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Bipolar Disorder (cont.)

Exams and Tests

No specific blood tests or x-rays will tell the health care provider that a person definitely has bipolar disorder. The diagnosis is made on the basis of all the signs and symptoms.

If a person experiences at least four of the symptoms of mania and depression for a period of at least two weeks, that person may have bipolar disorder or another form of mood disorder.

The person may have a long history of feeling depressed and then finally have a first manic episode. This clinches the diagnosis. However, any potentially treatable medical condition that could account for severe mood swings should be ruled out first.
A complete physical examination is performed to check for enlarged glands, poor nerve function, or any other signs of a medical condition.
A detailed interview will focus on the signs of bipolar disorder such as periods of racing thoughts, risky behavior, and inflated self-esteem followed by periods of depression.
Certain tests may be ordered to rule out medical conditions that could cause mood swings, especially when the first manic episode occurs after the age of 40. Tests will probably be ordered to check the balance of salts and sugar in the blood, hormone function, blood cell counts, and drug and alcohol levels. These tests all are blood or urine tests.
CT scan or MRI of the head may be ordered to check for blood clots, bleeding, or tumors.
Rarely, an EEG (electroencephalogram), a brain wave study, may be ordered if the person is thought to have a seizure disorder. Electrodes are placed all over the scalp and secured by an adhesive. The electrodes are hooked up to a machine that traces brain waves. This is seldom performed in the emergency department.
A spinal tap (lumbar puncture) may be ordered to get a sample of spinal fluid. This will be done if signs suggest a brain infection, such as meningitis or encephalitis. Such an infection is generally only considered a possibility if the behavior change happened relatively recently or if a fever or other signs of infection are present. The laboratory will study the fluid and be able to tell if an infection is present.

Treatment is based on the results of these tests. If test results are all normal, the diagnosis is most likely a psychiatric disorder, such as bipolar disorder.