The Dangers of Misdiagnosis of Bipolar Disorder: Overdiagnosis

Imagine being told by a doctor you trust that you have a disease, something most people don't understand and are frightened of. The doctor stamps your file with the name of the disease and gives you medicine, promising it will make you feel better. You struggle through months or years of different medications, different debilitating side effects, different times that you need to tell disclose the illness. Although you don't want to be ashamed of it or hide it since it's not your fault, some people treat you differently once they know. Then one day you find out you were misdiagnosed; you didn't have the disease after all and that most of the medication you took was unnecessary. Some of it probably exacerbated your symptoms, in fact.

Sounds impossible? This situation is occurring more and more often today for people diagnosed with bipolar disorder.

Overdiagnosis

A recent study found alarming numbers of people who had been misdiagnosed as having bipolar disorder. Nearly half of the outpatients in psychiatrist Mark Zimmerman's study didn't have enough symptoms to confirm that they were bipolar. Out of an estimated 5+ million people with bipolar disorder, this study suggests a very large portion of the population misdiagnosed.

Medication-induced bipolar disorder

The reasons for the overdiagnosis are many, but some experts point to a rush to pinpoint a cause, particularly when antidepressants don't seem to be working. Some antidepressants, such as Prozac, can trigger hypomania, and the DSM-V indicates that a single manic or hypomanic episode warrants a diagnosis of bipolar disorder. However, the manual also lists some restrictions. If the hypomanic episode may be caused by medication, the episode must persist when the medication is withdrawn in order to qualify.

In my case, the psychiatrist made his decision and switched prescriptions, adding lithium to the script for a different antidepressant, but the "hypomanic" symptoms had already stopped. Was I misdiagnosed?

Dangers

Most people who start taking antidepressants and mood stabilizers are suffering from depression or some other disorder, so why does it matter if people are misdiagnosed? Some disorders that are similar to bipolar disorder include thyroid problems, and thyroid problems are not treated with antidepressants. Delaying proper medication in these cases may cause further problems.

Lithium may actually cause thyroid problems. Low TSH thyroid levels typically create lethargy, weight gain, and depression, sometimes exacerbating patient problems. In the long term, lithium has been noted to cause kidney problems, as well. Levels must be closely monitored to help prevent toxicity.

Have you been misdiagnosed?

Some medical professionals see an overdiagnosis for bipolar disorder as a big problem today, leaving many patients doubtful about their own diagnosis. If you think you or a loved one may have been one of the many misdiagnosed, it is important to get another opinion from a trained professional. Nobody should stop taking medication without a doctor's consultation. Abruptly stopping medications may cause a manic episode in those truly bipolar, and the withdrawal from some antidepressants and mood stabilizers can be severe if the amounts are not tapered slowly.

The important thing is to get more information. Be aware and record activities and thoughts, and share honestly with your doctor.

The aftermath

Those who have seemingly been misdiagnosed with bipolar disorder and have gone off their medications can still not fully return to their previous lives. The medicines may sometimes have a lasting effect on the body. The bipolar label is difficult to erase from all records. And it is even more difficult to erase from people's minds.

References

Charlene Laino. "Bipolar Disorder Misdiagnosed?" webmd.com.

"Hypomanic Episode." American Psychiatric Association. Dsm5.org.

Alice Goodman. "Even Brief Lithium Exposure Can Harm." Renal and Urology News. Renalandurologynews.com.