Overdiagnosis of Bipolar Disorder

Not too long ago, people suffering from bipolar disorder were being underdiagnosed and went without treatment. Now, the number of people diagnosed with bipolar has risen dramatically. At first, it would seem that this was to compensate for mistakes of the past. However, a study conducted at The University of Rhode Island showed that more than half of the 700 people they interviewed for their study were mistakenly diagnosed with bipolar disorder.

Causes

• One reason bipolar disorder is so commonly misdiagnosed is that a number of other disorders and problems have similar symptoms. In addition, the doctor must use the patient's testimony of his symptoms to make a proper diagnosis. For this reason, diagnosis can be as variable as the patient's interpretation of what symptoms mean. Finally, if there is a family history of bipolar disorder and the patient appears to have bipolar symptoms, the psychiatrist may automatically assign a diagnosis of bipolar disorder without proper investigation.

Symptoms of Bipolar Disorder

• To better understand how the diagnostic process works, you should have a basic understanding of the symptoms. Bipolar disorder is characterized by periodic episodes where the patient swings between feelings of depression and mania or hypomania. Symptoms of depression include hopelessness, feelings of worthlessness, thoughts of suicide and depressed mood. Symptoms of mania and hypomania are rapid thoughts, elated mood, delusions of grandeur and irritability; these symptoms will be more intense with mania.

Diagnosing Bipolar Disorder

• Since the problem of overdiagnosis begins with the diagnostic process, it's important to understand how bipolar disorder is diagnosed. According to Dr. David Miklowitz's book, "The Bipolar Disorder Survival Guide," in order to be diagnosed with bipolar I disorder, your period of mania must have lasted for at least a week and/or resulted in hospitalization. You also must have had at least one major depressive episode, although some doctors will still diagnose bipolar disorder without this, assuming it will happen sometime in the future. A diagnosis of bipolar II disorder only requires that you have had at least one episode each of hypomania and depression.

Similar Disorders

• Many disorders can be easily confused with bipolar disorder during the diagnostic process. ADHD with secondary depression has almost identical symptoms to bipolar disorder and is very difficult to distinguish. Borderline personality disorder is also characterized by mood swings, but these are only related to relationships. Substance-induced mood disorder is almost identical to bipolar disorder except that its symptoms are triggered by frequent drug or alcohol use. There are even more disorders that have a strong resemblance to bipolar disorder; knowing this, it's easy to understand how misdiagnosing these disorders with bipolar disorder can lead to an overdiagnosis of the latter.

Correcting Misdiagnosis

• If you think your diagnosis of bipolar disorder is inaccurate, your best option is to discuss your worries with your psychiatrist. You may even want to seek a second opinion. Focus on accurately describing your symptoms and experiences. If the doctor asks you a question you don't understand, ask him to clarify rather than trying to make your best guess. If your doctor is sure of your diagnosis, your second opinion agrees and your medications are successful, then more than likely your diagnosis of bipolar disorder is correct.