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Diagnosing Bipolar Disorder: Ruling Out Other Physical Conditions

Bipolar Basics

By Kimberly Read

Updated April 20, 2013

Bipolar disorder is a difficult condition to diagnose. It is estimated that it takes an average of five years from onset of symptoms to reach the correct diagnosis (Evans, 2000).

Manic depression – another name for bipolar disorder – is a mental disorder characterized by extreme mood swings. As such, one of the difficulties in diagnosis is this: there are a number of physical conditions that can mimic the presentation of, or have similar symptoms to, bipolar disorder. This is further complicated by the fact that there is no definitive medical test such as blood work or X-rays to diagnose this illness. Therefore, other health concerns must first be ruled out to arrive at an accurate diagnosis. A complete physical exam and medical work-up should be completed for a patient who is struggling with significant variability in mood.

Physical conditions that can manifest symptoms similar to bipolar disorder include:

AIDS
Acquired immune deficiency syndrome is caused by the human immunodeficiency virus (HIV). As this virus attacks and weakens a patient’s immune system, a host of symptoms develop, which can include altered mental capacity as well as depression - often with suicidal tendencies (Zerr, July 2001).

Brain Tumor/Head Trauma
As with any disorder or disease that directly affects the central nervous system, a tumor or head trauma can compromise emotional stability.

Diabetes
For those who have this disorder, their bodies cannot correctly regulate the amount of glucose in the blood. The extreme highs and lows of blood sugar can cause irritability and extreme fatigue, symptoms seen in depressive episodes (McLaughlin, June 2001).

Epilepsy
Epilepsy is a disorder of the brain caused by sudden, large discharges of electrical impulses from brain cells. This disturbance affects the brain's normal functions and produces changes in a person's movement, behavior or consciousness (Epilepsy Foundation).

Lupus
Lupus is an autoimmune disorder in which the body creates antibodies against its own tissues. Serious damage can be caused throughout the body – including the brain and central nervous system (Cleveland, 2001).

Lyme Disease
Lyme disease is a serious bacterial infection caused by a tick bite. In the late stages, it has neurological manifestations that may cause the symptoms of psychiatric disorders such as depression, dementia, psychosis and bipolar disorder (Fallon et al, 1995).

Multiple Sclerosis
MS is a disease that damages the white matter of the brain. In that the central nervous system controls much of the body's functioning, this disease has a large array of symptoms. It can cause frequent changes in emotional state and a bipolar-type syndrome (Jones, 2003).

Neurosyphilis
This is an untreated form of the sexually transmitted disease syphilis that has gone to the brain. It can cause dementia and other psychiatric disturbances (Zerr, June 2001).

Sodium Imbalance
An imbalance of salt in the body, whether hyponatremia (too little) or hypernatremia (too much), counts irritability, confusion and depression among its symptoms (McLaughlin, September 2001).

Thyroid Disorder
The thyroid is an endocrine gland that produces thyroid hormone, which controls the processes that allow the body to transform food into energy and to rebuild cells. If the thyroid produces too much hormone (hyperthyroidism), nervousness is a resulting symptom. Hypothyroidism (too little) causes extreme fatigue (Harrison, 2001).

References:

Cleveland, M. (2001, August). "Systemic Lupus Erythematosus." HealthAnswers, Inc.

Epilepsy Foundation of San Diego County

Evans, D. L. (2000). Bipolar disorder: Diagnostic challenges and treatment considerations. Journal of Clinical Psychiatry, 61, 26-31.

Fallon, B.A., Schwartzberg, M., Bransfield, R., Zimmerman, B., Scotti, A., Webber, M., & Liebowitz, M. (1995). Late-stage neuropsychiatric lyme borreliosis differential diagnosis and treatment. Psychosomatics, 36, 295-300.

Jones, Paul (2003). Multiple Sclerosis Symptoms.

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