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Professor Danny Smith, who leads the psychiatry department at the University of Edinburgh, emphasized to the BBC the urgent need for improved screening methods by healthcare professionals. He highlighted that clinicians should routinely inquire about symptoms like mania and explore any family history of bipolar disorder during assessments. This call for updated screening protocols has been supported by both the Royal College of Psychiatrists and the charity Bipolar UK, which argue that enhanced screening could be crucial, even life-saving. This is especially important because treating bipolar patients with standard antidepressants for depression can sometimes worsen their condition.
One patient, Kimberley, experienced a breakthrough during her three-month hospitalization when her doctors looked beyond her initial depression diagnosis. Although she initially struggled to accept her bipolar diagnosis, reflecting on years of symptoms helped her understand her disorder better. She described her life before diagnosis as chaotic and credited medication as a key factor in achieving stability. Meanwhile, Jacqui Armstrong’s story reveals another common challenge in diagnosing bipolar disorder. Treated for depression for decades since her teenage years, Jacqui endured frequent hospital visits and even a suicide attempt while raising children and working as a teacher. Despite being given various antidepressants and electroconvulsive therapy, symptoms of bipolar disorder were present all along.
Jacqui experienced episodes of hypomania—periods of heightened mood and energy that are less severe than full mania—although these were often overlooked. She recalled bursts of confidence, increased sociability, and a surge of ideas that eventually led to a breakdown. It wasn’t until her final hospital admission that a psychiatrist directly asked if she had ever experienced such symptoms, leading to a diagnosis of bipolar II disorder more than 30 years after her initial mental health struggles. Kimberley, by contrast, had undergone a full manic episode, resulting in her diagnosis of bipolar I. Experts note that bipolar II is particularly difficult to identify since its hypomanic episodes are less extreme, and depressive episodes occur more frequently.
According to specialists like Professor Smith, bipolar disorder remains significantly underdiagnosed. While about one in every 100 people receive an official diagnosis throughout their lives, research suggests the number may actually be closer to one in 50. Furthermore, patients in the UK often face almost a decade-long wait between first symptoms and diagnosis. Smith pointed out that this delay is largely due to insufficient routine screening for mania or hypomania during medical consultations, which should ideally prompt referral to a psychiatrist. Although national guidelines exist urging doctors to carry out such screenings, Smith stressed that more effective, widely-publicized tools are needed to ensure this happens consistently. He acknowledged the difficulty general practitioners face when most patients present with depressive symptoms, making it less likely for them to probe for the presence of manic behaviors, especially since patients seldom volunteer such information. Recent efforts to increase awareness have been aided by prominent figures like Stephen Fry and Chappell Roan sharing their experiences, yet Bipolar UK warns that much remains to be done, as delayed diagnoses continue to have serious consequences.
Professor Smith reiterated that bipolar disorder is a highly manageable condition once properly diagnosed. With the right treatment, individuals can lead stable, fulfilling lives with successful careers and families. Both Kimberley and Jacqui had been prescribed antidepressants for years without improvement and were never questioned about manic symptoms until their conditions worsened and required hospitalization. Kimberley described how frightening it had been to behave as she did before diagnosis, and expressed relief at now feeling well and in control. She currently works full-time as an assistant psychologist for the NHS and has not experienced a manic episode since being hospitalized four years ago. Jacqui, reflecting on her own journey, described her recent years as the happiest she has had in a long time. She spoke candidly about no longer feeling embarrassed by her diagnosis, comparing it to how people wouldn’t feel ashamed if they had diabetes—emphasizing that the key is obtaining the right help
Read the full article from The BBC here: Read More
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