Bipolar Disorder is not just what many people understand about this condition, episodes of uncontrolled mania followed by deep depression. On many occasions, the mood is unstable and mistaken for conditions like recurrent depression which does not seem to respond to antidepressants. This clinic will bring the opportunity to establish an accurate diagnosis and provide the most appropriate treatment responsive to the person's needs.
Studies suggest that the universal lifetime prevalence for Bipolar Illness is 2.4% (Frank E. 2011), and the prevalence for Bipolar Spectrum conditions is 5% according to recent research (Bipolar UK). A UK study suggests that between 3.3% and 21.6% of Primary Care patients diagnosed with Unipolar Depression might have an undiagnosed Bipolar Disorder (Smith et al 2010). Bipolar UK figures suggest that on average it takes 10.5 years to receive a correct diagnosis for Bipolar in the UK, and that before it is diagnoses there is a misdiagnosis with an average of 3.5 times.
But the difficulties about establishing an accurate diagnosis are multifactorial. Patients themselves tend to present to services when they are depressed rather than elated as they tend to enjoy the initial stages of hypomania. Sometimes, those initial stages are followed by mania; when it happens it is more likely that patients attract the services attention if not by directly presenting themselves, being referred by others. In those cases it is easier to establish the diagnosis. However those manic episodes can take a long time to happen and in the meantime, the condition remains undiagnosed or misdiagnosed as Unipolar Depression which might be treatment resistant.
Many times, the initial stages of hypomania are not followed by full mania, and the most salient part of the condition is the depression. Then, the condition tends to be misdiagnosed as recurrent depression. This is typical in Bipolar type II, where depression is more prominent than elation of mood. This type of depression does not tend to respond to antidepressants which worsen the condition by triggering a Mixed Affective State with mixed features of mania and depression or a Rapid Cycling presentation. Both presentations can also happen spontaneously. A Mixed Affective State might be a risky situation for patients who presenting with suicidal ideation might have the energy and motivation to carry out the suicidal act.
In addition, the Bipolar Illness might be misdiagnosed as Emotionally Unstable Personality.
Bipolar Illness can many times be masked by excessive drinking to which patients resort in order to quell untreated symptoms.
But also, there is the risk of give patients a diagnosis of Bipolar Illness when they do not have it, and sometimes the publicity around this condition might induce people to believe they have it and seek this diagnosis.
Hence the importance of establishing an accurate diagnosis followed by an appropriate treatment tailored to the needs of that particular patient.