Diagnosis of Depression, Bipolar, Anxiety
AN ACCURATE DIAGNOSIS IS ESSENTIAL
In order to ensure the best possible treatment outcome, an accurate diagnosis is essential. Unfortunately, a large percentage of people with mental health conditions are misdiagnosed. This sometimes happens because the clinician does not have enough time with the patient to sufficiently make an accurate diagnosis, and often also because many physicians do not have an expertise in mental health disorders.
Depression and anxiety are diagnosed based on your specific symptom history. Testing of certain hormones and basic blood tests can be helpful to rule out underlying physical causes of changes in mood or energy. Your doctor will ask specific questions to determine the severity of your mood disorder, and also to understand associated symptoms and possible causes.
Depression is defined as feelings of sadness, low mood, or loss of interest in activities that would normally be enjoyable. If these symptoms interfere with your daily life, and occur at least 4 days per week for 2 weeks or more, you may have depression. Along with the mood changes, people with depression often experience the following symptoms:
Poor appetite with weight loss, or increased appetite with weight gain
Physical sluggishness or restlessness
Feelings of worthlessness or guilt
Increased desire for sleep, or difficulty sleeping
Recurrent thoughts of suicide
Most people with depression experience these symptoms for several weeks or months, and then the depression lifts. Periods of depression can recur multiple times throughout the year. If you have these symptoms continuously, rather than feeling depressed for a shorter period of time, you may have dysthymia. Dysthymia is defined as depressed mood that persists for 2 years or more, without a break in the symptoms. Low self-confidence often plays a part in the mood problems associated with dysthymia. People struggling with dysthymia can also have more intense depressive episodes that come on in the midst of the dysthymia.
Bipolar disorder is somewhat more rare than depression. This condition involves cyclical periods of depression and mania. This is why it is called bipolar disorder, meaning that the person has mood swings from one extreme (depression) to its polar opposite (mania). People with depression alone can have mood swings, irritability, or changes in energy; it is important to distinguish mood swings from a manic episode. Symptoms of mania include:
Decreased need for sleep
Impulsive, risky behavior
Excessive, rapid speech
Inability to concentrate with racing thoughts
Restlessness and extreme irritability
Excessive time spent in social or work activities
The depression symptoms last at least 2 weeks, and the mania lasts at least 5 days. Because of the increased energy and inflated self-esteem, most people with bipolar disorder often actually enjoy the manic periods, because it is such a change from feeling depressed. However, the impulsive, risky behavior can be very detrimental to a person’s safety and well-being. These behaviors can include gambling all of one’s savings, purchasing expensive items that one cannot afford, or engaging in sexual promiscuity. Some people with mania may not sleep for 3-4 days at a time, and can forget to eat or take care of themselves. They may work all day and night for days, or constantly go out to try to meet new people, to the point that it damages their health.
There are two main types of bipolar disorder. Bipolar I involves cycles of depression and manic episodes. Bipolar II involves cycles of depression and hypomania (symptoms similar to mania but less intense or of a shorter duration). Bipolar II is more common than bipolar I. The diagnosis of bipolar disorder is based on your symptoms, so your doctor will ask you questions to determine whether this condition affects you. Tests may be performed to rule out other causes of your symptoms.
Anxiety (also known as generalized anxiety disorder) is excessive nervousness or worry that interrupts daily activities, without reasonable cause for nervousness. Anxious feelings occur along with physical symptoms that are similar to those of depression, such as difficulty concentrating, restlessness or fatigue, and insomnia. The diagnosis of anxiety requires at least 6 months of these symptoms. People with anxiety can also experience feelings of depression, often alternating with anxiousness. Anxiety can also occur by itself, without ever having any feelings of depression.
Some people with anxiety also have panic attacks, which are sudden episodes of intense fear without reasonable cause. The fear associated with panic attacks is usually accompanied by shortness of breath, a racing heart beat, nausea, dizziness, or a headache. Some people also experience a sudden feeling of heat or coldness, tingling of the hands or feet, or chest pain.
POST TRAUMATIC STRESS DISORDER (PTSD)
Post traumatic stress disorder is another type of anxiety disorder. PTSD occurs after witnessing a life-threatening experience. This condition is prevalent among veterans, and is also common in victims of violent crimes, abuse, accidents, natural disasters, and other psychologically traumatic events.
Symptoms of PTSD may occur immediately after the event, or several months later. It is expected to be in shock for a few hours to a few days after any highly stressful experience. However, if the symptoms interfere with your daily life to a significant degree, or if the symptoms persist for more than 4 weeks, professional treatment may be necessary.
People with PTSD often have difficulty sleeping, may feel more “on edge” than normal, and can have flashbacks or disturbing thoughts that interrupt their daily activities. Some people will block out memories of the traumatic event, or become emotionally “numb” in an attempt to avoid the stress caused by the experience. Many people with PTSD will feel depressed or detached from others, and often turn to alcohol or substance abuse to medicate their depression or anxiety.
Curious about testing and treatment for your depression, anxiety, bipolar disorder, or other health concerns?
Get the details with a free 15 minute consult with Dr. Peyman.