Clinical Assessment

Dr. Federman’s Approach to Bipolar Assessment

Assessment of new patients with bipolar disorder can vary greatly depending upon the extent of previous assessment and treatment already received.  When one comes in with a well-established diagnosis and treatment history, the assessment can be a bit more streamlined than if the appointment represents a first meeting with a mental health professional.

That said, we also have to acknowledge that bipolar symptoms exist on a very broad spectrum and there are multiple other conditions that can be expressed through symptoms that look very “bipolar-like.”   I’m therefore cautious about assuming that previous diagnoses are always accurate.  My intent is to look at all the evidence including current symptom, established patterns of mood and behavior as well as previous treatment and to essentially ask – what’s really going on?

Initial Assessment Session(s)

Whenever possible I like to try to schedule a double appointment for an initial assessment meeting.  During that time I’ll be trying to gather in-depth information about symptom patterns, current life circumstances, previous treatment, current medications and family background.  I will also give a fair amount attention to how an individual may feel about a potential or already existing bipolar diagnosis.  I find that if the bipolar diagnosis is accurate, issues involving acceptance of the diagnosis can be some of the stronger challenges that one is faced with.

Assuming that by the end of the first assessment session I’ve arrived at some definite conclusions and recommendations, they will be shared with you and we will discuss plans for going forward with treatment.  There may also be times when due to the complexity of presenting clinical issues, additional sessions may be needed before I’m able to be definitive about diagnosis and treatment recommendations.

Adjunctive Assessment

There are sometimes circumstances when further assessment may be needed from other mental health and/or medical professionals.  Examples would be when the contributing role Attention Deficit Disorder needs to be ascertained or when it’s suspected that some other physiopathology that may be responsible for the current symptom picture (brain injury, thyroid dysfunction, etc.).   These possibilities and referral options will be discussed with you if appropriate.