In Bipolar Disorder For Dummies, we point out that as part of the initial work up for bipolar disorder you really should have a complete physical first to rule out any potential medical issues. Other possible diagnoses that may be considered by your doctor include the following:

• Thyroid malfunction
• Hormone imbalances
• Diabetes
• Mononucleosis
• Chronic Fatigue Syndrome (CFS)
• Lupus
• Cancer
• Cushing’s Syndrome
• Hepatitis
• HIV/AIDS
• Rheumatoid arthritis
• Medication or other substances that could have triggered symptoms

Sometimes we wonder whether doctors, including psychiatrists, follow the proper protocol in diagnosing bipolar disorder. Before diagnosing you and prescribing any medication, did your doctor perform a physical exam or refer you to an internist/specialist and/or order various tests to rule out medical issues that may have been causing symptoms of mania or depression?

What was the diagnostic process like for you?

Doctor image available from Shutterstock.

Part II of How’s That Working for You?

Tuesday’s post asked those with bipolar to weigh in on what works and what doesn’t. This week, family and friends of those with bipolar get their chance to weigh in on the same question in a different context. As a friend or loved one of someone who has bipolar disorder, what has helped you deal best with the situation in terms of helping yourself and your loved one?

I’ll kick off the discussion of what has and hasn’t worked for me in the past.

In an article in The New York Times entitled “Mental Health Needs Seen Growing at Colleges,” Trip Gabriel explores the increasing demand for mental health services on college campuses across the country.

The college years have always been vulnerable to mental health issues – partially due to the stresses of academic demands and the transition to living more independently and partially because late adolescence/early adulthood is the most common time to see full blown first breaks of major mental illnesses, including depression, bipolar disorder, and schizophrenia.

But in recent years it has become clear that more and more students are coming to campus with previously diagnosed psychiatric conditions and taking medications. While this may be a sign of over-diagnosed and over-medicated youth, I see it in a more positive light for three possible reasons:

My wife experienced a manic episode on Christmas Eve and ended up in the hospital near my home town of Chicago. Every day, she has been getting better.

Current plans are to pick her up tomorrow and bring her back home to Indiana. Please send positive energy and prayers her way. Me and the rest of my family could use them, too.

Wishing you all the best.

As more and more celebrities talk openly about living with bipolar disorder, the diagnosis is not only becoming more common – it’s becoming downright popular. The March issue of The Psychiatrist carries an article entitled “‘I want to be bipolar’… a new phenomenon,” in which authors Diana Chan and Lester Sireling point out the following:

Despite the stigma attached to mental illness, we have noticed in our clinical practice a new and unusual phenomenon, where patients present to psychiatrists with self-diagnosed bipolar disorder.

Personally, I think the title of the article is a tad bit misleading. People don’t generally want serious medical conditions. A more accurate reason behind this phenomenon is that when people feel bad, they yearn for an explanation.

Claudia asks…

Could you talk about the best ways to handle working with the frequent turnover of psychiatrists when getting services at a community-run health center?

I have been going to the only place in town where I can get mental health care at no cost. While I greatly appreciate their services and commitment, they have a steady turnover of doctors. I’ve been going for close to three years now, and I think I’ve had 5 (?) doctors.

The problem is that my file is pretty thick. I’ve been going there for so long. I know they haven’t read it, yet they base opinions about my care on what sometimes seems like a cursory glance.

There isn’t enough time to really go into my history in these sessions (usually 15 minutes). Basically, I had a complete psychotic break in 2003 and was practically catatonic for a year before I could slowly rebuild my life (and my mind) piece by piece.

Yet, recently, I had a doctor, who all she would do is look at my file and say disapprovingly, “You’re too young to be on this much medicine.” Her words verbatim.

You’re cruising through life with a pretty clear idea of where you’re going. You have dreams, goals, aspirations…. Then, wham! Bipolar disorder T-bones you. When you finally wake up, you don’t know what hit you. You’re still in shock, walking around in a daze, trying to figure out what happened.

Bipolar disorder gets a lot of bad press, even among those of us who have struggled with it in our lives. I have noticed this particularly online, from exasperated family members and exhausted individuals with bipolar who haven’t yet found effective treatment.

When we were in Slovenia a couple weeks ago, Cecie and I did an interview for a televised report on bipolar disorder. The interviewer asked me what it was like to be married to someone with bipolar disorder. I stammered and stuttered, not really sure how to answer and then offered up some feeble response about how terrible it is during the manias, but how normal it is most of the time.

Yesterday, on Good Morning America, accomplished actress Glenn Close and her sister Jessie Close spoke about mental illness in their family (watch the clip). Except for George Stephanopoulos saying that Jessie “is” bipolar, I thought it was a good piece. The Close sisters did an excellent job of presenting bipolar, the stigma surrounding it, and the necessity of making a commitment to manage the disorder.

Please watch the video and share your insights.