While mental illnesses like depression and anxiety are well known and understood fairly well, other illnesses like schizophrenia and obsessive compulsive disorder don’t receive the same kind of attention and are highly misunderstood. One such disorder is bipolar disorder, which can be quite debilitating and comes with a rage of symptoms that affect all aspects of life. Bipolar disorder consists of both depressive episodes that can be severe and manic episodes where a person can act erratic, risky and even be euphoric. These manic or hypomanic episodes can last anywhere from a couple of weeks to a couple of months, and they are followed up with depressive episodes again. It so happens that a large number of people suffering from bipolar disorder are misdiagnosed because they seek treatment when they have a depressive episode, and are diagnosed as having depression instead of bipolar disorder. However, with the right practitioner, it can be diagnosed correctly with the help of these questions:
1. Elevated Mood Continuously For Days
There is a difference between a person feeling better than usual after a depressive episode, and something much more than that. Those with bipolar disorder sometimes even feel a state of euphoria, which is a common occurrence during a manic episode. Questions like “Have you felt too good in the last few days?” or “Have you felt like your mood has been elevated for the last few days without any reason?” can be asked. Patients can also go quickly from confident and energetic to agitated and reactive. Doctors need to find out if a good day after a depressive episode was due to the situational circumstances, such as finding a new job, or because of a manic episode, and this question can lead them there.
2. Less Sleep But Also Less Fatigue
“Even though you slept less, did you notice that you didn’t really feel exhausted?” Changes in sleep patterns are a major factor contributing to mania, and a person might only sleep for a few hours but feels energetic and refreshed. These changes may be the first sign that a manic episode may be starting. Hence, it becomes important to understand how a person is sleeping because the changes eventually contribute to the significant mood change after a depressive episode.
3. A Lot Of Ideas, Or Sped Up Brain
Questions like “During your good mood period, did you feel like you had a lot of ideas and your brain felt sped up?” can help. Patients with bipolar disorder find it hard to keep up with the number of thoughts going through their mind, and they may be completely unaware of how much in happening inside their heads in the middle of a manic episode. In a hypomanic episode, the thoughts might seem crisp and clear rather than quick, but still points to the existence of bipolar disorder. Either way, the doctor should be able to understand that there is a change in the way the patients process or think of ideas, and how it affects their brain.
4. More Talking
People with bipolar disorder talk very quickly, and tend to jump from one idea to another very often. Questions like “Is it hard to follow what they mean to say?”, or “Do they speak like a mile a minute?” are asked to the patient’s caretakers to get a better idea about their behavior. Another important feature of bipolar disorder is lack if insight, meaning that the patient has no idea about this behavior change and will continue it as though it is normal.
5. Taking More Risks
A manic episode makes a person more impulsive, so they are more prone to take risks. A doctor needs to understand whether the person is just acting out or if this behavior is starkly different to their normal behavior. Questions like “Have you done things that you would consider risky” are asked to both the patient and the caretakers. Manic episodes are much more risky than a hypomanic one, with patients driving and spending recklessly, and even taking part in dangerous sexual encounters. However, excessive behavior that cannot be controlled is also a part of the risk taking, such as excessive shopping.
6. A Surge In How Positively You Feel About Yourself
A manic or hypomanic episode comes with elevated mood that can raise a person’s confidence, self-esteem and optimism well above the normal range. For example, a patient can tell the clinician that they feel like they’re doing well with their job and because they’re feeling so good, they want to quit now and start that business venture they’ve been planning for years without a concrete plan. Questions like “Have you felt smarter, more successful or attractive lately?” can be asked.
7. Family History
A family history can be extremely helpful when trying to diagnose bipolar disorder. The risk of developing bipolar disorder increases significantly for those who have close family members with the disease, such as a parent or a sibling. Moreover, asking these questions to both the patient and the family member can work out well because often, a patient does not fully understand what is going on and cannot always answer questions completely and truthfully.