Bipolar Disorder – Diagnostic Interviewing for Manic Episode
Time to read: 2 minutes
Bipolar disorder is a disturbance in mood that consists of patients moving between depression and hypomania or mania. A newer entity Bipolar depression, although not present in DSM-V is a valid entity that presents with predominantly depressed mood that lies along a bipolar trait. Following are the questions that will help you come closer to the diagnosis of Bipolar Disorder.
- Have you ever had the opposite of depression, when you’ve been extremely happy, over the top, doing things out of character or talking too fast? (Elevated mood)
- How long did it last for? (in a borderline construct mood swings will be present over an extended period of time beginning from adolescence and pervading through adulthood)
- During this period did/do you feel especially confident, like you were on top of the world?
- How do/did you see yourself in comparison to others?
- Did/do you feel you had special powers that others didn’t?
- Did/do you feel a special connection with God?
- Do you consider yourself special in any way?
- Do you think God has a special purpose for you here?
FLIGHT OF IDEAS
- Do you find your thoughts racing?
- Do you find it difficult to keep track of your thoughts?
- Do your thoughts jump from place to place that makes it difficult for you to keep track of them?
PRESSURE OF SPEECH
- Do you find it hard to stop talking?
- Have your friends/family commented on the way you are talking?
- Have they said that they find it difficult to follow your speech?
- Have you needed much less sleep than usual?
- Do you feel like you can work all day without needing rest/sleep?
INCREASED GOAL DIRECTED ACTIVITY
- Have you taken on any new activities lately?
- Have you come across any brilliant ideas lately?
INDISCRETION / RECKLESSNESS
- Have you been in trouble with the police or your family lately?
- Have you been doing things that are out of character for you?
DIFFERENTIALS AND CO-MORBIDITIES
- Schizoaffective Disorder – Criteria of Schizophrenia should be present
- Personality Disorder – esp. Borderline Personality Disorder. Both can co-exist
- Substance misuse – High degree of alcohol and drug misuse in Bipolar patients
- Drug-induced and ECT induced Mania
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