Am I bipolar? Or is it something else…
Hello friends! We had a reader reach out requesting more information on bipolar disorder and how likely it is that a misdiagnosis can occur. Today we are going to dive into some history of the disorder as well as address some of the issues revolving around diagnosis and the unfortunate chance of misdiagnosis.
History of Bipolar Disorder
Way back in 1854, psychiatrist Jules Falret described a condition that was characterized by “episodes of depression and heightened moods”, he called this condition folio circulaire(circular insanity). Nearly a year later it would be given the name maniac depressive psychosis. Originally, this condition wasn’t considered to be a legitimate illness, it wasn’t until the early 1970s when things began to change and it became more widely recognized as a serious illness, due in part to certain laws regulations and organizations forming within society.
In the Diagnostic and Statistic Manual of Mental Disorders (DSM) it was originally listed as maniac-depressive disorder, but was changed in the DSM-III in 1980 to bipolar disorder. In the DSM-4 they classified it into more categories: bipolar I, bipolar II, cyclothymia, and bipolar disorder, not otherwise specified (NOS). Currently, we use the DSM-5 and it classifies the disorder as, bipolar I, bipolar II, cyclothymic disorder, substance/medication-induced bipolar and related disorder, bipolar and related disorder due to another medical condition, other specified bipolar and related disorder, and unspecified bipolar and related disorder.
Now, obviously, the DSM-5 has several different categories than any of the previous editions, but for the most part it all comes down to the requirements and symptoms necessary to possess in order to be properly diagnosed.
Misdiagnosis
According tot he National Institute of Mental Health (NIMH), nearly 4% of people in the US are diagnosed with bipolar disorder at some point in their lives, and nearly 2.8% were diagnosed within the past year. There are also studies suggesting that some of these diagnoses are incorrect, while other studies say that these numbers are far less accurate than the true amount of people suffering with bipolar disorder.
According to a study conducted by Mark Zimmerman, MD, nearly half of the individuals who were diagnosed with bipolar disorder did not actually have the condition. The study found that there are a few reasons that can lead to a misdiagnosis. One reason he found quite notable is the aggressive marketing to doctors by drug companies used to treat bipolar disorder.
“When a pharmaceutical company repeatedly says, don’t miss bipolar disorder, don’t miss bipolar disorder…and when you diagnose it, here are some medications you can use to treat it, there’s a tendency to expand the concept” says Zimmerman.
Also, the amount of time a clinician may spend with a patient can also contribute to a misdiagnosis.
Another reason that can lead to misdiagnosis is that bipolar disorder shares some of the same symptoms as other illnesses, specifically borderline personality disorder, with impulsive behaviors, problems relating to other people, etc. So, it is very common that those with borderline personality disorder may be diagnosed as bipolar and vis versa, without there being evidence of that condition.
Often times, individuals can be diagnosed as having depression rather than bipolar disorder. There can be a variety of reasons for this diagnosis. For example, if you are a younger individual, you may only be experiencing the depressive episodes and haven’t had a manic episode yet, therefore you are not sharing these signs of mania with your doctor/mental health professional, and they are unable to diagnose properly. It could be as simple as you have great coping skills for when you are going through a manic episode and you don’t feel the need to discuss these times, because you feel as though you “have it under control”. Those that are misdiagnosed as depressed, typically become properly diagnosed later in life as they are not able to properly manage both the depressive and manic episodes further down the line.
Another thing to keep in mind, is that most individuals with bipolar disorder are also suffering from another mental health condition too, such as an anxiety disorder, eating disorder, or even a substance abuse problem which could potentially lead to misdiagnosis.
I was diagnosed as bipolar, but maybe I’m not? What do I do now?
First and foremost, make sure you are sharing ALL of your symptoms and emotions with your doctor/mental health professional, that means both the good and bad. Also remembering that your doctor/mental health professional is unable to read inside of your mind, so whatever information you are allowing them to know is all they have to go off of when diagnosing you. Making sure they have the most accurate information is key.
Finally, once given your diagnosis, it’s important to communicate with your doctor/mental health professional, especially if you have any questions or doubts regarding the diagnosis. By simply asking them to explain their reasoning for the diagnosis, you can either gain more insight, or determine whether or not you want to get a second opinion from another doctor. Typically, good doctors are willing to share their reasoning with you and explain any questions there may be.
Ultimately, it is possible to be misdiagnosed, but it is also possible that the diagnosis given was the most accurate available given the information on your symptoms, emotions, behaviors, etc. at the time of diagnosis. It is essential that there be an open line of communication between you and your providers to ensure that misdiagnosis doesn’t occur and that everyone is on the same page when it comes to the bigger picture.
As always, if you have any questions or concerns, or even just a topic you are interested in reading, please don’t hesitate to reach out to us!
