Deep Bench: Getting a proper diagnosis for bipolar I disorder

(WZAW) -- Roughly 11 million adults in the U.S. live with bipolar disorder, but nearly 70% have been misdiagnosed at least once, and on average it takes 10 years to get an accurate diagnosis.

Psychiatrist Dr. Andrew Cutler was on the Deep Bench via satellite on Tuesday to talk about why getting a proper diagnosis can be so hard and the latest approaches in managing this disorder. He was joined by Matt, a husband and father of two living with bipolar I disorder.

Dr. Cutler said bipolar I disorder is a common and chronic condtion that's characterized by unpredictable high and low mood swings, known as manic and depressive episodes that can last from days to months.

"The depressive symptoms can be confused with another condition called major depressive disorder, and those include mood that is depressed or sad or hopeless, low energy and fatigue. The manic episodes are unique to bipolar I disorder, and those can include symptoms such as racing thoughts, decreased need for sleep, abnormally high energy and also some behaviors that show poor judgement like spending sprees or reckless driving," Dr. Cutler explained.

He said there are cases where the manic and depressive episodes can occur at the same time, which is called a mixed episode.

"Bipolar disorder usually starts in the teenage years or early 20s, and it's a lifelong condition," added Dr. Cutler.

He said one of the big reasons why it's commonly misdiagnosed is that patients are less likely to report the manic symptoms and are more likely to report the depressive symptoms that bother them more and cause more impairment.

"So it's very important to get the right diagnosis."

Matt said it took him 25 years to get a proper diagnosis. His symptoms started when he was around 13 or 14 years old.

"I reported a lot of the depression episodes, because that's what I was feeling. I didn't realize that I was having manic episodes. I didn't realize because I was depressed that I was laying on my couch all night watching TV, that that was considered a manic episode. I just didn't have the vocabulary or knowledge to help myself when I was young," Matt said.

Dr. Cutler said that's why it's so important to report all behaviors to get a proper diagnosis, because being treated for MDD differs greatly than treatment for bipolar disorder, and many anti-depressants can make the bipolar disorder symptoms worse.

He said one treatment option for bipolar I disorder is Vraylar (cariprazine). It works to help smooth the ups and downs that happen with bipolar I disorder. The medication was recently approved by the FDA.

In clinical trials, the most common side effects were:

- Uncontrolled movements of the body and face
- Indigestion
- Muscle stiffness
- Vomiting
- Sleepiness
- Restlessness

However, it's important to discuss the best treatment options for you with your physician.