Diagnosing Bipolar Disorder: From the Patient's Experience to Clinical Diagnosis

Abstract

Bipolar disorder (BD) is one of the psychiatric conditions whose diagnosis remains among the greatest challenges in contemporary psychiatry. Despite well-defined diagnostic criteria provided by the ICD and DSM classifications, establishing an accurate diagnosis requires more than the identification of individual symptoms. It also involves analysing their course, clinical context, and co-occurrence with other mental disorders.

This practice-oriented article is based on the author's clinical experience and current scientific literature. It discusses the most common diagnostic challenges in bipolar disorder, including the differentiation between bipolar I and bipolar II disorders, distinguishing hypomania from mania, recognizing mixed features, and the differential diagnosis of bipolar disorder from major depressive disorder, attention-deficit/hyperactivity disorder (ADHD), borderline personality disorder, and other psychiatric conditions. Particular attention is given to the importance of psychiatric comorbidity, comprehensive clinical interviewing, and collateral information obtained from family members or other close informants.

From an existential perspective, the diagnostic process begins with understanding how patients experience themselves, their relationships, and changes in mood. Only then can these experiences be meaningfully related to formal diagnostic criteria. The phenomenological perspective is not presented as an alternative to contemporary psychiatric diagnosis but as a complementary approach that may facilitate a deeper understanding of patients' symptoms and their impact on everyday functioning.