People with bipolar disorder suffer from extreme mood swings. They swing between periods of abnormally elevated mood known as mania, down to the depths of severe depression.

Bipolar disorder is sometimes called manic depression. It is a common mood disorder. More than 6 million adults in America experience the condition every year. People of any age can have bipolar disorder. The typical person though, starts experiencing symptoms during their late teens or early 20s.

Bipolar disorder has not always been recognized as an illness. It wasn’t until the 1950s that Congress recognized it as such. Further, Social Security benefits were not granted to those with the disorder until the 1970s.

Previously, many doctors believed that bipolar disorder was underdiagnosed. Today, however, a growing number of doctors believe that it’s overdiagnosed.

Diagnosis Guide for Bipolar Disorder

The Underdiagnosis of Bipolar Disorder

The Bipolar Spectrum
There are four different types of bipolar disorder. These types may be expanded to include subtypes of bipolar depression and psychiatric conditions that are often found in combination with the disorder.

The definition of bipolar disorder was expanded after it was recognized as an official medical illness. That helped doctors to improve their diagnostic tools. As doctors got better at diagnosing bipolar disorder, there was a growing awareness that the condition was being underdiagnosed.

An estimated one in 30 people diagnosed with unipolar or severe depression actually met the diagnostic criteria for bipolar disorder, according to study results published in The British Journal of Psychiatry.

The Best Bipolar Disorder Blogs of the Year

Or Is Bipolar Disorder Overdiagnosed?

A study published in The Journal of Clinical Psychiatry found that less than half of the participants who were diagnosed with bipolar disorder actually met the American Psychiatric Association’s (APA) diagnostic criteria for the condition. This suggests that while a diagnosis is missed in some people, others are falsely diagnosed. Some psychiatric conditions have symptoms that overlap with the symptoms of bipolar disorder.

These conditions include:

  • unipolar depression, a mood disorder without manic episodes
  • anxiety disorder
  • acute psychosis
  • personality disorders, including narcissistic personality disorder, antisocial personality disorder, and borderline personality disorder
  • attention deficit hyperactivity disorder (ADHD)
  • substance abuse disorder

It’s believed that people are often misdiagnosed as having bipolar disorder as a result of this overlap.

Why Is Bipolar Disorder so Difficult to Diagnose?

Bipolar disorder can be difficult to diagnose due to a number of factors. Clinical interviews, which play a major role in diagnosis, can be subjective. The point of view and memory of the person being evaluated can be faulty.

Additionally, some people don’t recognize or acknowledge their symptoms. The euphoria and energy of acute mania are so appealing to some people that they don’t report those symptoms. Instead, they may only report their symptoms of depression. This could lead to a misdiagnosis, particularly of unipolar depression.

Finally, tools used to diagnose bipolar disorder are more effective with some types of the disorder than others. These tools may be less valid when used to diagnose people who have less severe symptoms that are not as well-defined.


Today, it is believed that bipolar disorder is both under- and overdiagnosed, depending on practitioner and geographic/demographic variability. Doctors continue to look for ways to provide greater accuracy in the diagnosis and treatment of the condition.

If someone you know is being evaluated for bipolar disorder, there are certain things you can do to help:

  • Go to one of the doctor’s (or therapist’s) appointments to help provide historical information.
  • Take notes before the appointment on symptoms you have witnessed in the person in question, as well as details about their behavior and mood swings.
  • Help compile a detailed family history.
  • Ask candid questions and be open about any of your concerns.