Photo credit: Abode of Chaos
It is not uncommon for us, bipolars, to receive our correct diagnosis about 10 years after we first go to a doctor. There are a myriad of reasons why this happens. Below I have compiled a list of the main difficulties of diagnosing Bipolar Disorder (BD).
- BD is a complex illness with a wide range of symptoms that play out differently for each person.
- Besides, BD is in reality a spectrum of different types which are easily misdiagnosed as Anxiety Disorder, Schizo-Affective Disorder or a Personality Disorder.
- In addition, mixed episodes are really difficult to detect since symptoms of both (hypo)mania and depression coexist.
- BD usually starts with one or more (up to 5) episodes of depression before (hypo)mania hits. Hence, patients are often misdiagnosed with Major Depressive Disorder.
- As the medical journey many times starts with the GP it is vitally important that he is able to be aware of the differences in unipolar and bipolar depression. Sadly this is not the case for the majority of GP’s.
- It is an art to be able to ask the right questions in order to find out if someone is also suffering from (hypo)mania.
- If the right questions are being asked, the patient still has to recognize the symptoms in his own life. This is made even harder since the patient might not be aware of the symptoms, as it seems to him his normal life.
- Also, because of the stigma of a mental illness (where depression is a far more acceptable diagnosis) it is easy to downplay any possible symptoms that point to BD.
- Especially when the patient is (ultra) rapid cycling he doesn’t meet the criteria for BD plus he is even more likely to encounter difficulties in recognising symptoms in his own life.
- Family history plays an important part in susceptibility for BD. However, the likelihood of (grand)parents being undiagnosed is huge. Furthermore the family medical history might not be known.
- Other complicating factors are certain diseases which mimic some symptoms of BD, like lupus, Lyme disease, thyroid disorder and epilepsy, amongst others.