes of both mania and depression, though an episode of depression is not necessary for a diagnosis. Cyclothymic Disorder or Cyclothymia is a chronically unstable mood state in which people experience hypomania and mild depression for at least two years.

People with cyclothymia may have brief periods of normal mood, but these periods last less than eight weeks. Treatment Bipolar disorder is treated and managed in several ways: Psychotherapy , such as cognitive behavioral therapy and family-focused therapy. If you or a friend or family member are thinking about taking part in clinical research, this page contains basic information about clinical trials.

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There are three types of bipolar disorder. All three types involve clear changes in mood, energy, and activity levels. Less severe manic periods are known as hypomanic episodes.

Bipolar disorder is typically diagnosed during late adolescence teen years or early adulthood. Occasionally, bipolar symptoms can appear in children. Although the symptoms may vary over time, bipolar disorder usually requires lifelong treatment. Following a prescribed treatment plan can help people manage their symptoms and improve their quality of life.

People with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns and activity levels, and uncharacteristic behaviors—often without recognizing their likely harmful or undesirable effects. During an episode, the symptoms last every day for most of the day. Episodes may also last for longer periods, such as several days or weeks. Do risky things that show poor judgment, such as eat and drink excessively, spend or give away a lot of money, or have reckless sex.

Sometimes people experience both manic and depressive symptoms in the same episode. This kind of episode is called an episode with mixed features. People experiencing an episode with mixed features may feel very sad, empty, or hopeless, while, at the same, time feeling extremely energized. A person may have bipolar disorder even if their symptoms are less extreme.

For example, some people with bipolar disorder Bipolar II experience hypomania, a less severe form of mania. During a hypomanic episode, a person may feel very good, be able to get things done, and keep up with day-to-day life.

The person may not feel that anything is wrong, but family and friends may recognize the changes in mood or activity levels as possible bipolar disorder.

Without proper treatment, people with hypomania can develop severe mania or depression. Proper diagnosis and treatment can help people with bipolar disorder lead healthy and active lives. Talking with a doctor or other licensed health care provider is the first step. The health care provider can complete a physical exam and order necessary medical tests to rule out other conditions.

The health care provider may then conduct a mental health evaluation or provide a referral to a trained mental health care provider, such as a psychiatrist, psychologist, or clinical social worker who has experience in diagnosing and treating bipolar disorder. Accurate diagnosis in youth is particularly important. Note for Health Care Providers: People with bipolar disorder are more likely to seek help when they are depressed than when they are experiencing mania or hypomania.

Taking a careful medical history is essential to ensure that bipolar disorder is not mistaken for major depression. This is especially important when treating an initial episode of depression as antidepressant medications can trigger a manic episode in people who have an increased chance of having bipolar disorder.

Some bipolar disorder symptoms are similar to those of other illnesses, which can make it challenging for a health care provider to make a diagnosis. In addition, many people may have bipolar disorder along with another mental disorder or condition, such as an anxiety disorder , substance use disorder , or an eating disorder.

People with bipolar disorder have an increased chance of having thyroid disease, migraine headaches, heart disease, diabetes, obesity, and other physical illnesses. Psychosis: Sometimes, a person with severe episodes of mania or depression may experience psychotic symptoms , such as hallucinations or delusions. For example:. As a result, people with bipolar disorder who also have psychotic symptoms are sometimes incorrectly diagnosed with schizophrenia.

When people have symptoms of bipolar disorder and also experience periods of psychosis that are separate from mood episodes, the appropriate diagnosis may be schizoaffective disorder.

Anxiety: It is common for people with bipolar disorder to also have an anxiety disorder. Misuse of Drugs or Alcohol: People with bipolar disorder may misuse alcohol or drugs and engage in other high-risk behaviors at times of impaired judgment during manic episodes.

Although the negative effects of alcohol use or drug use may be most evident to family, friends, and health care providers, it is important to recognize the presence of an associated mental disorder. Eating Disorders: In some cases, people with bipolar disorder also have an eating disorder, such as binge eating or bulimia.

Researchers are studying the possible causes of bipolar disorder. Brain Structure and Functioning: Some studies indicate that the brains of people with bipolar disorder may differ from the brains of people who do not have bipolar disorder or any other mental disorder.

Learning more about these differences may help scientists understand bipolar disorder and determine which treatments will work best. You will usually be offered an antipsychotic first. The common antipsychotics used for the treatment of bipolar disorder are:. Sodium valproate is an anticonvulsive medication.

Your doctor will suggest different dosages and combinations to you depending on what works best for you. Your personal preferences should be listened to. Depression Your doctor should offer you medication to treat depressive symptoms. You may be offered the following medication:.

If you would like to take medication, doctors will use different dosages and combinations depending on what works best for you. If you have an episode of depression you should be offered medication and a high intensity talking therapy, such as:.

What is cognitive behavioural therapy CBT? CBT is a talking therapy that can help you manage your problems by changing the way you think and behave. What is interpersonal therapy? Interpersonal therapy is a talking therapy that focuses on you and your relationships with other people. Bipolar disorder is a life-long and often recurring illness.

You may need long term support to help manage your condition. Your doctor will look at what medication worked for you during episodes of mania or depression. They should ask you whether you want to continue this treatment or if you want to change to lithium.

Lithium usually works better than other types of medication for long-term treatment. Your doctor should give you information about how to take lithium safely. If lithium doesn't work well enough or causes you problems, you may be offered:. Your doctor should monitor your health. Physical health checks should be done at least once a year.

These checks will include:. You should be offered a psychological therapy that is specially designed for bipolar disorder. You could have individual or group therapy. The aim of your therapy is to stop you from becoming unwell again. Family intervention is where you and your family work with mental health professionals to help to manage relationships.

This should be offered to people who you live with or who you are in close contact with. The support that you and your family are given will depend on what problems there are and what preferences you all have. This could be group family sessions or individual sessions. Your family should get support for 3 months to 1 year and should have at least 10 planned sessions. If you want to return to work, you should be offered support with that including training.

You should get this support if your care is managed by your GP or by your community mental health team. You might not be able to work or to find any. Your healthcare professionals should think about other activities that could help you back to employment in the future. Your healthcare team should help you to make a recovery plan.

The plan should help you to identify early warning signs and triggers that may make you unwell again and ways of coping. Your plan should also have people to call if you become very distressed.

CPA is a package of care that is used by secondary mental health services. You will have a care plan and someone to coordinate your care. All care plans should include a crisis plan. CPA should be available if you have a wide range of needs from different services or you are thought to be a high risk. Both you and your GP should be given a copy of your care plan. Your carers can be involved in your care plan and given a copy if you give your consent for this to happen.

You can speak to your doctor about your treatment. You could ask what other treatments you could try. Tell your doctor if there is a type of treatment that you would like to try. Doctors should listen to your preference. A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. You can also ask for a second opinion if you disagree with your diagnosis. But your doctor should listen to your reason for wanting a second opinion.

An advocate is independent from the mental health service. They are free to use. They can be useful if you find it difficult to get your views heard.

There are different types of advocates available. Community advocates can support you to get a health professional to listen to your concerns. And help you to get the treatment that you would like. You can complain about your treatment or any other aspect of the NHS verbally or in writing.

You can learn to manage your symptoms by looking after yourself. Selfcare is how you take care of your diet, sleep, exercise, daily routine, relationships and how you are feeling. Routine helps many people with their mental wellbeing. It will help to give a structure to your day and may give you a sense of purpose.

This could be a simple routine such as eating at the same time each day, going to bed at the same time each day and buying food once per week. Your healthcare professionals should offer you a combined healthy eating, exercise and sleep programme.

You can find more information about wellbeing any physical health at: www. You could join a support group. A support group is where people come together to share information, experiences and give each other support.

You might be able to find a local group by searching online. The charity Bipolar UK have an online support group. They also have face to face support groups in some areas of the country. Their contact details are in the Useful contacts at the bottom of this page. Rethink Mental Illness have support groups in some areas. You can find out what is available in your area if you follow this link: www. Or you can contact our General Enquiries team on or info rethink.

Recovery colleges are part of the NHS. They offer free courses about mental health to help you manage your symptoms. They can help you to take control of your life and become an expert in your own wellbeing and recovery. You can usually self-refer to a recovery college.

But the college may inform your care team. To see if there is a recovery college in your area you can use a search engine such as Google. Learning to spot early signs of mania or depression is important in self-management. The idea of the WRAP is to help you stay well and achieve what you would like to. The WRAP looks at areas like how you are affected by your illness and what you could do to manage them. There are guides that can help with this.

You can ask your healthcare professional to make one with you or ask them for a template of one. There is more information about the WRAP in the further reading section at the bottom of this page. This is a guide based on information from people who have or support someone with bipolar disorder.

You can download it here: www. There can be complications and risks for people who live with bipolar disorder. But these risks can be lessened with the right support and treatment. You might have an illness where you experience psychosis, such as schizophrenia or bipolar disorder. You are more likely to try to take your own life if you have a history of attempted suicide and depression. It is important that you get the right treatment for your symptoms of depression and have an up to date crisis plan.

If you have mania or hypomania you may struggle to manage your finances. You may spend lots of money without thinking about the effect that it may have on your life. This means that you pick someone that you trust to manage your finances if you lack mental capacity to manage them by yourself.

You can work with your carer and mental health team. You can form an action plan. This can say what they can do if you have a period of mania or hypomania and you start to make poor financial decisions. People with bipolar disorder have a higher rate of physical illnesses such as diabetes and heart disease.

You should have a physical health check at least once every year to help manage these risks. Drinking alcohol, smoking or taking other drugs while taking medication could stop your medication working properly and make your symptoms worse. You must stop driving if you have an episode of severe depression, hypomania, mania or psychosis. You can speak to your GP.