The diagnosis results from the current psychic complaints and behavioural changes that persons afflicted describe. Already in this phase it has proven helpful to include relatives or friends with their consent. Through this additional information the hitherto course can be better estimated, as well as mood swings, which maybe appear “normal” to themselves, however are conspicuous to their surroundings. This is important since experienced and observed behaviour often differ from each other.
Your therapist can record the course of the illness with the help of a so-called “life chart”. Here, the mood swings are entered in connection with particular life events, drug changes etc. (on paper or in the PC). This permits important conclusions to be drawn regarding the right diagnosis, treatment, prognosis etc.
A physical investigation (blood analysis, computer tomography etc.) is integrated in order to exclude an organic cause such as e.g. a dysfunction of the thyroid gland. The diagnosis of a bipolar mood disorder is a “clinical diagnosis”, i.e. no laboratory values exist which could give information about the (lacking) existence of the disorder.
The diagnosis is then made by means of so-called diagnostic criteria. In Germany, the “International Classification of Psychic Disorders” in its tenth version (ICD-10) is used. The following table provides you with a general overview by means of which criteria the individual phases are diagnosed.
Unfortunately, the diagnosis of a bipolar mood disorder today is still made much too late. This also means that an effective treatment can only be applied subsequently. On average, today ten years pass between the onset of the first episode of the illness and the right diagnosis. One estimates that one half of the persons afflicted are even never treated at all based on a correct diagnosis.
Type of episode: Manic episode
A. A manifest period of abnormal and permanently elated, exuberant or irascible mood which lasts more than one week.
B. During the period of the mood disorder three (or more) of the following symptoms continue persistently up to a significant degree:
C. The symptoms do not coincide with the criteria of a mixed episode.
D. The mood disorder is sufficiently serious to bring about a manifest impairment in professional areas of responsibility or unusual social activities or relationships with others or requires a stay in hospital. The intention here is to prevent the person from afflicting harms on him / herself or others.
E. The symptoms are not caused by direct physiological effects of a substance (e.g. drug abuse, drugs or other treatments) or a general drug-induced state of mind (e.g. overfunction of the thyroid gland).
A. A manifest period of permanently elated, exuberant or irascible mood, by all means lasting four days, which is clearly different from the usual non-depressive mood.
B. During the phase of the mood disorder, three (or more) of the following symptoms (four, if the mood is only irascible)up to a certain extent permanently existing:
C. The episode is accompanied by a distinct change of the mode of action which is uncharacteristic for the person as long as it is without symptoms.
D. The mood disorder and the change of demeanour are observed by others.
E. The episode is not serious enough to cause a manifest impairment in social or professional responsibilities or require a stay in hospital and there are no psychotic characteristics.
F. The symptoms are not caused by direct physiological effects of a substance (e.g. drug abuse, drugs or other treatments) or a general drug-induced state of mind (e.g. overfunction of the thyroid gland).
A. Five (or more) of the following symptoms exist during the same two-week period and signify a change from earlier activities.
B. The symptoms do not coincide with the criteria for a mixed phase
C. The symptoms cause clinically significant pains or an impairment in social, professional or other important spheres of responsibility.
D. The symptoms are not caused by direct physiological effects of a substance (e.g. drug abuse, drugs or other treatments) or a general drug-induced state of mind (e.g. overfunction of the thyroid gland).
E. The symptoms are induced by bereavements, e.g. the loss of a loved person. The symptoms last longer than two months or are characterized by a manifest functional impairment; morbid occupation with worthlessness, suicidal thoughts, psychotic symptoms or psychomotor slowdown.