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Diagnosing Bipolar Disorder Can be Challenging

Fast Bipolar Disorder Facts

From Stanley Bipolar Network patient data of its first 250 outpatients:

  • 85.1 percent had been hospitalized in the past, on average three times.
  • The peak age of onset was between 15 and 19 years of age.
  • The rate of suicide attempts was 50.3 percent.
  • 54 percent had a family member with bipolar disorder, and 32 percent of family members had unipolar depression.
  • A third were currently married, another third single, and the rest were separated, divorced, or widowed.
  • Despite the fact that approximately 90 percent had high school diplomas and a third had completed college, almost 65 percent were unemployed and 40 percent were on welfare or disability.
  • The rate of depressive symptoms over six months was twice the rate of manic symptoms (63.6 percent vs 33.1 percent).

A 2003 Stanley Foundation survey of its next 258 of its next bipolar outpatients, 76 percent with bipolar I, found they were depressed three times more than they were manic (33.2 percent of the year vs 10.8 percent). Despite being on 4.1 psychiatric medications, 62.8 percent had four or more mood episodes a year, two thirds were substantially impacted by their illness, 26.4 were ill for more than three fourths of the year, and 40.7 were intermittently ill.

According to the NIMH, bipolar disorder affects approximately 2.3 million American adults, or about 1.2 percent of the US population age 18 and older in a given year, equally among men and women. A 2003 University of Texas Medical Branch Galveston and other centers study suggests that the prevalence rate for bipolar could be three times as high. Researchers sent the Mood Disorders Questionnaire to 127,800 people age 18 and above selected to represent the US adult population. Of the 85,358 (66.8 percent) who responded, the positive screen for bipolar I or II was 3.4 percent, and 3.7 percent when adjusted for the nonresponse bias. Only 19.8 percent receiving positive screens reported receiving a diagnosis of bipolar from a physician while 31.2 percent reported a diagnosis of unipolar depression. Positive screens were far more common in young adults and those with low income. Migraine, allergies, asthma, and alcohol and drug dependence were “substantially higher” among those with positive screens.

A 2003 Case Western Reserve mail survey of 85,458 adults found that more than half those with symptoms of bipolar were at high risk of being fired or laid off, with nearly half reporting poor job performance. In addition, symptomatic individuals were only half as likely to marry and twice as likely to separate or divorce. The survey also found bipolar is eight times more likely to affect those aged 18 to 24 than those over 55, and that people in this age group reported that symptoms disrupted their lives 70 percent of the time.

Findings from the McLean Hospital-Harvard First-Episode Mania Study that tracked 166 bipolar patients two to four years following their first hospitalization for mania or a mixed episode found fifty percent achieved syndromal (cluster of symptoms) recovery by 5.4 weeks, 98 percent by two years, but 28 percent remained symptomatic. Factors associated with shorter time to recovery for half the subjects were female sex, shorter hospitalization and lower initial depression ratings. Only 43 percent achieved functional recovery (these patients tended to be older with shorter hospitalizations). Forty percent experienced a new episode of mania (20 percent) or depression (20 percent) within two years of syndromal recovery (19 percent switched phases without recovery). Predictors of mania recurrence were initial psychosis, lower occupational status, and initial manic presentation while predictors of depression onset were higher occupational status, initial mixed presentation, and any co-occurring illness.

Diagnosing Bipolar Disorder Can be Challenging

Psych Central Staff

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APA Reference
Psych Central. (2020). Diagnosing Bipolar Disorder Can be Challenging. Psych Central. Retrieved on September 23, 2020, from
Scientifically Reviewed
Last updated: 17 Jan 2020 (Originally: 17 May 2016)
Last reviewed: By a member of our scientific advisory board on 17 Jan 2020
Published on Psych All rights reserved.