David Baxter PhD
Late Founder
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.
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.