Q:  Can a Family Physician Diagnose Bipolar Disorder?

My husband of three years has become increasingly verbally abusive.  I left my home for a week and returned after his plea and promise he would seek professional help. I work for a state agency that offers services for domestic abuse and counseling.  After describing my husbands behavoir to a counselor, I was told he could be bi-polar.  After studying the symptoms of this disorder on your website, I am convinced the counselor is correct. Can a family physician diagnose this disorder or is it more psychological than medical in nature??  Thank you.

Dear Ms. T'
As it seems that this "diagnosis" could be pretty subtle -- i.e. there hasn't been anything in his behavior that was so obviously "manic" no one could miss it -- this would be a tough call for most primary care doctors. I've tried to help them by making available some resources, particularly the Mood Disorders Questionnaire (first bullet on this page; or under my main site, as a questionnaire in the context of making a diagnosis.  You could try completing that on your husband, and take that to your primary care doc', and see what happens. 

In addition to using your counselor to guide you further, you might have a look at a book called The Verbally Abusive Relationship: How to recognize it and how to respond (here it is on Amazon with some pretty rave reviews).  I haven't read it yet but a patient of mine found it extremely helpful, as apparently did numerous others, per the reviews. 

Dr. Phelps  

Published August, 2001