Some Warning Signs of Bipolar Disorder

February 20th, 2010

The older term for bipolar disorder, manic depression, is perhaps too narrow in its focus on the two most extreme moods found in bipolar disorder. Regarding these extreme instances or poles as only the top and the bottom of the entire globe provides us insight into how an entire world of emotions is part of everyone’s emotional life.

People seeking to help or diagnose individuals suffering from bipolar disorder may need to sort through a whole range of emotional states – only some of which that can be characterize as mental illness. The classic manic-depressive sequence may not play out in persons that are in fact bipolar. Milder forms of bipolar disorder may not be detected at all or escape detection for a number of years. Bipolar extremes may closely resemble other forms of depressive mental illness. Since around 50 per cent of persons diagnosed with bipolar disorder abuse drugs and alcohol those substance may interfere with diagnosis also.

The following facts need to be considered by anyone seeking to diagnose this type of mental illness:
• About 20 per cent of people that present to a healthcare professional with complaints of depression are suffering from bipolar disorder.
• As many as three professionals have misdiagnosed about half the cases of bipolar disorder before those cases are correctly identified as bipolar disorder.
• The average delay between initial symptoms and treatment of bipolar disorder is ten years. Some of that problem is attributable to misdiagnosis.

What Makes Bipolar Disorder Mistaken For Mere Depression So Often?
Psychiatric workers encounter classic depression in patients very frequently. In people with bipolar II disorder episodes of depression outnumber manic episodes by a factor of 35 to 1. In people with bipolar I disorder episodes of depression outnumber manic episodes by a factor of just 3 to 1. Those three factors should serve to convince those tasked with the job of diagnosing people with mental problems that bipolar disorder should not be ruled out quite so quickly when symptoms of depression are in evidence.

When we look at mania our caution regarding ruling out bipolar disorder too quickly is reinforced. Recall that in cases of bipolar I disorder depression outweighs mania by a 3 to 1 factor. Add to that the fact that the severe mania that characterizes bipolar I disorder is relatively easy to diagnose and it isn’t surprising that an absence of severe mania in bipolar I disorder patients causes a misdiagnosis. In bipolar II disorder the milder forms of mania (hypomania) may also lead diagnosticians to conclude that no mania is present at all.

The following checklist should help those assessing people with psychological symptoms to carefully consider the possibility of bipolar disorder before ruling it out. Don’t consider this an exercise in “guilt by association” but take heed that the following are often associated with a developing bipolar disorder, especially in teenagers.
Depression
Substance abuse
Thoughts of suicide
Impulsive behavior
Attention-deficit/hyperactivity disorder (AD/HD)
Anxiety

No one factor can confirm the possibility of bipolar disorder, but these indicators can point to that possibility.

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