The Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association includes Bipolar Disorder Not Otherwise Specified (NOS) as one of several classifications that fall under the bipolar disorder spectrum. Though the "NOS" label might suggest that bipolar disorder NOS is less severe than other forms, this is most certainly not the case. Without proper medical attention, bipolar NOS can greatly impact the quality of life for the patient and for those around him.
Symptoms
Symptoms of bipolar disorder NOS can encompass the symptoms that exist across the bipolar disorder spectrum. They include mania, hypomania, depression, racing thoughts, sleep disturbances, delusional or grandiose thinking, hypersexuality and risky behavior with no regards for the consequences.
A Catch-All Diagnosis
The bipolar NOS classification allows mental health professionals to highlight the presence of bipolar symptoms that do not meet the criteria for any of the more clearly defined bipolar classifications. For instance, a bipolar NOS diagnosis can be made by a mental health professional when a patient rapidly alternates between manic and depressive symptoms. To meet the criteria for the other bipolar classifications, the time spent in either depression or mania must be longer in duration. In addition, when patients experience recurring hypomanic episodes without the presence of depression, this may warrant an NOS diagnosis.
A Provisional Diagnosis
Doctors sometimes use the NOS diagnosis on a provisional basis when there is not information available to make a more complete bipolar diagnosis, but they wish to document that the symptoms fall in line with bipolar disorder. Over time, as more information becomes available, a patient's diagnosis may change from NOS to one of the other classifications.
The Presence of Other Disorders
A psychiatrist may label a person as having bipolar disorder NOS when he suffers from manic or mixed mood episodes that appear to be part of another disorder. Examples of other mental health conditions that can be superimposed with bipolar NOS include delusional disorder and residual schizophrenia.
Treatment
As with other bipolar disorder classifications, bipolar NOS is treated with a combination of medications for mood stabilization, depression and psychosis. Treatment plans are usually individualized to ensure that each patient's unique set of circumstances with regards to manic and depressive episodes is addressed. Psychotherapy and/or counseling is often used together with medication treatment.
