Advertisement
Thanks Thanks:  0
Likes Likes:  0
Page 1 of 2 12 LastLast
Results 1 to 10 of 12
  1. #1

    Bipolar disorder is frequently misdiagnosed

    Bipolar disorder is frequently misdiagnosed
    March 07, 2006
    New York Times Syndicate

    Cox News Service (WEST PALM BEACH, Fla.) -- People who suffer from bipolar disorder -- that mental illness marked by extreme changes in mood, thought, energy and behavior -- may go 10 years or more before getting an accurate diagnosis.

    And why is that so terrible?

    Because the bipolar condition -- more commonly known as manic depression -- may come on gradually, the manic portion of the illness may not show up right away, or symptoms may be subtle.

    So, even if those with the disorder are treated for the depression they appear to have, those medications -- usually antidepressants -- may just exacerbate the illness.

    "Doctors frequently diagnose the disorder as major depression and prescribe conventional antidepressants," says Dr. Joseph Calabrese, professor of psychiatry and director of the Mood Disorders Program at Case Western Reserve University.

    "But one-quarter to one-third of bipolar patients may be susceptible to antidepressant-induced manias."

    That means, he said, that the antidepressants can throw bipolar patients into a manic state.

    "Traditional antidepressants never have been shown to stabilize mood in bipolar patients," he added. "They can push people in a mania or accelerate their cycling (from highs to lows.)

    "Remember that controversy about Prozac causing suicides?

    People who say, 'The day after I started Prozac, I was off the wall.' Prozac wasn't the cause of the suicide. It would make people worse if they didn't have major depression."

    "The state of the art isn't good enough," Calabese said, "to distinguish those who will develop bipolar. But family history can be useful. The illness may not be accompanied by mania right away."

    How, then, do people who have a depression gain some certainty that they aren't bipolar? Aside from a history of bipolar disorder in the family, which often is the signal, Calabrese suggests checking the Web site www.dbsalliance.org to take a mood disorders quiz.

    The Depression and Bipolar Support Alliance, which sponsors this Web site, contains information that could help a patient make that diagnosis. Calabrese said the screening questionnaire on the site is a "validated instrument" that can provide a good indication if there is bipolar disorder.

    Efforts are being made to develop better diagnostic tools for bipolar illness. Two years ago, the Radiological Society of North America presented a study on magnetic resonance spectroscopy as such a tool, saying it identified significant differences between the brain chemistries of people with and without bipolar disorder.

    Since the illness tends to run in families and appears to have a genetic link, that may be the best clue now to identify it in a person who is showing signs of depression.

    "Progress is being made," Calabrese said. "There is some reason for optimism."

    Carolyn Susman writes for The Palm Beach Post.

  2. #2

    Re: Bipolar disorder is frequently misdiagnosed

    "Doctors frequently diagnose the disorder as major depression and prescribe conventional antidepressants.... Traditional antidepressants never have been shown to stabilize mood in bipolar patients," he added. "They can push people in a mania or accelerate their cycling (from highs to lows.)"
    Is it really this difficult to diagnose bipolar disorder even w/ the training physicians receive? I understand that in general there isn't a big emphasis on mental health, but if you know that traditional antidepressants can throw some people into mania or a more rapid cycling, then wouldn't that be reason enough to try to rule out things like bipolar when prescribing medication? if family history is a good indicator, then what happens when there is no "available" family history in this regard???

  3. #3

    Re: Bipolar disorder is frequently misdiagnosed

    1. There often isn't a family history of bipolar - as often as not you may see a family history of anxiety or depression but not bipolar.

    2. If there has never been any evidence to date of a hypomanic or manic episode, it is more parsimonious and better medical practice to assume unipolar depression than bipolar, especially since for many people the medications to treat bipolar may be more difficult to tolerate. Sometimes, the first clue that it may be bipolar is a medication-induced hypomanic state.

  4. #4

    Re: Bipolar disorder is frequently misdiagnosed

    thanks for clearing that up. I always thought that bipolar runs in the family, hence why they mentioned family history... but there isn't a history of that in our family, or at least not as far as we know.... however, we're more and more realizing that there may very well be a history of depression as you said.... I think when it comes down to it I don't understand much about bipolar and I should look into it, and two, I'm mad about everything that has happened w/ my sister....

  5. #5

    Re: Bipolar disorder is frequently misdiagnosed

    "Sometimes, the first clue that it may be bipolar is a medication-induced hypomanic state."

    That might be what happened to me. I saw a therapist and a psychiatrist for eleven years before they observed a hypomanic episode, and later a full-blown manic episode. In those eleven years, I had been told both by the therapist and the psychiatrist that I was a hard guy to pin down with a diagnosis, but I believe the drugs they gave me were intially intended to treat "anxiety." (Those drugs were klonopin at first, and later trilafon to off-set psychotic symptoms that seem to have resulted from the klonopin.)

    I am not sure how the initial manic episode was triggered, but the reason why I came to believe it was medication-related is that it stopped after I stopped taking the klonopin. Although klonopin made me "feel" more relaxed, people around me reported that it made me much more talkative and disinhibited. I sometimes said and did odd things that later I couldn't see the reasoning behind, although they must have made sense to me at the time. I became disinterested in sleeping and eating, I began to overexercise, and I lost track of my spending habits. I also had delusions of grandeur and paranoid thoughts. When I stopped taking it, all of that gradually dissolved. I still experience what "feels" like hypomania and depression, but I'm not nearly as out-of-it as I was then.

  6. #6

    Re: Bipolar disorder is frequently misdiagnosed

    What was the dose of klonopin (clonazepam), stargazer?

    Clonazepam is a mild tranquilizer/benzodiazepine. I don't think hypomania would be an expected side-effect at normnally prescribed doses. I suppose it may have disinhibited you in some way. Or the onset of a hypomanic state might have been coincidental.

  7. #7

    Re: Bipolar disorder is frequently misdiagnosed

    You might find this shocking, but they had me on 6mg a day. That's the highest legal dosage here.

  8. #8

    Re: Bipolar disorder is frequently misdiagnosed

    Hmmm... that is a pretty high dose.

    I had not heard of this before but just found the following listed under "ADVERSE REACTIONS":

    http://www.rxlist.com/cgi/generic/clonaz_ad.htm

    Psychiatric: Confusion, depression, amnesia, hallucinations, hysteria, increased libido, insomnia, psychosis, suicidal attempt (the behavior effects are more likely to occur in patients with a history of psychiatric disturbances). The following paradoxical reactions have been observed: Excitability, irritability, aggressive behavior, agitation, nervousness, hostility, anxiety, sleep disturbances, nightmares, and vivid dreams.

  9. #9

    Re: Bipolar disorder is frequently misdiagnosed

    Sounds like I had a few of the "paradoxical reactions," as well as some of the psychiatric ones. I've heard, by the way, that higher dosages than 6mg are allowed in Canada. (Not sure if that's true.)

  10. #10

    Re: Bipolar disorder is frequently misdiagnosed

    I just noticed this part of your earlier post: " I don't think hypomania would be an expected side-effect at normnally prescribed doses. I suppose it may have disinhibited you in some way. Or the onset of a hypomanic state might have been coincidental."

    I'm wondering if the hypomania might have resulted from a combination of the high dose of clonazepam and other factors, such running longer faster distances and not getting much sleep. Seems to me I also got in the habit of having a couple drinks late at night (around 11pm) every night, thinking they would help me sleep, and then I usually got a "second wind" and would stay up till around 3am and get up at seven to go to work. It was definitely an unusual time in my life.

    I don't recall what brought the change in habits on, but I think it had something to do with my Mom dying, which was shortly before the episodes.

Page 1 of 2 12 LastLast

Similar Threads

  1. Borderline Personality Disorder frequently misdiagnosed
    By David Baxter in forum Borderline Personality Disorder
    Replies: 13
    Last Post: February 12th, 2012, 01:13 AM
  2. Bipolar I Disorder versus Bipolar II Disorder
    By David Baxter in forum Bipolar Disorder, Cyclothymia
    Replies: 40
    Last Post: July 1st, 2009, 10:19 AM
  3. Bipolar Disorder Commonly Misdiagnosed
    By HA in forum Bipolar Disorder, Cyclothymia
    Replies: 3
    Last Post: June 28th, 2007, 05:42 PM
  4. Borderline Personality Disorder and Bipolar Disorder seem very similar
    By Steven_v in forum Borderline Personality Disorder
    Replies: 3
    Last Post: April 25th, 2007, 06:25 PM

Bookmarks

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •