A recent study by the National Institute of Mental Health says that about 2. 4 percent of the world’s population has bipolar disorder.  (The National Institute of Mental Health web site reports that an older study shows that in America, the number of adults with bipolar disorder is closer to *2.6 percent (5.7 million people).

This new study shows that the disorder is undertreated in poor countries. In fact, only 25.2 percent of people with bipolar disorder are being treated.

This doesn’t come as a surprise. The NIMH statistics from previous studies show that in America, around 50 percent of people are receiving adequate treatment (the number varies depending on the type of treatment).

Since the study focuses on poorer countries, is easy to jump in and say, “Let’s get some funds to these people so they can get treatment!”

I think that this is reductionist thinking. I want to point out, that in even a comparatively wealthy country such as the U.S.A.,  there are people with private health insurance as well as those on government health plans like Medicaid and Medicare that also do not receive treatment for bipolar disorder – remember, only about half of Americans with the disorder are getting adequate treatment.

The possible reasons are many. Sometimes, especially in poorer countries, care is simply not available. Sometimes, people aren’t correctly diagnosed. In some cases people with bipolar disorder are dually diagnosed and have other problems such as anxiety or addiction that contribute to symptoms, which means that professionals might have a hard time differentiating the causes.

(FYI: A person needs to be off substances for 6-8 months in order to distinguish whether or not the symptoms are drug/alcohol induced or whether it is an underlying major mental illness).

In other cases, people with the disorder have sought treatment and unfortunately stopped their treatment because it felt much better to be “manic.” Also, men from some segments of American culture and other cultures around the world, perceive that it is better to feel bad than to seek professional help, and that it simply isn’t “manly” to seek help.

Some members of minority groups in the U.S.A. feel genuine fear, from their perspective quite a reasonable fear, that treatment professionals don’t respect their culture, aren’t trustworthy, and might give them the wrong medication or even try to brainwash them.

Unfortunately, these and other factors mean that people here and around the world will continue to refuse care unless educated about the disorder (and other major mental illnesses), and the treatments available. And this education must be culturally sensitive.

Bipolar disorder is certainly not the only mental health problem that is undertreated. But because there are treatments, *usually a combination of medication and counseling that can help stabilize patients, it is very sad that more people are unable to access treatment.

*Children and teens aren’t included in the 2.6 percent figure.

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    Last reviewed: 8 Mar 2011