Bipolar Disorder Being Misdiagnosed as Major Depression

As many as 1 in 3 patients diagnosed as suffering from major depression actually has undiagnosed bipolar disorder instead, according to a recent study by psychiatrist Charles Bowden at the Texas Health Sciences Center.

The study included 5,635 participants that had already been diagnosed as having major depression. Patients were from 18 countries in Asia, Europe and Africa. It was presented at the annual conference of the American Psychiatric Association.

An accurate diagnosis is important because bipolar patients usually do not improve on antidepressants. In fact, the antidepressants may make any symptoms of mania more pronounced. Instead, the bipolar patient needs mood-stabilizing drugs.

The San Antonio researcher identified five characteristics that helped predict which depressed patients would later be diagnosed as having bipolar disorder. Among the risk factors were a family medical history of mania, and first having psychiatric symptoms younger than 30. Patients who had two or more mood episodes (bouts of depression or mania) were more likely to be bipolar, instead of depressed.

Traditionally, bipolar patients may have a manic period or depression that lasts months or even years. However, Bowden found that many of the misdiagnosed patients had profound mood swings within the same day, or showed mixed symptoms of depression and mania at the same time.

Under current diagnostic standards, only patients with elevated mood or irritability are assessed for possible bipolar disorder.

Other studies suggest that of patients diagnosed as having major depression, 31 percent or 41 percent actually have bipolar disorder. However, among the patients with Dr. Bowden’s characteristics, 47 percent were eventually diagnosed as bipolar.

The study evidence is strong due to the large number of participants. However, it is not clear if the same results would hold true for patients in the U.S.

Bipolar disorder is also called manic depression or bipolar affective disorder. Patients may go through periods of mania, during which they are talkative and more active than usual. In extreme cases, the manic patient experiences psychosis. These episodes alternate with periods of depression and often with periods of normal mood, or mixed episodes with both manic and depressive characteristics.

By Joni Holderman, [email protected], contributing reporter for Mental Health News.