While there are different strategies and tools to screen for and diagnose bipolar disorder, the process should always be led by a trained psychiatrist.
While bipolar disorder can often be mistaken for moodiness or mood swings, it is a serious mental health condition. While there can be many signs and symptoms of bipolar disorder, a clinical diagnosis of bipolar disorder is required to meet certain criteria.
There is no clear biomarker or blood test that can be used to determine if someone has bipolar disorder, which can make the diagnosing process complex. Bipolar screening and diagnosis require several steps, and the process is guided by strict regulations and criteria. Screening for bipolar disorder is done by a psychiatrist who uses clinical assessment tools to help evaluate symptoms.
A psychiatrist can help you compare your symptoms to those that match the criteria for bipolar disorder. While recognizing the signs of bipolar may seem straightforward, accurate screening and diagnosis require a trained medical professional.
Clinical Assessment Tools
To measure and understand a patient’s symptoms, psychiatrists use a set of tools in their assessment. These are usually questionnaires or interviews that have been developed and tested to capture relevant symptoms for a diagnosis of bipolar disorder.
Bipolar screening tools have been developed so that they are easy to use and can ensure the correct diagnosis. The tools used to diagnose bipolar are designed as a semi-structured interview. This means that the interview will not necessarily follow a set list of questions, but will include open-ended questions and discussion. Examples of these tools include the Structured Clinical Interview for DSM-5 (SCID) and the Schedule for Affective Disorders and Schizophrenia (SADS).
These tools are similar, but use different diagnostic manuals as their guide. They provide question prompts during the interview process to guide the interviewer. These prompts will often ask the interviewee about their experiences, thoughts, symptoms that would rule out a diagnosis of bipolar disorder. These tools have certain thresholds for a clinical diagnosis.
Self-report measures, or questionnaires that are filled out directly by the patient, can help a psychiatrist get an idea of a person’s symptoms or how they may change over time. While self-assessments for bipolar disorder can be a guide or record of symptoms, they are not the gold-standard for a formal diagnosis.
Administering bipolar screening questions can be time-consuming, and a health professional may not have adequate training or resources to conduct an interview. In this case, self-assessment for bipolar disorder can be a useful tool in obtaining a formal diagnosis. There are a few common measures used, including the General Behavior Inventory and Mood Disorder Questionnaire.
These measures ask questions about symptoms, where patients report if, how often and how intensely they experience those symptoms. The total score is added up to assess whether bipolar disorder is likely to present.
Mental disorders often have a lot of overlap. Accurately diagnosing them is complicated and requires years of training. Self-report measures can be helpful, but should not be the only tool used for diagnosis.
Diagnostic Assessment of Bipolar II
Bipolar II follows a similar pattern to the more well-known bipolar disorder. This form of bipolar disorder includes depressive periods as well as periods of hypomania, which are less severe than full manic episodes. Because the manic phase is less extreme, bipolar II can be more difficult to recognize and diagnose.
Diagnosis of bipolar II can be made using semi-structured interviews like the SCID. Bipolar II can often be misdiagnosed or mistreated, which can worsen symptoms and outcomes. It’s important that this assessment is done by a trained psychiatrist to ensure it is as accurate as possible.
Assessment of Symptom Severity
Once a diagnosis of bipolar disorder is given, it’s important to track symptoms over time to assess whether treatment is effective. This is mainly done by a clinician interviewing their patients on their symptoms and how often and severely they experience them. Two common tools used to monitor symptoms are the Young Mania Rating Scale (YMRS) and the Bech-Rafaelsen Mania Rating Scale (MAS).
Tracking symptoms is an important part of bipolar disorder treatment. If symptoms worsen over time, this can prompt an adjustment in medication or therapy.
Misdiagnosis of Bipolar Disorder
Many types of mental disorders have similar symptoms, like changes in mood and behavior. Often, the differences between one disorder and another are subtle. Bipolar disorder, characterized by both a depressive and manic phase, shares similarities with disorders like depression, personality disorders or even schizophrenia.
A misdiagnosis of bipolar disorder can be harmful, as it can lead to the wrong treatment or no treatment at all. To avoid misdiagnosis, it’s important to be assessed by a trained professional.
If you suspect that you or someone you care about may be suffering from a substance use disorder as a result of bipolar disorder, contact The Recovery Village today to discuss treatment options.
Miller, Christopher J., et al. “Assessment Tools for Adult Bipolar Disorder.” Clinical Psychology, June 1, 2009. Accessed August 21, 2019.
Findling, Robert L., et al. “Clinical decision-making using the Gener[…]juvenile bipolarity.” Bipolar Disorders, 2002. Accessed August 21, 2019.
Psychology Tools. Young Mania Rating Scale. Accessed September 3, 2019.
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