Bipolar disorder: Diagnosis
If your GP thinks you may have bipolar disorder, they'll usually refer you to a psychiatrist or a community mental health team.
If your GP or a family member is concerned that you are at risk of harming yourself you will be referred as an emergency.
The psychiatrist or mental health nurse will assess you. They'll ask you questions and perform a mental state examination which looks at your overall mood state, thoughts and thinking patterns (cognition).
This is to determine if you have bipolar disorder. If you do, they'll decide what treatments are most suitable.
They will also complete a risk assessment which includes thoughts of suicide or hopelessness.
The psychiatrist or mental health nurse will ask about your symptoms and when you first experienced them. They will ask about how you feel leading up to and during an episode of mania or depression. They will also ask if you have thoughts about harming yourself.
The psychiatrist or mental health nurse will want to know about your medical background and family history. Especially whether any of your relatives have had bipolar disorder.
If someone else in your family has the condition, the psychiatrist may want to talk to them. They'll ask for your agreement before doing so.
They will interview your close family members to get a full objective history of your recent life. This is called collateral history and will only happen with your permission.
Interviews without your permission will only take place if there is an immediate risk to your life or someone else’s life. Confidentiality is an important part of you developing trust in the professionals assisting you to recover.
Depending on your symptoms, you may also need tests to see if you have a physical problem. For example, an underactive thyroid or an overactive thyroid.
A brain scan and other tests may be required to measure activity in your brain.
If you have bipolar disorder, you'll need to visit your GP regularly for a physical health check.
If you're diagnosed with the condition, it's important to talk to your psychiatrist. You should be involved in the decisions about your treatment and care.
These are not legally binding in Ireland at present but it is always useful to plan how you would like treatment to be in the event of a relapse of your condition. All treatments are developed to prevent relapses (getting ill again).
You may not always be able to make informed decisions about your care or communicate your needs decisions if you are experiencing a severe mania episode. Especially if your symptoms become severe. If this happens, it may be possible to draw up an advanced directive.
An advanced decision directive is a set of written instructions. These state what treatments and help you want, or don't want, in advance. It is in case you can't communicate your decisions at a later stage.
Your GP or psychiatrist can give you further help and advice.