Bipolar disorder stigma can delay diagnosis

While depression is more recognizable to people, mania may be not be as familiar. Though bipolar disorder can wreak havoc with an individual’s life, it’s often not obvious to others that something is wrong.

“It’s a great misconception that you are a basket case if you have bipolar disorder,” Jamison said. “I am someone who has specialized in this all my professional life and I’ve been around specialists who treat mood disorders. When I went public, most of my colleagues were shocked. It can be deceptive in that respect.”

“It’s a great misconception that you are a basket case if you have bipolar disorder. I am someone who has specialized in this all my professional life and I’ve been around specialists who treat mood disorders. When I went public, most of my colleagues were shocked. It can be deceptive in that respect.”

“It’s a great misconception that you are a basket case if you have bipolar disorder. I am someone who has specialized in this all my professional life and I’ve been around specialists who treat mood disorders. When I went public, most of my colleagues were shocked. It can be deceptive in that respect.”

The condition does have some clear symptoms, said Dr. Andrew Nierenberg, a professor of psychiatry at Harvard Medical School and director of the Dauten Family Center for Bipolar Treatment Innovation at Massachusetts General Hospital. A manic episode must include at least three of the following symptoms for more than 1 week:

  • increased talkativeness
  • increased self-esteem or grandiosity
  • decreased need for sleep
  • increased energy level or irritability
  • racing thoughts
  • poor attention, and
  • increased risk-taking behavior

Mania is much more extreme than a sudden burst in energy or motivation or a happy mood. “They’re not only talking fast, but other people can’t get a word in edgewise,” said Nierenberg. Someone with bipolar “might be walking by a Tesla in the mall and decide to buy even if you don’t have the money.”

It often results in problems in work, school, and relationships, and in some cases it may require hospitalization.

Sometimes the symptoms of bipolar disorder may contribute to the length of time it takes to get diagnosed. When depressed, people may not have the energy or will to seek treatment.

“When you’re depressed, a cardinal sign is hopelessness,” Jamison said. “When people start to get manic they very often feel better than they ever have in their lives. So they don’t feel that anything is wrong.”

Still, Jamison said, when bipolar disorder is untreated, “there’s tremendous disability and pain and suffering.”

Carey may be an example of an association Jamison pointed out years ago: the strong prevalence of bipolar disorder among creative folk, such as writers, painters and composers. Actress Carrie Fisher was praised for her candidness about her struggles with bipolar before her death in 2016.

While some patients may worry that treating the disorder might crimp their creativity, “most people, in the few studies that have been done, are as productive if not more productive once they’ve gotten treatment,” Jamison said.

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