Diagnosis Errors in Bipolar Disorder: Causes and Explanations
Bipolar disorder, a mental health condition characterized by severe shifts in mood and energy levels, is often misdiagnosed, especially in the early stages or when it arises at a young age. This misdiagnosis can lead to inappropriate treatment, illness progression, and an increased risk of suicide.
The condition is marked by mood episodes that may involve depression, mania, hypomania, and mixed states. However, the symptoms can overlap with other mental health disorders, such as unipolar depression, schizophrenia, attention deficit hyperactivity disorder (ADHD), borderline personality disorder (BPD), and substance use disorder.
One of the most common misdiagnoses is major depressive disorder (MDD). Up to 40% of people with bipolar disorder are misdiagnosed, with this misdiagnosis being even more prevalent in those with bipolar I disorder with psychotic features, where 50% are misdiagnosed as having other disorders.
The reason for this misdiagnosis is multifaceted. It can be due to symptom overlap, incomplete patient history, and subtle manic symptoms. For instance, emotional dysregulation, common in those with a history of trauma or PTSD, can be mistaken for rapid-cycling bipolar II disorder. Similarly, a diagnosing doctor may mistakenly believe someone with bipolar disorder has ADHD instead.
Interestingly, up to half of those with ADHD may also have bipolar disorder. This comorbidity adds another layer of complexity to the diagnostic process. Conditions like BPD, characterized by intense emotions, impulsive behavior, and suicidal thoughts or actions, may also lead to misdiagnosis of bipolar II disorder in 40% of cases.
Ethnicity may also play a role in misdiagnosis, with people with African ancestry more often misdiagnosed compared to those of non-African ancestry.
In the United States, bipolar disorder is diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). The manual outlines three main types of bipolar disorder: bipolar I disorder, bipolar II disorder, and cyclothymia.
It's important to note that misdiagnosis can have serious consequences. Early and accurate diagnosis is crucial to ensure appropriate treatment, prevent illness progression, and reduce the risk of suicide. If you or someone you know is experiencing symptoms of bipolar disorder, it's essential to seek help from a mental health professional.
Symptoms of other mental health disorders, such as generalized anxiety disorder (GAD), including anxiety, restlessness, and agitation, may also be misdiagnosed as bipolar disorder. So, it's crucial to provide a comprehensive patient history to help the diagnosing doctor make an accurate diagnosis.
In conclusion, while bipolar disorder can be challenging to diagnose, understanding its symptoms and potential misdiagnoses can help improve the accuracy of diagnoses and provide appropriate treatment for those affected by this condition.
