How Is Bipolar Disorder Diagnosed
Bipolar disorder is diagnosed through a clinical interview with a licensed mental health professional, explains Simon A. Rego, PsyD, Chief Psychologist at Montefiore Medical Center and Associate Professor of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine in New York City.
Sometimes, the mental health professional will also ask the person to complete some assessment measures to aid in the diagnosis, Rego says. They may also ask to speak with a family member or partner, or other significant person in the persons life, in order to get additional information about the impact the disorder has had on the person and their relationships.
Can Bipolar Disorder Get Worse With Age
Bipolar disorder may get worse with agebut this is generally the case over time if it is left untreated, explains Simon A. Rego, PsyD, Chief Psychologist at Montefiore Medical Center and Associate Professor of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine in New York City. If treated with a combination of medication and therapy, people have a much better chance of managing their bipolar disorder, Rego says. Even then, its important for people to monitor their symptoms and seek help right away if they start to feel a change in their mood, he says.
Do Over The Counter Antidepressants Exist
There are no FDA-approved antidepressants available over the counter. Antidepressants need to be prescribed by a doctor because they arent right for everyone and may interact negatively with certain medications and medical conditions. When you start a new depression medication you may experience side effects and should be closely monitored by your prescribing physician to ensure your health and safety.
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Unsure Where To Start Take Our Substance Abuse Self
Take our free, 5-minute substance abuse self-assessment below if you think you or someone you love might be struggling with substance abuse. This evaluation consists of 11 yes or no questions that are designed to be used as an informational tool to assess the severity and probability of a substance use disorder. The test is free, confidential, and no personal information is needed to receive the result. Please be aware that this evaluation is not a substitute for advice from a medical doctor.
Can Depression Be Prevented
Even if you are more vulnerable to depression, there is plenty you can do to keep symptoms away.
Some proven strategies to help you stay well include:
- avoiding harmful levels of alcohol and other substance use
- improving your sleep
- reducing anxiety, such as through relaxation techniques
- staying active
- staying sociable, so you avoid becoming isolated
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Why The Diagnosis Is Difficult
- People with bipolar disorder spend much more time in a depressive state than in mania or hypomania. This is especially true of bipolar type II. Chances are, a doctor will not observe manic or hypomanic symptoms during an evaluation when the patient is in a depressed state.
- People with bipolar disorder don’t remember or even recognize mild or hypomanic symptoms as problematic. They assume these rare breaks from depression are what it feels like to be normal. Willa says: “I didn’t go to the doctor to complain that I wrote a book in one week. If I didn’t already have the appointment, the doctor would never have heard about it.”
- People with bipolar disorder may not understand the diagnostic criteria when asked about them especially if not asked in easily-understood language. Flight of ideas? Psychomotor agitation? As Willa says: Our very perspective during an episode prevents us from thinking we have ‘inflated self-esteem‘ and ‘irritability.’ Instead, we think other people are the ones who are irritating when they can’t acknowledge our importance. And an abnormally elevated mood is that the same as saying we are crazy? And who wants to think they are going on spending sprees or making foolish business decisions?”
Rule Out Other Conditions
If you identify with the symptoms of depression, your next step should be a visit to your family doctor or general practitioner for a thorough exam and screening. Your provider will ask you about your health history and risk factors and may use written questionnaires to assess your symptoms.
Your family doctor or general practitioner will also want to rule out several medical conditions that can contribute to symptoms of depression, such as vitamin and mineral deficiencies, female hormonal changes, and thyroid conditions. In addition, several medications may have depressive symptoms as a side effect.
If your general practitioner doesn’t find any of these factors as a cause of your depression, they may prescribe an antidepressant or refer you to a mental health professional, such as a psychiatrist, psychologist, or counselor.
In 2017, an estimated 17.3 million adults in the United States experienced at least one episode of severe depression, or 7.1% of all adults. For adolescents between the ages of 12 and 17 years old, the percentage is even higher, with an estimated 3.2 million adolescents in the U.S. experiencing at least one major depressive episode in a year.
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How Is Depression Diagnosed
If you are concerned about your mental health, or the mental health of someone you care about, its important you speak with a health professional, such as a GP. A mental health assessment usually involves a discussion or answering a questionnaire, as well as a physical examination. This will help your doctor differentiate between mental and physical health problems.
Your doctor will want to understand how you feel and think, and check for any symptoms of depression, such as in your energy levels, appetite, sleep and whether you are feeling restless, hopeless or sad. If you have a family history of mental illness either depression or some other condition tell your GP since this can help with your diagnosis. Your answers will help your GP determine whether a specialist such as a counsellor, psychologist or psychiatrist might be helpful.
Mental Health Support Groups
Mental health support groups are designed to augment, not replace, the relationship between a patient and his or her mental health care provider. Read the list below for links and a short explanation of each mental health support group and any associated mental health support services:
If youre interested in participating in a research study or clinical trial for mental health, check the HealthyPlace clinical trials information page or the National Institutes of Mental Health Clinical Trials page. The page lists all the NIMH-funded clinical trials currently recruiting participants.
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Who Can Diagnose Mental Illness
In order to accurately diagnose a mental illness, a professional must be able to recognize concerning symptoms in a client and then differentiate among the wide-ranging possible disorders that could cause those symptoms. A clinician must have enough training and experience to confidently make an assessment that will then lead to treatment actions. Only certain practitioners are qualified to diagnose mental illness, and fewer practitioners are qualified to prescribe the full range of appropriate treatments.
What Are The Symptoms Of Depression And How Is It Diagnosed
The NHS recommends that you should see your GP if you experience symptoms of depression for most of the day, every day, for more than 2 weeks.
Doctors make decisions about diagnosis based on manuals. The manual used by NHS doctors is the International Classification of Diseases .
When you see a doctor they will look for the symptoms that are set out in the ICD-10 guidance. You do not have to have all of these to be diagnosed with depression. You might have just experience some of them.
Some symptoms of depression are:
- low mood, feeling sad, irritable or angry,
- having less energy to do certain things,
- losing interest or enjoyment in activities you used to enjoy,
- reduced concentration,
You may also find that with low mood you:
- feel less pleasure from things,
- feel more agitated,
- find your thoughts and movements slow down, and
- have thoughts of self-harm or suicide.
Your doctor should also ask about any possible causes of depression. For example, they may want to find out if youve experienced anything traumatic recently which could be making you feel this way.
There are no physical tests for depression. But the doctors may do some tests to check if you have any physical problems. For example, an underactive thyroid can cause depression.
On the NHS website, they have a self-assessment test which can help you to assess whether you are living with depression: www.nhs.uk/mental-health/conditions/clinical-depression/overview/
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Medications And Side Effects
Serious medications make a serious medical condition more believable. So, you must try all the recommended medications even if you fear the side effects.
If youre not taking antidepressants,, then the insurance company will think your symptoms arent serious enough to qualify for disability benefits. Its common for doctors to have you try multiple medications and different dosages to find the right treatment. So, if you have a bad reaction to one medication, you cant refuse the troubleshooting that follows. You have to try all other medications or changing your dosage.
If you have bad reactions to your medications, your medical records must report that in detail. And, if your doctor recommended against a medication, you need to have it documented that the side effects were worse than the condition. Again, you run the risk of denial if you stray from standard treatments without a good reason.
Whats The Screening Test For Bipolar Disorder Like
Talking with a doctor or mental health professional is the first step in identifying bipolar disorder. Specific criteria for diagnosis are laid out in the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders .
In a screening for bipolar disorder, youll be asked several questions about your symptoms and how long they have occurred.
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Work With A Therapist To Test For Depression
There are different types of depression, such as major depressive disorder, seasonal affective disorder, perinatal depression, and psychotic depression, which require different therapeutic approaches. A psychologist will ask their patient a series of questions to better understand the condition from the individuals experience the therapist is also likely to use one or more psychological tests to better diagnose the specifics of the condition. Examples of these tests include the Beck Depression Inventory, Hamilton Depression Rating Scale, and the Zung Self-Rating Scale for Depression. A past history of substance abuse, or problems with the liver or kidneys, could also manifest as depression.
The DSM-5 has been updated to help therapists better diagnose depression in their new clients and make more accurate diagnoses. Since symptoms of depression can manifest differently in different people, finding a diagnosis that fits can take time and patience.
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How Can My Healthcare Provider Tell Whether I Am Sad Or Depressed
Throughout life, people face many situations that result in feelings of sadness or grief: death of a loved one, loss of a job, or the ending of a relationship. Your healthcare provider, during your appointment, will likely have an unstructured conversation with you to figure out whether you might be clinically depressed or whether you are struggling with a temporary sadness that is not depression.
While depression shares some characteristics with grief and sadness, they are not the same. Typically, people experiencing grief will feel overwhelming sad feelings in waves, according to the American Psychiatric Association. In the case of grief, self-esteem is usually maintained.
With Major Depressive Disorder , the painful emotions tend to persist without much relief and often are paired with feelings of worthlessness and self-loathing. The National Institutes of Health writes that Major Depressive Disorder causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. These symptoms must be present for at least two weeks in order to be diagnosed with depression.
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Working With A Mental Health Professional Or Treatment Program
Once the diagnosis is made, the professional can then advise the individual on treatment for the condition. Depending on the type of condition and severity, there are several general treatment types that may be prescribed, either alone or in combination, as described by the American Association of Community Psychiatrists:
- One-on-one work with a counselor or psychiatrist
- Outpatient treatment through a treatment program
- Inpatient treatment through a rehab or treatment center
- Hospitalization or other emergency measures
The care plan will be determined by the treatment professional based on the severity of the disorder, how well the individual is able to function, the expected potential for recovery or relapse risk, the persons living environment and its ability to support recovery, and the individuals safety risk, among other factors.
Thinking About Treatment Recovery And Beyond
It may take time to find the exact combination of treatments and support for you, but you can expect to feel better. With treatment, at least 80% of people recover.
Most people talk about recovery in terms of controlling symptoms so they can live well without letting depression get in the way. Everyone’s recovery journey looks different. Some parts may take a long time, while others will pass quickly. You may even take a few steps back from time to time. What matters is being kind to yourself, working on your health in a way that makes sense to you, and seeking extra support when you need it.
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Continuation Maintenance Phases Of Depression Treatment
Once you have gotten your depressive symptoms under control, your healthcare provider will likely establish how treatment will happen during the continuation phase.
In many cases, according to the APA, the healthcare provider will not make any changes to treatment for at least four to nine months if the treatment is working .
Given that there is a significant risk of relapse during the continuation phase, systematic assessment of depressive symptoms, functional status, and quality of life is essential, the guide states.
After this period, the healthcare provider will evaluate your condition and determine whether to alter your treatment plan.
In general, the same treatment that was effective in the acute and continuation phases should be used for the maintenance phase. Antidepressants should generally be continued at full therapeutic dose. Reduced frequency of psychotherapy sessions may be considered, the guide states.
Because there is a potential for relapse, the APA advises providers to continue monitoring their patients. If you relapse, there should be a plan in place regarding treatment resumption.
While clinical depression can be hard to treat, the end goal for both you and your doctor is getting you back to feeling like yourself and living life as fully as possible. In clinical terms, this is defined as remission. Those reaching remission claim to feel more motivated, excited for social outings, less obsessive and more stable regarding their mood.
Workers Compensation Benefits For Depression
Workers compensation pays short- and long-term benefits to people injured on the job.
Each province has its own program. To qualify, you must have suffered an injury at work. Also, your employer must be covered not all jobs are.
Its difficult but possible to prove a workplace injury caused or worsened your depression.
Historically, workers compensation programs only considered mental health claims that came from a single workplace incident. They wouldnt recognize situations of chronic workplace stress caused over time.
This is changing, however. In January 2018, WSIB in Ontario implemented a new policy to allow claims for chronic mental stress caused by their work. This policy isnt adopted by all workers compensation programs in Canada. Check with the program in your province to see if benefits are available.
To succeed in this claim, you need a doctor to support your belief that the workplace injury triggered the depression or made it permanently worse. Youll need to have a diagnosis of depression or related mental illness. You will need to prove the specific workplace conditions or events that caused the depression. Workplace harassment and bullying are two common reasons. The workers compensation program will have to independently verify these events from your employer or coworkers.
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Is Depression A Disability In Canada
Yes. All disability benefits providers in Canada recognize depression as a disability. Its a condition that can qualify for benefits.
However, a diagnosis on its own wont qualify you.
Providers pay benefits to people who can prove their conditions keep them from working. When reviewing claims for depression, providers focus on the seriousness of your symptoms. They will consider the medical treatment youve had and future treatment plans. They look at how your symptoms affect your work and how hard you tried to keep working.
You must have all of this documented in medical records or other paperwork with your claim.
Getting An Official Diagnosis
This is why its so incredibly important to get an official diagnosis, which involves speaking to a mental health care provider and undergoing a process of actual behavioral analysis. An uninformed diagnosis is not only unhelpful, it could be missing key aspects of a persons mental health that require attention and specialized care.
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Can People Tell They Are Bipolar
People can often tell that something is wrong , but may not always be able to accurately label it as bipolar. For example, it is frequently easy for people to know when they are depressed, but sometimes symptoms of mania go unnoticed, or feel good, so they are not as easily seen as an issue, says Simon A. Rego, PsyD, Chief Psychologist at Montefiore Medical Center and Associate Professor of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine in New York City.