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Bipolar Disorder May Be Misdiagnosed at Alarming Rates, With Serious Consequences

A mental illness affecting millions of people each year is also among one of the most commonly misdiagnosed. Bipolar disorder, hallmarked by drastic mood shifts and changes in behavior patterns, touches the lives of 2.5 million people annually, says the National Institute of Mental Health. However, this disorder is often mislabeled as depression or schizophrenia, thus delaying treatments and adding to a sense of confusion and frustration for patients and their families.

In one study, with findings presented in 2009 at the Royal College of Psychiatrists’ Annual Meeting, researchers said that more than one-fourth of total patients who actually have bipolar disorder were first diagnosed with conditions like depression when they sought help from a professional in the mental health field.

Most people with bipolar disorder will receive a diagnosis early in life, before they reach the age of 20, and most can indicate a family member who suffers from serious depression or who also has bipolar disorder. For females, the symptoms of bipolar disorder are more commonly called depression, with an estimated one-third of people falsely diagnosed with depression instead of bipolar disorder. For men, schizophrenia seems to be the leading misdiagnosis.
Other studies show that people who receive the diagnosis of bipolar medication may be given up to three different mood-altering or stabilizing prescriptions at the same time, such as antipsychotics, antidepressants and benzodiazepines, further heightening the critical need for an accurate diagnosis.
The confusion, say experts, lies in the fact that depression can be a part of the range of moods a person with bipolar disorder manifests. A person with this illness can seem depressed on a daily basis, avoid activities they once enjoyed, have trouble sleeping, be overly tired and show symptoms of poor self-worth or even suicidal tendencies.

Yet the mania that also accompanies bipolar depression – with symptoms including bouts of euphoria, impulsive actions, fast speech or highly-charged future goals – can prompt dangerous actions, overspending or drug or alcohol abuse. It is the mania element that many experts say may be overlooked when patients describe their symptoms or when physicians consider their diagnosis.

Further danger comes from prescribing the wrong medications, because people with this mental illness may react differently to common pill-based treatments. If someone with bipolar disorder, says Stacey Weiland, Colorado-based internist, is given typically prescribed treatments for depression – like selective serotonin reuptake inhibitors – they can experience a serious incidence of mania.
Instead, health experts have called for a focus on treatment that involves not only medication, but also counseling and the teaching of new ways to deal with self-esteem problems and life challenges. For some patients, this can include a new awareness that the illness of bipolar disorder isn’t a label for the patient as a total package, but rather a piece of the person’s life.

The American Psychiatric Association (APA) is also exploring the confusion and misdiagnosis surrounding bipolar disorder, and will modify some phrases used in the Diagnostic and Statistical Manual of Mental Disorders when it is printed again in 2013. In addition to assisting professionals in accurately diagnosing adults, the APA hopes to prevent misdiagnosis toward children, who may be over-diagnosed with the illness, a fear backed by major increases in the number of bipolar diagnoses among children in recent years.
 

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