Bipolar Disorder: A Difficult Diagnosis

According to the National Institute for Mental Health (NIMH), doctors and clinicians need to be aware of the difficulty when diagnosing a patient with bipolar disorder. Often, bipolar patients have other illnesses or comorbidities, such as Generalized Anxiety Disorder (GAD), eating disorder, or substance abuse. These other disorders may present themselves more prominently than a manic episode, and avert attention from the root cause. Also, bipolar disorder can have several symptoms in common with schizophrenia, yet there are very distinct differences between the two.

The disorder runs in families and has a very high genetic predisposition, but other factors outside the genetic code can also play a role in the onset of the disorder. Bipolar disorder has polygenic determinants, involving a combination of many genes. Research has found the environmental triggers for this disorder come from traumatic and stressful life events, possibly affecting the brain’s chemistry at important stages of development.

Be Curious

Dr. Andrew Cutler, Meridien Research’s Chief Medical Officer, has studied the causes of bipolar disorder and many of the comorbid illnesses and disorders associated with it. “To be a good clinician is to be curious,” explained Dr. Cutler. “If you’re curious, people pick up on that and offer more information.” He believes in lengthy assessments in order to correctly diagnose a patient. “I need to follow all of the data. I need the patient’s history and I need the patient to tell me all of the important things.” Gathering specific details on patient psycho-social history allows for a more global view of their health.

Diagnosis and treatment is critical for patients with bipolar disorder, because of the adverse effects that mood episodes can cause. “Depression, mania and psychosis are bad for the brain,” said Dr. Cutler. “When you do brain scans you see how more mood and psychotic episodes cause brain shrinkage.” He believes patients should undergo disease state management, finding and sticking to the right treatments, which can slow or stop the progression of damage to the brain.

A Significant Disorder

Nearly 6 million American adults (about 2.6% of 18 and older adults) have bipolar disorder. Assessing the proper type provides the appropriate roadmap for a treatment plan (a combination of medications and talk therapy are suggested by the NIMH).

There are four specific types of bipolar disorder:

  • Bipolar I,
  • Bipolar II,
  • Cyclothymic, and
  • Other types.

Bipolar causes more than just mood swings. The list of symptoms and criteria is extensive.

Research suggests that bipolar disorder has the same frequency in adolescents as it does in adults. According to the American Academy of Child and Adolescent Psychiatry, an early-onset bipolar diagnosis for adolescent and pre-pubescent children is very difficult, because of their age and the symptoms. Usually dismissed as typical teenage behavior, bipolar children have dramatic and unpredictable mood cycles; however, in contrast to adults, their mood changes are more frequent.

Research has significantly grown within this field, only within the past decade. Yet more is needed.


Many famous and accomplished people have been diagnosed with bipolar disorder. We have included a couple resources for additional reading that have not been included in this Article.

Article: A very interesting perspective on one person’s struggle with bipolar disorder


Lots of resources at The New York Times Health Guide

Depression and Bipolar Support Alliance

National Institute for Mental Health

National Alliance for the Mentally Ill

Dr. Andrew Cutler is currently involved in multiple studies on bipolar disorder in adults and adolescents. Each study has varying goals and timelines. Meridien Research is dedicated to helping patients with bipolar disorder. Our studies focus on the latest research backed therapies and goal is to work with pharmaceutical companies to find interventions that regulate brain function. If you or someone you love is living with bipolar disorder, please feel free to reach out to our team at 941-756-8680 today.