Q:  Must-Have Symptoms of Bipolar Disorder

What are the chances of getting an incorrect Bipolar diagnosis? What are the eliminating criteria for other diagnosis? Alternatively,what are the Bipolar must have symptoms.

thanks for the opportunity. Looking forward to your reply. Would appreciate your answering all or partofthe question above

Dear Mona -- 
Try my little essay on "sensitivity and specificity" of the only "test" for bipolar disorder, to start.  As far as must-have symptoms, which is a good way to think about it, there's no solid research.  In my experience, if somebody is sleeping just fine, that's almost a "rule out" right there.  It isn't perfect though, and as an individual, what you're looking for is an absolute call; unfortunately, in this business, we don't have that.  

Let's see, any other "must-have"?  Some energy symptom, I guess:  anxiety, agitation, or profound fatigue, lethargy, lack of motivation when the depressions hit -- those are at least so common that if they aren't present in some form, I'd wonder more.  Good on ya' for thinking hard about it.  After a while thinking like this, it comes down to trying a mood stabilizer or two (most people in your circumstance have already been offered at least one antidepressant trial...) to see what happens.  That isn't going to offer a sure "diagnosis" either, as getting better on a med doesn't prove you have what that med' treats in others; but at that point, the whole issue loses some steam, yes? 

Dr. Phelps  

Published July, 2001