Diagnosing bipolar disorder

- [Voiceover] We've previously talked about diagnosing Depression, but what about diagnosing Bipolar Disorder? Well, it turns out that the main focus is correctly diagnosing a manic episode in someone who already meets the criteria for Depression. And that's because those manic episodes are really the distinguishing feature of Bipolar Disorder. There is no disorder that consists of just mania. So as we talk about the symptoms for Bipolar Disorder, remember that we also expect to see these symptoms of Depression that we talked about in a previous video. And just as with Depression, we have a long list of possible symptoms for a manic episode and in order to meet the diagnosis, someone must have a certain number of them. In this case, they need three or more in order to qualify for the diagnosis. The first symptom is inflated self esteem and this isn't just thinking that your'e a good singer, this is thinking that you are the greatest singer in the world. So really, it's about having a lot of grandiose ideas about the self. The second symptom is racing thoughts, so thoughts coming into a person's head at a mile a minute, just idea after idea after idea. And this leads to the third system, which is pressured speech, or talkativeness. So someone having a manic episode might talk more or talk faster than we would generally deem to be appropriate. And the next symptom is distractibility. And that means that they can't keep their attention on any one topic. They're always jumping from one thing to the next. But also associated with this symptom is the fact that people with Bipolar Disorder are often distracted by unimportant details, things that other people might consider to be irrelevant. There are also changes in sleep patterns, specifically they might show a decreased need for sleep so they might feel rested after only three hours a night. There might also be psychomotor agitation and this can include pacing quickly around the room or pulling off clothes or putting them back on. People with Bipolar Disorder might also show an increase in goal directed activity so they might become really focused on work or on going to the gym and spend all of their time on that one task to the exclusion of everything else that they need to do in their lives. Another thing that might occur during a manic episode is that a person might become extremely focused on seemingly pleasurable activities, activities that, with repetition, tend to have dangerous consequences. So while a certain amount of sexual activity is normal in adulthood, these individuals might become over involved with risky sexual activity. And while some people might enjoy shopping, people having a manic episode might become really unrestrained in shopping behaviors. So they might just keep on shopping and spend way more money than they actually have. And lastly, there's going to be a general increase in energy, which is something that seems like an important element for all of the symptoms of a manic episode that we've described here. So as I said before, an individual needs three or more of these symptoms in order to be diagnosed with Bipolar Disorder but just like with Depression, we have some qualifiers that someone with Bipolar Disorder also needs to meet. The first is this mood must last for at least a week. Another thing is that one of these three symptoms must be that increased energy so the symptoms have to include an abnormally elevated mood but in some people, this mood doesn't come off as elevated. It might come off as irritable. So someone who has an irritable mood for over a week in addition to some of these other symptoms of a manic episode can also meet the diagnosis. And as before, with Major Depressive Disorder, the symptoms of Bipolar Disorder must be severe enough to negatively impact a person's life. So it must be negatively impacting their job or their relationships with friends and family. I also want to mention here that Bipolar Disorder isn't just one disorder. We have Bipolar I Disorder, which is characterized by full episodes of depression and full episodes of mania. And then, we also have Bipolar II Disorder and with this disorder, someone might have severe depressive episodes but they don't have full manic episodes. Instead, they have what we refer to as hypomania. And so in terms of whether or not someone should be diagnosed with Bipolar I or Bipolar II disorders, it really depends on the intensity of the symptoms and their duration. There isn't really a different list of symptoms so the symptoms need to last for at least a week to be diagnosed with mania but only need to be present for four days for a diagnosis of hypomania. For mania, the symptoms need to have a really negative effect on their day to day functioning but this not true of hypomania, where it can, at least on the surface, seem to actually make someone more productive or more social, at least temporarily. And so it's really up to the clinician to look at the symptoms that a person has and determine whether or not someone meets the qualifications for Bipolar I or Bipolar II.