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Why Is Bipolar Disorder So Difficult to Diagnose?

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When someone is experiencing bipolar disorder, they may not even know they suffer from this mental health disorder. Initially, they may believe they are going through depressive periods because of excess stress and anxiety. They could also view the ups as having extra energy and being overly happy. These are just a few of the reasons why bipolar disorder is so difficult to diagnose. 

What Is Bipolar Disorder?

Bipolar disorder is a mental health condition where a person will go through periods of ups and downs. As their moods shift, they will experience different behaviors related to whether they are in an up or a down. The up period is often referred to as mania, while the low period is referred to as depression. These changing behaviors and moods make it difficult to diagnose bipolar disorder.

Why Is Bipolar Disorder so Difficult to Diagnose?

Bipolar is challenging to diagnose because the symptoms people experience vary from one person to another. It can be challenging for healthcare professionals to identify initially because the person may be in a depressive state. So, they could be diagnosed with depressive disorder.

Another reason why diagnosis can be difficult is some people may not think anything is wrong. For example, their depressive symptoms may be mild, so they may believe they are just going through a period where they just feel down and sad. On the other hand, when they experience a manic episode, they may think they are just over-energized and not think anything is wrong.

Furthermore, some people may go for long periods where they do not experience either mania or depression. As a result, they can feel normal for long periods, so when they do have an episode, they may not seek medical care or speak to a mental health professional. 

Symptoms of Bipolar Disorder

Mania and depressive episodes have their own symptoms that can help someone realize they have bipolar disorder. The extent of symptoms do vary based on the type of bipolar disorder someone has and could include the following:

Mania Symptoms

  • Excessive energy
  • Impulsive decision making
  • Elevated activity levels
  • Insomnia
  • Euphoric, happy, and joyful moods
  • Overly talkative
  • Rapid thought patterns that jump from one thought to another
  • Jumping from one task to another
  • Engaging in risky behaviors
  • Reduced appetite

Depressive Symptoms

  • Loss of energy
  • Feeling sad, down, and blue
  • Problems focusing and concentrating
  • Excessive sleeping
  • Excess eating as a means of comfort
  • Crying for no reason
  • No interest in activities
  • Thoughts of self-harm

Types of Bipolar Disorder Diagnoses

There are several types of bipolar disorder depending on the extent of symptoms one is experiencing. Bipolar I is when an individual cycles through one or more mania and depressive episodes. There can also be periods between the episodes where the person feels normal.

Bipolar II is where the person cycles through depressive episodes and elevated mania episodes, called hypomania because they are more intense than mania episodes. A person experiencing hypomania will be highly energetic, very talkative, and very active. They also have a hard time sitting still for long periods. 

The third type of bipolar disorder is called a cyclothymic disorder. This disorder is when the person has minimal depressive symptoms but experiences hypomania episodes. They must also have cycled through at least one of each episode and have experienced repeat episodes for two years or longer. 

There are also variations of different disorders that have bipolar disorder symptoms but do not always fit with these types. Consequently, these variations are yet another reason why bipolar disorder is so difficult to diagnose.

How Long Do Episodes Last?

It depends on the person and the extent of their bipolar disorder. Some people may feel mania or depression for a few days before feeling normal. Other people can go for several weeks in a manic or depressive episode.

However, once the episode is over, they do not automatically jump from one to the next. Instead, they can go weeks or months where they feel normal and experience no symptoms whatsoever. In addition, some people can experience the same episode as their previous one before experiencing the other one. 

For example, someone could have a mania episode followed by a period of normalcy only to have another mania episode later. Then after their normal period, they could experience a depressive episode or vice versus. 

Why Do Some People Use Substances to Treat Bipolar Disorder?

Some people use alcohol or drugs to treat bipolar disorder and regulate their manic or depressive episodes to feel more normal. For instance, someone experiencing mania could drink or use depressants to bring them back down. Conversely, they could use stimulants when they feel depressed to help make them feel more normal. 

Unfortunately, self-treating one’s bipolar disorder can lead to further problems and make symptoms of manic and depressive episodes worse. In addition, the more someone drinks and uses substances, the more likely they will develop an addiction.

Eventually, they can get to the point where they cannot function without drinking or using substances while still dealing with the symptoms of their bipolar disorder. Fortunately, it is possible to get help with co-occurring conditions when someone wants to overcome their alcohol or substance use disorder and get help for their bipolar disorder. 

Bipolar Disorder Diagnosis and Treatment in Orange County, CA

When you are struggling with bipolar disorder and alcohol or substance use disorder, Pacific Sands Recovery Center in Orange County, CA, offers dual-diagnosis treatment services. We provide a safe, supportive, and caring environment at our IMS and JCAHO-accredited treatment center. Contact us today.


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