Bipolar disorder affects nearly six million Americans every year. Bipolar is characterized by both episodes of major depression and episodes of mania or hypomania. Symptoms of depressive episodes are identical to those of unipolar depression and include sadness, lethargy, disturbed sleep, slow movements, feelings of hopelessness, poor concentration, physical aches, losing interest in things you used to enjoy, and thoughts of suicide or death. Manic symptoms include abundant energy, little need for sleep, delusions of grandeur, paranoia, impulsiveness, reckless behavior, and starting ambitious projects. Bipolar disorder is one of the most commonly misdiagnosed mental health conditions. About 70 percent of people who have been diagnosed with bipolar disorder were originally misdiagnosed as having depression. This is because a depressive episode of bipolar disorder is indistinguishable from a depressive episode of unipolar depression. Unless you mention manic episodes to your doctor, there’s no way to tell the difference. What’s more, people rarely seek help for a manic episode, although they are sometimes so severe that the patient has to be hospitalized. It takes an average of 10 years for someone who has been misdiagnosed to get a correct diagnosis. This can have significant consequences because bipolar disorder and unipolar depression are not treated in the same way. Someone with bipolar disorder who takes antidepressants without a mood stabilizer is at higher risk for a manic episode. Women as especially vulnerable to misdiagnosis for several reasons. First, while men and women suffer from bipolar disorder at an equal rate, women suffer from other depressive disorders at about twice the rate of men. Women also tend to experience less intense manic episodes. While someone in the throes of paranoid delusions is bound to draw attention, someone who is in exceptionally good mood might not. These more moderate hypomanic episodes sometimes escape notice, making bipolar harder to correctly diagnose. Perhaps the clearest symptom of a manic or hypomanic episode is a decreased need for sleep. If someone is only getting a few hours of sleep a night but still seems to have plenty of energy, she may be having an episode. The extra energy is a signal too. It may manifest as restlessness, talking a lot, or starting many new projects. These may also be related to another symptom: being easily distracted. Someone experiencing a manic episode may suffer from racing thoughts and jump from one idea to another, making concentration difficult. A manic or hypomanic episode may also lead to a hyperactive sex drive as well as impulsive or reckless behavior. She may also start having grandiose thoughts, often having to do with religion. Not all of these symptoms have to be present to indicate a manic or hypomanic episode. They may be present in varying degrees and are sometimes mistaken for a lift in depressive symptoms. This is more common in women who are more likely than men to switch rapidly from depression to mania. A manic episode typically lasts anywhere from a few days to a few weeks.
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