Bipolar affects people of many ages and demographics, and it is a very difficult condition both to diagnose and to treat. Over the past year, various reports have supported this: some indicate that bipolar is over-diagnosed (by as many as half the diagnoses delivered), while others suggest that it’s under-diagnosed (with patients receiving an incorrect “borderline personality disorder” diagnosis instead).
The University of Cincinnati’s Caleb Adler, MD, who works as a UC Health psychiatrist and associate professor at the University’s psychiatry and behavioral neuroscience department, recently spoke with PhysOrg.com for a feature on the multiple symptoms that can point to bipolar. Symptoms can include deep depression, strong mania, or a both. Because these symptoms run the gamut of high and low, it’s easy for bipolar to look like something else if the person is only evaluated in their current frame of mind. Depressive moods that last for a long period of time may be diagnosed as depression or anxiety, and frenetic moods may simply appear to just be high energy or creativity.
But in reality, these extremes can be far more debilitating, and that’s when the problem becomes profound enough that bipolar may be an appropriate diagnosis. Adler gives the example of someone who, in a manic episode, stays up all night studying, but retains none of the information because their brain jumps from one idea to another the whole night. Manic episodes can be either negative (the person may become extremely irritable or even aggressive) or positive (such as over-indulging in otherwise pleasurable things, like impulsive shopping or traveling). “In the end, it comes down to behavior [that’s] out of proportion to the circumstances,” he explains. Genetics and family history can also play a role in reaching a secure diagnosis. Treatment is equally complex, and while medication is often considered necessary, it’s far more effective when paired with appropriate therapy, which differs from individual to individual.
© Copyright 2010 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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