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Misdiagnosis of Bipolar disorder/cyclothymic disorder/hypomania

Alternative diagnoses list for Bipolar disorder/cyclothymic disorder/hypomania:

For a diagnosis of Bipolar disorder/cyclothymic disorder/hypomania, the following list of conditions have been mentioned in sources as possible alternative diagnoses to consider during the diagnostic process for Bipolar disorder/cyclothymic disorder/hypomania:

Rare Types of Bipolar disorder/cyclothymic disorder/hypomania:

Bipolar disorder/cyclothymic disorder/hypomania: Medical Mistakes

Related medical mistakes may include:

Bipolar disorder/cyclothymic disorder/hypomania: Undiagnosed Conditions

Commonly undiagnosed conditions in related areas may include:

Common Misdiagnoses and Bipolar disorder/cyclothymic disorder/hypomania

Unnecessary hysterectomies due to undiagnosed bleeding disorder in women: The bleeding disorder called Von Willebrand's disease is quite common in women, but often fails to be correctly diagnosed. Women with the condition tend to have heavy periods, since they actually have a bleeding disorder. Severe afflictions may result in the women receiving a hysterectomy unnecessarily, when the underlying cause has not been identified. See the introduction to Von Willebrand's disease and bleeding disorder.

Cluster of diseases with difficult diagnosis issues: There is a well-known list of medical conditions that are all somewhat difficult to diagnose, and all can present in a variety of different severities. Diseases in this group include multiple sclerosis, lupus, Lyme disease, fibromyalgia, thyroid disorders (hypothyroidism or hyperthyroidism), chronic fatigue syndrome, diabetes - all of these can have vague symptoms in their early presentations. Also, depression can have some symptoms similar to these conditions, and also the reverse, that many of these conditions can mimic depression and be misdiagnosed as depression.

Undiagnosed stroke leads to misdiagnosed aphasia: BBC News UK reported on a man who had been institutionalized and treated for mental illness because he suffered from sudden inability to speak. This was initially misdiagnosed as a "nervous breakdown" and other mental conditions. He was later diagnosed as having had a stroke, and suffering from aphasia (inability to speak), a well-known complication of stroke (or other brain conditions).

Alzheimer's disease over-diagnosed: The well-known disease of Alzheimer's disease is often over-diagnosed. Patients tend to assume that any memory loss or forgetulness symptom might be Alzheimer's, whereas there are many other less severe possibilities. Some level of memory decline is normal with aging, and even a slight loss of acuity may be noticed in the 30's and 40's. Other conditions can also lead a person to show greater forgetfulness. For example, depression and depressive disorders can cause a person to have reduced concentration and thereby poorer memory retention.

Dementia may be a drug interaction: A common scenario in aged care is for a patient to show mental decline to dementia. Whereas this can, of course, occur due to various medical conditions, such as a stroke or Alzheimer's disease, it can also occur from a side effect or interaction between multiple drugs that the elderly patient may be taking. There are also various other possible causes of dementia.

ADHD under-diagnosed in adults: Although the over-diagnoses of ADHD in children is a well-known controversy, the reverse side related to adults. Some adults can remain undiagnosed, and indeed the condition has usually been overlooked throughout childhood. There are as many as 8 million adults with ADHD in the USA (about 1 in 25 adults in the USA). See misdiagnosis of ADHD or symptoms of ADHD.

Bipolar disorder misdiagosed as various conditions by primary physicians: Bipolar disorder (manic-depressive disorder) often fails to be diagnosed correctly by primary care physicians. Many patients with bipolar seek help from their physician, rather than a psychiatrist or psychologist. See misdiagnosis of bipolar disorder.

Eating disorders under-diagnosed in men: The typical patient with an eating disorder is female. The result is that men with eating disorders often fail to be diagnosed or have a delayed diagnosis. See misdiagnosis of eating disorders or symptoms of eating disorders.

Depression undiagnosed in teenagers: Serious bouts of depression can be undiagnosed in teenagers. The "normal" moodiness of teenagers can cause severe medical depression to be overlooked. See misdiagnosis of depression or symptoms of depression.

Undiagnosed anxiety disorders related to depression: Patients with depression (see symptoms of depression) may also have undiagnosed anxiety disorders (see symptoms of anxiety disorders). Failure to diagnose these anxiety disorders may worsen the depression. See misdiagnosis of depression or misdiagnosis of anxiety disorders.

Bipolar disorder/cyclothymic disorder/hypomania: Rare Types

Rare types of medical disorders and diseases in related medical areas:

Failure To Diagnose Bipolar disorder/cyclothymic disorder/hypomania

Failure to diagnose Bipolar disorder/cyclothymic disorder/hypomania may be associated with the following:

  • Bipolar disorder is often undiagnosed as patients are hesitation about discussing their concerns because of the stigma attached to the condition. People don't like to acknowledge that they have a mental health problem
  • Bipolar is often undiagnosed as the patient often does not recognise that they have a problem. As with the majority of mental illnesses, the greatest hurdle is patients recognising that they have a problem and seeking help
  • Mood disorders may vary in severity and often people soldier on with their symptoms until it becomes more serious or other people start to hint that something may be amiss
  • Bipolar patients who have manic phases are less likely to seek medical help than patients who have primarily depressive phases. The patient doesn't recognize that their manic symptoms are more than just positive feelings
  • Children who have suffered a history of abuse and neglect who also often have bipolar disorder I may have their symptoms dismissed as being a result of their unhappy prior environment. Conversely, behavioural and mood problems in children may be misdiagnosed as bipolar disorder whereas their symptoms may simply be a result of abuse or neglect
  • Undiagnosed bipolar patients often resort to drugs or alcohol in an attempt to self-medicate. Thus, often patients with a substance abuse problem may have underlying bipolar disorder and treatment for both conditions will be required
  • Bipolar disorder is often undiagnosed and misdiagnosed as diagnosis often relies heavily on the patient's report of symptoms experienced. However, a person with a mental disorder is often unable to view their symptoms objectively. For example, patients may not report symptoms such as a reduced need for sleep or racing thoughts as they may not be consciously aware of them or consider them insignificant. Also, patients hesitate to direct the investigation towards bipolar disorder due to the stigma attached to the disease. A patient would often rather be diagnosed with depression rather than bipolar disorder and may hence steer the investigation in that direction. It is often useful to have input about symptoms from another source such as a relative or friend
  • Cyclothimia is often undiagnosed as it has less severe symptoms which may fail to be recognised by the health professional or by the patient
  • Bipolar disorder may remain undiagnosed because the nature of its symptoms (e.g. fatigue, feelings of hopelessness, helplessness and self-loathing, difficulty making decisions) may affect a person's motivation to seek medical advice

Notes On Hidden Causes Of Bipolar disorder/cyclothymic disorder/hypomania

The following may be hidden causes of Bipolar disorder/cyclothymic disorder/hypomania:

  • Experts believe that it is usually a combination of factors that cause bipolar disorder. Genetics are believed to play a role in the development of bipolar disorders. Other predisposing factors may be cognitive problems, neurodevelopmental problems and environmental factors (behaviour, education, exposure to toxic substance, alcoholism or drug abuse)
  • Factors that can exacerbate symptoms or trigger onset of a phase are: alcohol abuse, drug abuse, lack of sleep, excessive sleep and stress
  • Hypomania may be caused by hyperthyroidism

Notes On Wrong Diagnosis Of Bipolar disorder/cyclothymic disorder/hypomania

Wrong diagnosis of Bipolar disorder/cyclothymic disorder/hypomania may be associated with the following:

  • Bipolar patients often only report their depressive symptoms as these may be more obvious and incapacitating than the manic symptoms. Thus they may be misdiagnosed as having depression. The symptoms of depression overlap those of bipolar disorder which makes misdiagnosis more likely. The overlapping symptoms mainly involve those of depression that occur during the depressive phase of bipolar disorder. Conversely, patients with only depression may be misdiagnosed as having bipolar disorder which leads to unnecessary medications which often have significant side-effects. Patients suffering from depression should also be screened for signs of mania
  • Severe cases of bipolar disorder may involve the patient having hallucinations or hearing voices which may lead to a misdiagnosis of Schizophrenia
  • Bipolar disorder is often misdiagnosed because it is a spectrum disorder which means that it has a range of presentations. Thus it may be misdiagnosed as conditions such as depression and anxiety. Mild cases of bipolar disorder may present only with symptoms of depression or may have a substance abuse problem. These cases may be misdiagnosed as depression or substance abuse and treated accordingly even though the underlying condition is actually bipolar disorder. The danger in misdiagnosis is that inappropriate treatment may trigger a more severe case of bipolar
  • Hypomania is a relatively mild form of mania and is often not recognised as abnormal and may be considered simply as normal positive feelings. Also, patients don't generally seek medical advice because they are feeling "overly happy"
  • Some experts believe that a significant number of children diagnosed and treated for ADHD may actually have the early stages of bipolar disorder. Bipolar disorder is considered an adult condition and is rarely considered as a differential diagnosis in children with behavioural or mood problems. Bipolar symptoms in children may vary from those of adults and the cycling between the low and high phases may be extremely rapid with the two phases often alternating within a day. For example, a child may be very difficult to get out of bed and energized ready for school but by the time it is bedtime, the same child may be full of energy and very difficult to get to sleep. Often parents may put this down to poor sleeping habits
  • Other experts believe that bipolar disorder does not exist in children or is very rare and that many people are being unnecessarily diagnosed with the condition and subjected to treatment
  • Bipolar disorder in children may also be misdiagnosed as having oppositional defiant disorder, depression, schizophrenia and Tourette syndrome. Diagnostic difficulty may be greatly increased when children suffer bipolar disorder as well as another psychiatric disorder at the same time
  • Patients with bipolar disorder II have less severe mood swings which can make it more difficult to diagnose correctly. It is often mistaken for depression as there may not be a clear manic phase
  • Bipolar patients who are misdiagnosed with depression and treated accordingly may face a greater risk of more severe manic and depressive phases and are more likely to commit suicide. Also, some studies indicate that prior use of antidepressants make lithium treatment less effective once patients are accurately diagnosed with bipolar disorder
  • Bipolar patients may be misdiagnosed with narcissistic personality disorder as the symptoms during the manic phase may be similar to those of narcissistic personality disorder. Common symptoms include substance abuse, reckless and impulsive behaviour
  • Bipolar disorder may be more difficult to diagnose when there are co-existing disorders such as anxiety which can mask some of the symptoms of bipolar disorder, especially if they are relatively mild. Comorbidity is extremely common in bipolar sufferers. Comorbid disorders may include anxiety, substance use, conducti disorders, eating disorders, sexual behaviour, ADHD, impulse control, Tourette's disorder and autism spectrum disorders. Other more general medical conditions that frequently occur in bipolar patients are: obesity, type II diabetes, migraine, thyroid disorder and cardiovascular disorder
  • An overlap of symptoms in bipolar disorder and schizo-affective disorders may also result in misdiagnosis. Common symptoms include hallucinations and delusions
  • The risk of misdiagnosis with depression is the fact that some bipolar patients have very long cycling periods - years may pass between subsequent depressive episodes and manic episodes may be very mild.
  • General medical conditions such as stroke, multiple sclerosis, hypothyroidism and brain tumor may cause depressive symptoms which may be misdiagnosed as bipolar I disorder
  • Hypomania is often misdiagnosed as unipolar depression or disregarded simply as "happiness"
  • Hyperthyroidism may be misdiagnosed as hypomania and hypomania is often a symptom of hyperthyroidism
  • The fatigue associated with these depressive disorders may be misdiagnosed as chronic fatigue syndrome or a sleep disorder

Complications Of Misdiagnosis Of Bipolar disorder/cyclothymic disorder/hypomania

The following may be complications of misdiagnosis of Bipolar disorder/cyclothymic disorder/hypomania:

  • Eating problems such as lack of appetite caused by bipolar disorder may be misdiagnosed as anorexia nervosa
  • Sleeping problems and a depressed mood may be misdiagnosed as a sleeping disorder

General Misdiagnosis Articles

Read these general articles with an overview of misdiagnosis issues.

About misdiagnosis:

When checking for a misdiagnosis of Bipolar disorder/cyclothymic disorder/hypomania or confirming a diagnosis of Bipolar disorder/cyclothymic disorder/hypomania, it is useful to consider what other medical conditions might be possible misdiagnoses or other alternative conditions relevant to diagnosis. These alternate diagnoses of Bipolar disorder/cyclothymic disorder/hypomania may already have been considered by your doctor or may need to be considered as possible alternative diagnoses or candidates for misdiagnosis of Bipolar disorder/cyclothymic disorder/hypomania. For a general overview of misdiagnosis issues for all diseases, see Overview of Misdiagnosis.


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