A manic-depressive question

No, I’m not going to say “Why am I so miserable? No, wait! Why am I so happy? No, wait!..” :wink:

Seriously, my question is, how is bi-polar disorder diagnosed? Is it strictly a judgemental thing, based on behavior, history, etc? Or is there an accurate and specific medical means of diagnosing the illness?

Fifteen or so years ago, an apparently relatively normal family member was diagnosed as manic-depressive after a sudden episode that involved chasing through the street, strapping to hospital tables, and assorted other ugliness. This diagnosis was based on the nature of the episode and the inability of doctors to find any other explanation. He was prescribed lithium, with the explanation that it would prove the diagnosis by being effective, as opposed to doing nothing. Said relative took the medication for some time, noticed only the most trivial of effect one way or the other, and eventually stopped, with doctor’s approval. He has never had another manic episode, or any other mental problems since then beyond the ordinary stuff we all go through, so I/we doubt that he in fact ever actually suffered from the illness. It is not, in fact, this person that I am concerned about; I mention this only as background, to say that this was my previous experience with how such a diagosis was made; also that this not an entirely new topic to me, since I did research it to the best of my ability at the time. But times change and medicine marches on.

It is now another individual I am concerned about, who has had no incident so dramatic as that one, but who certainly has some mood issues. (Also had a bi-polar parent, which gives him the hereditary inclination factor.) Thing is, I’m not sure if it’s symptomatic of a physical problem (true bi-polar disorder), or if it’s just his normal (for his personality) moody mental function. Obviously, some degree of mood variation is normal if you’re not yet brain dead, and some people are just by nature moodier than others.

My question is, if I were to get this person to a doctor, is there a blood test, for instance, that can accurately diagnose the presence or absence of such a chemical imbalance? Or is the method still “Take the drugs and if they have an effect we’ll know you have the illness”? Apparently at the time of my first encounter with the illness (or at least purported encounter), this was pretty much the means of diagnosing. If that’s still the case, I’m not going to bother making the effort of argument and persuasion, because that “try taking some drugs and see” just isn’t going to happen with this person. But if there is now a more specific and scientific means of testing for this disorder, I believe I can get him to the doctor to give a blood sample or whatever and get a yes or no answer once and for all. Any input, from manic depressives, those who know and love them, or those who treat them?

[concerned, and nearing the end of my rope as well]
– Mods, if this belongs in GQ, you can move it, but I posted it here since it is indeed mundane, if not pointless. Besides, this is where I always hang out, and I thought I could count on my fine MPSIMS comrades to come through as they always do.

Based on the experiences of some people I know and knowledge garnered where I used to work, I would venture to say that diagnoses for this type of thing are pretty subjective. Yeah, they can make some reasonably accurate assumptions, but ultimately it seems to be trial and error to (maybe) find something that works for the afflicted individual. I’m not aware of anything resembling a physical test for bi-polar, attention deficit, or any other such thing.

I know a few people who have been treated for bi-polar disorder <generalization> and my own observation is that the only ones who stick with it over the long haul are those who have scared the living hell out of themselves at least once </generalization>. It’s gotta be very understandably tough to depend on mind-altering drugs all the time, so I guess you have to know beyond question that it’s your best option.

Hope this helps, although I’m not sure it does.

I would add that by “most” descriptions that “I” have read about a bi-polar disorder, the “symptoms” are pretty general. As a matter of fact, by the definition that I know, almost every person I’ve ever come into contact with has a bi-polar disorder.

[tangent]
This was espescially disconcerting for a hypochondriac(sp?) such as myself. My ex-wife told me that she thought I was bi-polar. I know now that I’m nothing more than just your average bit of crazy, but reading all that I could about the subject led me to believe that I actually was, and I was thinking of putting myself in the psych ward of our hospital here.
[/tangent]

Hope I’ve helped at least a little bit. As far as I know, there isn’t neccesarily a chemical determining factor for bi-polar disorder.

Yeah, that’s my problem; by the presumably prevailing standards of measure, most people would qualify for a shot on drugs, and that’s a pretty lame measure. What if your doctor said, “Yeah, it might be cancer; let’s do chemo and see if it affects that little lump or not”?

**

Even more specifially my problem - I don’t want to play the role your ex-wife did - is it a genuine illness or just your average bit of crazy? I’m sure there were plenty of times in my life that doctors would have made the same assumption about me. (In fact, I was once placed on anti-depressants, a totally inappropriate course of action, based on similar criteria in a five-minute interview with a doctor who had never seen me before – but that’s a whole nother story.) I don’t want to be one of those “Oh my god you have a mental illness!” people. Not to mention that such vagueness would be highly counterproductive in this particular situation.

Thanks for the input, both, and I will continue to hold out a forlorn hope that someone out there knows something we “joe public” don’t?

Let me preface this by saying not to diagnose yourself, but there’s a book used by psychiatrists and psychologists called the DSM IV (Diagnostic and Statistical Manual of Mental Disorders). Basically, if you exhibit a certain number of criteria for bipolar disorder as outlined in the DSM and judged by the professional, the psych will dx you with bipolar disorder.

http://www.frii.com/~parrot/dsm.html