How Can Clinicians Better Identify and Diagnose Bipolar Disorder?

At Psych Congress 2022, Psych Congress Network sat down with Steering Committee Member Dr Julie Carbray, PhD, APRN, clinical professor at the University of Illinois at Chicago, to discuss distinguishing symptoms and characteristics of bipolar disorder from those that may be due to other mood disorders.

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Julie A. Carbray, PhD, PMHNP-BC, PMHCNS-BC, APRN, is a clinical professor of psychiatry and nursing at the University of Illinois at Chicago. Dr Carbray holds her PhD (93) and Master of Science (88) degrees from Rush University, Chicago, and her Bachelor of Science (87) degree from Purdue University in West Lafayette, Indiana. Dr Carbray was recognized by the UIC community in 2008 by receiving the Karen Gousman Excellence in Nursing Award and the American Psychiatric Nurses Association’s (APNA) Best Practices in Outpatient Mental Health Nursing Award. In 2012, Dr Carbray was awarded the University of Illinois at Chicago’s Inspire award for her long-standing commitment to UIC values and her inspiration of others in her work, and in 2016, Dr Carbray was awarded the Distinguished Service Award by APNA for her service to the profession of psychiatric nursing.
 

Read the transcript:

Julie Carbray, PhD:
Differentiating symptoms of bipolar disorder from other mood disorders can be pretty challenging. Can be challenging for the patient and challenging for clinicians. It's important, both for the patient and clinician, to be very clear about what those symptoms are of their illness. And remember, one person with bipolar disorder does not look like another in terms of symptoms. For instance, one person with bipolar disorder, their symptoms might result in more spending or more hypersexuality. Another may find themselves having impulsivity around gambling or around intense creative time periods that are accompanied with very little sleep. Really understanding the signature of illness of your patient is critical.

And as a clinician, you need to understand the core components of a bipolar syndrome in your patient and really be looking for the symptoms that your patient experiences. And then looking across the domains of mood dysregulation disorders and always having a balance of how much of those symptoms of depression is that patient experiencing? And when you're in question, use some clinician rating scales, maybe use a self-report scale, and use collateral information from those that surround your patient, whether it's appearance or loved ones. And while you're trying to collect, what is symptomatology and what is just personality? That is the biggest question where we usually struggle. And that is, "who am I?", especially in younger adults, and "what is my illness?"