Bipolar disorder is a disabling psychiatric illness that is often misdiagnosed, especially on initial presentation. Misdiagnosis results in ineffective treatment, which further worsens the outcome.
A 2021 study also supported the need for blood biomarker tests health professionals can use to diagnose bipolar disorder, which researchers found to be misdiagnosed up to 70% of the time.
Cyclothymia symptoms alternate between emotional highs and lows. The highs of cyclothymia include symptoms of an elevated mood (hypomanic symptoms). The lows consist of mild or moderate depressive symptoms. Cyclothymia symptoms are similar to those of bipolar I or II disorder, but they're less severe.
To diagnose bipolar disorder, a doctor performs a physical exam, asks about your symptoms, and recommends blood testing to determine if another condition, such as hypothyroidism, is causing your symptoms. If the doctor does not find an underlying cause of your symptoms, he or she performs a psychological evaluation.
Moreover, impulsivity, a hallmark of BPD, is also increased among bipolar patients, even during periods of euthymia [17, 18]. In a recent study, nearly 40% of BPD patients were found to have a mistaken diagnosis of BD [8], whereas other studies reported an even higher rate (56%) of over diagnosis of BD [12].
Patients with bipolar disorder are often misdiagnosed as having unipolar depression in many circumstances. The reason is related to clinicians or patients lacking knowledge about manic and hypomanic symptoms.
Bipolar disorder can be an elusive disorder for doctors to identify because the symptoms can vary widely and is often masked or exacerbated by other factors such as concurrent drug use or remission of symptoms. Stigma makes it even more difficult for people to get help.
“To make a diagnosis of bipolar disorder, you have to see either a manic or a hypomanic episode,” says Ben Michaelis, PhD, a psychologist in New York City. These manic symptoms are ultimately what distinguishes bipolar disorder from unipolar depression.
What tests will the doctor use to make a bipolar diagnosis? Your doctor may have you fill out a mood questionnaire or checklist to help guide the clinical interview when they assess mood symptoms. In addition, your doctor may order blood and urine tests to rule out other causes of your symptoms.
As summarized in Table 4, bipolar disorder should be suspected if prominent behavior problems, anxiety, and substance abuse were present during childhood in someone with recurrent depression and a family history of affective disorders.
The manic episodes associated with Bipolar may not be obvious. They can be mistaken for other behaviours such as those commonly found with ADHD (rapid speech, inability to concentrate) because the person may not have had a manic episode until later in life.
Cyclothymia (cyclothymic disorder) is a milder form of bipolar disorder. It involves frequent mood swings of hypomanic and depressive episodes. Bipolar disorder is a lifelong mood disorder and mental health condition that causes intense shifts in mood, energy levels, thinking patterns and behavior.
A stressful circumstance or situation often triggers the symptoms of bipolar disorder. Examples of stressful triggers include: the breakdown of a relationship. physical, sexual or emotional abuse.
Bipolar disorder and anxiety are two mental health conditions that can look and feel similar. Some people also experience anxiety and bipolar disorder together. The differences come in the triggers behind the overarching symptoms.
A person may be happy at one point but could quickly shift to frustration, irritability, or anger after something happens to them. On the other hand, bipolar disorder daily mood swings are much more intense and can be much more difficult for a person to control.
Childhood traumatic events are risk factors for developing bipolar disorders, in addition to a more severe clinical presentation over time (primarily an earlier age at onset and an increased risk of suicide attempt and substance misuse).
First-line treatments for bipolar depressive episodes include lithium or lamotrigine monotherapy. For more severe cases, can add second mood stabilizer (e.g., lamotrigine combined with lithium or divalproex). Atypical antipsychotics can be added for patients with psychotic features (e.g., delusions, hallucinations).
Specialist assessment
During the assessment, you'll be asked about your symptoms and when you first experienced them. The psychiatrist will also ask about how you feel leading up to and during an episode of mania or depression, and if you have thoughts about harming yourself.
Bipolar disorder can occur at any age, although it often develops between the ages of 15 and 19 and rarely develops after 40. Men and women from all backgrounds are equally likely to develop bipolar disorder. The pattern of mood swings in bipolar disorder varies widely between people.
All types of bipolar disorder are characterized by episodes of extreme mood. The highs are known as manic episodes. The lows are known as depressive episodes.
"Bipolar disorder can worsen if left undiagnosed and untreated. Episodes may become more frequent or more severe over time without treatment. Also, delays in getting the correct diagnosis and treatment can contribute to personal, social and work-related problems.
Bipolar disorder is frequently inherited, with genetic factors accounting for approximately 80% of the cause of the condition. Bipolar disorder is the most likely psychiatric disorder to be passed down from family. If one parent has bipolar disorder, there's a 10% chance that their child will develop the illness.
Experts believe bipolar disorder is partly caused by an underlying problem with specific brain circuits and the functioning of brain chemicals called neurotransmitters. Three brain chemicals -- norepinephrine (noradrenaline), serotonin, and dopamine -- are involved in both brain and bodily functions.
One of the most common bipolar triggers is stress. In a study published in June 2014 in the Journal of Affective Disorders, negative or stressful life events were associated with subsequent mood swings.