Best Differential Diagnosis Book


1)Let go of any assumptions you may have about bipolar. Some people’s illness is obvious to all who meet them, others may be stable on medication and no-one would ever guess they were living with bipolar. People as young as 10 and as old as 80 have been diagnosed bipolar although most people first show symptoms between the ages of 15 and 30. Equal numbers of males and females are diagnosed with the disorder.

2)Educate yourself from reputable resources about bipolar disorder and it’s various forms – bipolar I, bipolar II and cyclothymia are the forms that are standardly diagnosed. However you may also come across rapid cycling bipolar, bipolar with mixed episodes, anti-depressant induced bipolar and bipolar NOS (not otherwise specified).

3)Watch them. They may alternate from manic or hypomanic (the less extreme form of mania experienced by people with bipolar II) to depressed, with each extreme usually lasting for a period of several months. This is the main sign of bipolar but just because you haven’t witnessed a mood swing yourself doesn’t mean someone hasn’t got bipolar – and not everyone who has mood swings suffers from bipolar.

  • Symptoms of mania or hypomania: Agitation or irritation, inflated self esteem, little need for sleep, hyperactivity, increased energy, lack of self control, racing thoughts, poor temper control, reckless behaviour, binge eating/drinking/drug use, impaired judgement, spending sprees, sexual promiscuity and easily distracted.
     
  • Symptoms of depression: Fatigue, social withdrawal, aches and pains, sadness, self criticism, memory problems loss or increase of appetite, feeling hopeless, sleep disturbance and thoughts of death or suicide.
  • 4)Pay attention to their emotions and their extremes of emotions. If they are a friend or family member you can encourage them to share their thoughts and feelings with you by listening without making judgemental comments about what they say to you.
  • 5)Consider their family and history. It is currently believed that bipolar is caused by a combination of a genetic tendency combined with a traumatic event. If someone already has family members diagnosed with bipolar then they obviously have the genetic capability to develop the illness – although you can still have the genes for bipolar without knowing of a family member with the disease. However even if someone has the genes that can lead to bipolar it is believed that without experiencing a sufficiently stressful situation the illness will never go on to develop. If you know someone with a family history of bipolar and who has also lived through some very stressful situations then it could be that the extremes of moods you’re witnessing are a sign of bipolar.
  • 6)Don’t ask them. How would you like it if someone asked you if you had a mental illness? Bipolar is not a light subject and is something to be taken seriously. It may upset the person if you ask them.
  • 7)If you are concerned that a friend or family member may have undiagnosed bipolar and believe they may need treatment then start by trying to just be a friend to them and encourage them to talk to you about their feelings. If they don’t raise the subject of treatment themselves then avoid mentioning it when they appear to be in a manic phase… They simply won’t believe they have a problem. It’s best to wait until they’re in a depressive phase. Don’t try and diagnose them as bipolar – that’s for a psychiatrist to do! – but just tell them how concerned you are about how sad they are and that you don’t like to see them suffer when someone could help them. Offer to go see a doctor with them.
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