Bipolar Disorder: A Mistaken Diagnosis

By Marissa Kristal

One of biggest difficulties concerning bipolar disorder is the thorny issue of mistaken identity. It's a wonder that it even gets treated. A lot of people only notice the low mood swings, never mind those unbelievable highs that seem to send them to the moon. Bipolar disorder affects some 2 to 5 percent of Americans, but how can they combat an illness when they don't know what they have?

A study showed that 40 percent of patients initially diagnosed with depression were actually suffering from bipolar disorder. Differentiating the two can be tricky because symptoms look pretty much identical: The thing to remember is that bipolar disorder instigates bouts of depression and mania. In fact, patients may assume the mania is part of their personality rather than signs of illness. Besides, who can remember "up" episodes when the depressive ones are so low?

S. Nassir Ghaemi, director of the Bipolar Disorder Research Program at Emory University, adds that many patients don't have the necessary insight to describe or understand their manic symptoms anyway. In turn, patients don't help the situation by downplaying their symptoms (since bipolar disorder comes with a boatload of stigma). And adding to this confusion is a physician's lack of knowledge about a patient's family history and mood patterns.

Now that physicians are thoroughly befuddled, they go forth by prescribing antidepressants that only make matters worse. A study led by psychiatrist Gary Sachs, of Massachusetts General Hospital, found that antidepressants, in conjunction with the standard treatment of mood stabilizers such as lithium, rarely help patients with bipolar disorder. While Sach's study showed that antidepressants do not provoke manic episodes, many researchers argue that they do. They also argue that antidepressants cause other ill effects such as inducing rapid cycling between depressed and manic states, as well as increasing suicidal thoughts.

Bipolar disorder is a recurrent illness, and patients who go untreated can suffer tremendously—both personally and professionally. What's more, among untreated sufferers 50 percent turn to drug and alcohol abuse. And no wonder, manic-depressives experience longer lasting and more severe ups and downs— with fewer "normal" moods in between.

Knowledge may be a manic-depressive's biggest ally. Here are some pointers to keep you informed:

What to Look For In the Height of Mania:

• Increased energy and restlessness
• Excessively euphoric mood
• Extreme irritability
• Fast thinking
• Inability to concentrate
• Difficulty sleeping
• Poor judgment
• Increased sex drive
• Abuse of drugs
• Aggressive behavior
• Denial that anything is wrong

In the Depths of Depression:

• Feeling sad, empty, hopeless, guilty
• High levels of anxiety
• Loss of interest in activities once enjoyed
• Decreased energy; feeling lethargic and fatigued
• Difficulty concentrating and making decisions
• Change in appetite
• Unexplained aches and pains
• Thoughts of death or suicide