Bipolar disorder is a serious mental health problem that affects about 2.3 million Americans, more than one percent of the population. The main reason many people with bipolar disorder are not being treated is because it's hard to diagnose. But even after diagnosis, treatment may be difficult. Some people who are diagnosed stop their treatment because they decide they don’t need it anymore, or because medication side effects are too distressing.
All of this adds up to many people with bipolar disorder who are not getting the treatment they need—and who risk serious health consequences.
Why Bipolar Disorder Is Hard to Recognize
Most people with bipolar disorder—about 70%—are misdiagnosed at least once before the condition is identified, and the average length of time from when symptoms start to a correct diagnosis is 10 years.
Bipolar I disorder is the most common type. Once called manic depressive disorder, bipolar I involves mood swings from extreme highs (mania) to extreme lows (depression).
Bipolar II disorder involves severe depression, but the manic moods, called hypomania, are less so. This type of bipolar disorder is often not recognized by primary care doctors, largely because hypomania is hard to spot.
Hypomania has some of the same characteristics as mania, but it doesn’t last as long (four days compared to at least a week for mania) and is not accompanied by major disruptions in your social or work life. In fact, some people view hypomania in a positive light. A hypomanic person may be the “life of the party,” always coming up with new ideas, and not needing much sleep.
Other reasons for misdiagnosed bipolar disorder:
Many people with mania, especially hypomania, do not recognize it as abnormal. They may think of it as simply a high amount of energy or joy.
People may have more depression than mania and may be misdiagnosed as having major depression.
People in a severe manic episode may see, hear or believe things that are not real and be misdiagnosed as having schizophrenia.
Up to 60% of people with bipolar disorder also abuse drugs or alcohol, and bipolar disorder is sometimes misdiagnosed as substance abuse.
In children and adolescents with bipolar disorder, the symptoms may be misdiagnosed as ADHD (attention deficit hyperactivity disorder).
The Risks of Untreated Bipolar Disorder
Bipolar disorder tends to get worse the longer it goes untreated. Delays in diagnosis and treatment can lead to personal, social and financial problems that make the disorder more difficult to deal with for those who have it and for those around them.
Dangers of untreated bipolar disorder include:
Loss of ability to work. Bipolar disorder is the sixth leading cause of disability in the world.
Stress on personal relationships. This can result in unemployment, divorce, and legal problems.
Substance abuse issues. Delayed diagnosis may contribute to people with bipolar disorder abusing drugs and alcohol. Studies show that 56% abuse drugs and 44% abuse alcohol.
Suicide. Thirty percent of people with untreated bipolar disorder commit suicide.
Getting Diagnosed and Getting Treated
While bipolar disorder is generally a life-long illness, treatment helps most people manage their symptoms. You may still have lingering symptoms and relapses, but you can enjoy a good and productive life. Because there is no blood test or brain scan that can diagnose bipolar disorder, you need to let your doctor know if you have any of the symptoms. You may be at increased risk of bipolar disorder if you have a family history of the disease.
Symptoms to report include:
Periods of depression when you may be very tired, have no energy, be unable to think straight, feel helpless, or have thoughts of death or suicide
Periods of mania when you may not need sleep, talk very fast, be very restless, have unrealistic ideas, and engage in reckless behaviors
Periods of mania or depression that last for at least seven days
Periods of mania or depression that are a major change from your normal behavior, most likely affecting your work and social life
Shifting back and forth between periods of feeling low, sad and helpless and feeling high, unstoppable and energetic
Bipolar disorder is a serious mental health problem that often goes undiagnosed, misdiagnosed and untreated.
Bipolar disorder may be confused with many other mental and behavioral disorders.
Untreated bipolar disorder can lead to social, emotional and financial problems as well as substance abuse and suicide.
Early diagnosis and early treatment offer a good chance for a full and productive life.