3 Reasons Bipolar Disorder Can Be Challenging To Diagnose And Treat

Bipolar disorder is classified as an affective disorder with cycles of depression and mania, hypomania, or mixed episodes. Sometimes the cyclic nature of this affective disorder can make it harder to identify and manage.

It's Misdiagnosed As Depression

Many people with bipolar disorder are first misdiagnosed with depression. This is not a matter of care providers simply misjudging bipolar patients, it happens because they rarely see the full range of mood states. People with bipolar may only seek help during depressive or mixed episodes because they feel miserable. Hypomanic and manic episodes, depending on the severity, can easily feel like the cloud of depression has lifted, or the patient may feel like they can take on everything.

Unfortunately, it is also easy for those around the patient to misjudge the change in mood as good unless their manic episodes are severe enough to be obviously a problem. If a patient with depression has friends or family, it is better if the practitioner asks for their input to see if other people are noticing anything more than depression instead of relying on self-report alone.

Medication Adherence

Once a diagnosis of bipolar disorder is made, there are several classes of medications that can be used alone or in combination to help stabilize the patient. Sometimes mood stabilizers or antipsychotics are used alone or an antidepressant might be added. Depending on the mood stabilizer or antipsychotic and each patient's response to treatment, there can be challenges adhering to treatment.

Lithium requires routine blood monitoring until the patient is safely within the therapeutic window. Changes in weight or other medical conditions that may affect the concentration of lithium in the blood also need to be monitored to stay within that therapeutic window. Some mood stabilizers and antipsychotics are more often associated with significant weight gain, which may cause patients to stop their medication. Finding the right combination of medications that are effective, but with few side effects can be challenging. Patients must realize that combination may be within reach, but they will need to be patient and not abruptly stop their medicines.

The High Highs

Not everyone with bipolar disorder will experience a manic episode (also considered "full-blown" mania). For those who do, these highs can be extremely high and potentially dangerous. Not only can manic episodes make a patient feel like they do not need treatment or their treatment might damper their energy or creativity, but it is also during these highs patients are more likely to find themselves in trouble. Some problems associated with mania are spending sprees, encounters with law enforcement, drug use, and abuse, leaving home, or promiscuity. Hallucinations may also occur in some people with manic episodes. Once the patient comes off this "high" they may find themselves in serious trouble that is impossible to rectify.

Bipolar disorder can be a challenge to identify and manage, but with more attention on the disorder, it is easier for practitioners and loved ones to recognize the symptoms. As newer treatments emerge, it may be easier for patients to adhere to their treatment plan.

For more information about mental health services, contact a company like Comprehensive  Behavioral Health Associates Inc.