Beyond the Book
Every For Dummies book has a Cheat Sheet chock-full of helpful information that you can refer to on a regular basis. You can find this book’s Cheat Sheet at www.dummies.com/cheatsheet/bipolardisorder.
We also offer some bonus goodies at www.dummies.com/extras/bipolardisorder. You can read a bonus Part of Tens chapter on ten questions to ask a psychiatrist, a bipolar disorder glossary, and additional articles related to bipolar disorder.
Where to Go from Here
Think of this book as an all-you-can-eat buffet. You can grab a plate, start at the beginning, and read one chapter right after another, or you can dip into any chapter and pile your plate high with the information it contains.
If you want a quick overview of bipolar disorder, check out the chapters in Part I. Before you visit a psychiatrist for a diagnosis, see Chapters 4 and 5 to find out what to expect during the diagnostic process. For information and insight into the medications used to treat bipolar disorder, head to Chapter 7. Turn to the chapters in Part IV for self-help strategies. If you have a friend or family member with bipolar, skip to Part VI. Use the index to look up any bipolar term you’re unfamiliar with and find out where we cover it in the book. Wherever you choose to go, you’ll find plenty of useful information.
Part I
Getting Started on Your Bipolar Journey
In this part …
✔ Understand what bipolar disorder is and what it isn’t according to the diagnostic categories spelled out in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) – the book psychiatrists look to when developing their diagnosis.
✔ Explore genetic and nongenetic factors, such as physical and emotional stress, that likely team up to trigger the manic and depressive episodes characteristic of bipolar disorder.
✔ Take a look inside the different parts of the brain to understand the biology of bipolar disorder.
✔ Get a bird’s-eye view of the diagnosis and treatment of bipolar disorder, so you know what’s involved and the sort of outcome you can expect when treatment proceeds according to plan.
Chapter 1
Grasping Bipolar Disorder: Symptoms and Diagnosis
In This Chapter
▶ Meeting the manual used to diagnose bipolar disorder
▶ Recognizing the two poles of bipolar: mania and depression
▶ Telling the difference between bipolar I, bipolar II, and other types
▶ Augmenting the diagnosis with specifiers and distinguishing it from other conditions
▶ Diagnosing bipolar in children … or not
When you initially encounter bipolar disorder, one of the first questions you’re likely to ask is, “What is it?” The short answer is this: Bipolar disorder is a medical illness characterized by alternating periods of abnormally elevated and depressed mood. The second question that most people ask is, “Can I get tested for it?” And the short answer is no. Doctors arrive at a diagnosis by conducting a physical and mental status examination; taking a close look at a person’s symptoms, medical history, and family history; and ruling out other possible causes. For guidance, doctors use a book called the Diagnostic and Statistical Manual of Mental Disorders (DSM), which presents the diagnostic criteria for determining whether a person is likely to have bipolar disorder.
This chapter digs deep into the DSM to reveal what bipolar disorder is and isn’t. It describes what elevated and depressed moods look like and provides you with the details you need to tell the difference between the various bipolar diagnoses, including bipolar I, bipolar II, and a form of bipolar called rapid-cycling. We discuss diagnostic specifiers that enable doctors to more precisely describe a person’s symptoms and inform his treatment decisions. We distinguish bipolar disorder from conditions that may have similar symptoms and discuss other conditions that commonly accompany bipolar disorder, such as alcoholism and substance use disorder. We wrap up with a discussion of the challenges of diagnosing bipolar in children and young adults.
Cracking Open the Diagnostic Manual: DSM-5
When a doctor in the United States diagnoses a mental illness, such as bipolar disorder, she turns to the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) for guidance. This manual defines numerous patterns of symptoms and illnesses that are supported by scientific research and a consensus among a wide variety of experts. During the writing of this book, the APA recommends using DSM-5, the fifth edition, which was published in May 2013. Don’t be surprised if you see references to earlier editions, particularly DSM-IV, the fourth edition.
Throughout this chapter, we describe the symptoms of bipolar disorder according to the diagnostic criteria presented in DSM-5. Although the fundamental criteria haven’t changed all that much from DSM-IV to DSM-5, some of the language has been modified and criteria have been added to help doctors arrive at and describe a person’s condition more fully.
Doctors in countries throughout the world (not the United States) rely on the World Health Organization’s (WHO) International Classification of Diseases, a classification system for all health issues. Chapter V of the ICD specifically addresses mental and behavioral disorders.
The major difference between DSM-5 and ICD-10 is that the WHO manual doesn’t use the labels bipolar I and bipolar II as primary distinctions. Instead, ICD-10 refers to the disorder as bipolar affective disorder and then further classifies it by the nature of the current episode: currently hypomanic, currently manic, currently depressed, mixed disorder, or in remission. In addition, the ICD-10 requires two or more mood episodes, with at least one being manic or hypomanic, to qualify for a bipolar diagnosis, while the