Self-Diagnosis of Bipolar Disorder

Bipolar Disorder (BD) is one of the most important and debilitating mental health conditions. Typically, individuals with BD alternate between periods of depression and mood elevation, also known as manic episodes. During the depressive phase they experience different degrees of sadness, loss of pleasure, decreased energy, appetite changes, and even at times thoughts of death and suicide, while the opposite happens during manic episodes. During mania, a person can feel extremely happy or irritable, full of energy, overconfident, talkative, and behave in an out-of-character way, such as acting impulsively and taking risks they normally would not take.

For many years, BD was surrounded by an aura of mystery. Certain terms used in the past to characterize BD, such as “manic-depressive illness” or “manic-depressive psychosis,” have acquired negative connotations and contributed to the stigma associated with this condition.

Over the past two decades, however, a considerable effort has been made to create more awareness about BD among health care providers, patients, and families, emphasizing the existence of effective treatments aiming at relieving symptoms and improving patients’ quality of life. BD has been incorporated into popular culture, depicted in books, movies, and TV series, often with a high degree of realism. A growing number of celebrities and other highly successful individuals have publicly shared their experiences of having BD, which has led to reduced stigma and increased public awareness.

Nevertheless, easy access to information regarding BD and its increased popularity may have some unforeseen consequences. In the Internet era, it is very easy to find material listing diagnostic criteria and other descriptions of BD. Some websites even include online screening instruments for BD, which can be filled out within minutes. Consequently, individuals who suspect they or a family member might have BD are able to promptly gather information and come up with “preliminary diagnosis” for their symptoms.

Is this good or bad?

There is nothing wrong with having access to information, and it totally understandable for someone experiencing mental health issues to try to learn as much as possible about them. We all feel tempted to go to the Internet when experiencing difficulties of any nature and often find useful information that guides us toward a solution or resources for help. On the other hand, information available online can often be misinterpreted and, at times, misleading. In the specific case of BD, inaccurate information can be particularly concerning for several reasons.

First, diagnosing BD is not an easy task. In real life, symptoms of depression and mania are often not as clear-cut as they appear in movies or publications showing textbook descriptions of BD. Even mental health professionals with considerable experience may struggle to reach a diagnosis of BD, especially after having just met a patient for the first time and not having access to additional information from relatives or friends. Therefore, it is highly unrealistic for someone to diagnose themselves (or a family member, for that matter) based on information obtained from websites.

Second, there is not yet an accurate diagnostic test that can, with a high degree of precision, determine whether someone has BD or not. Many medical conditions, such as pneumonia, are accompanied by physical symptoms and can be diagnosed using tests (e.g. blood work, chest X-Ray). This is not the case with BD. Despite many advances in the understanding of the biological factors that seem to contribute to the development of BD, its diagnosis remains purely clinical, based on signs, symptoms, and history rather than laboratory and imaging exams. The mental health provider’s expertise and experience with similar patients allow them to determine whether the person’s history is consistent with a BD diagnosis.

Third, the symptoms of BD can be easily misinterpreted or taken on face value by someone without mental health training. When trying to confirm an initial impression, our mind often engages in confirmatory bias—we tend to focus on information that will confirm our belief rather than information that goes against it. A person who begins with the assumption that they could have BD might tend to believe that certain diagnostic criteria apply to them. In contrast, if someone is strongly convinced that they do not have BD, their mind might automatically interpret the diagnostic criteria as not accurately describing them.

There is nothing wrong with accessing available information about BD and trying to learn more about it. But it is wise to always take diagnostic information you obtain online with a grain of salt. Mostly important, always keep in mind that we cannot accurately diagnose ourselves with BD or other mental illness, and seek a mental health professional if you suspect you might have BD.

About the Author:

Marsal Sanches, MD, PhD, is a board-certified psychiatrist who works on Menninger's Hope Program for Adults. In addition, he serves as director of Research Training. His interests include mood disorders, psychopathology and medical education.”