Bipolar Affective Disorder, previously called “manic depression” is a condition that is both over diagnosed and under diagnosed.
It is under diagnosed in people who only present with depressive symptoms but who do not go to the doctor when their mood is elevated.
It can be over diagnosed in people who have symptoms of emotional instability but who recognise familiar symptoms in Bipolar “checklists”, some self administered screening instruments and other peoples’ accounts of their own bipolar illness. Screening instruments have an important role but should be followed up with a sophisticated assessment by a psychiatrist who can test the nature of the symptoms and take a history of their tempo, chronicity, and their temporal relationship to other symptoms.
Bipolar Affective Disorder, if untreated, can lead to severe impairment of functioning, considerable distress, disinhibited behaviour which makes the person a danger to themselves and others and in some cases, suicide. Bipolar Disorder has one of the highest suicide rates of any psychiatric condition.
There are also significant problems faced by people who are misdiagnosed with Bipolar Affective Disorder. It can mean that their true condition remains unrecognised and therefore untreated. It can also mean that they are prescribed unnecessary medications and therefore exposed to potential side effects without any significant clinical benefit.
It should be clear that a sophisticated assessment is essential whenever Bipolar Affective Disorder is suspected.