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Misdiagnosing Bipolar Disorder as Anxiety

Misdiagnosing Bipolar Disorder as Anxiety
Misdiagnosing Bipolar Disorder as Anxiety

When you don’t feel well for a while, the usual course of action is to give your primary care physician a call. You drag yourself over to their office trying not to touch anything in the waiting room. Then you get to wait in the room with all of the posters and figure out exactly what a duodenum is. Once your physician comes in you can get down to the nitty gritty. You tell them that you’ve been feeling abnormally anxious for the past few months. They will probably ask you a few more questions before offering any suggestions. There’s a fair chance you’ll end up being diagnosed with an anxiety disorder and given medication.

First off, if you think there’s a problem, you should talk to your doctor. Period. They can get you on the right track. The problem is that getting a correct diagnosis of a mental illness after the first assessment is not really any better than chance. Only half of primary care physicians consult the Diagnostic and Statistical Manual of Mental Disorders, which outlines psychiatric disorders and gives criteria for each of them. So, on the surface it may seem as if you have something as common as generalized anxiety disorder. However, there are other disorders that should be considered and screened for just to make sure.

Bipolar disorder is one of the illnesses that should be considered when dealing with anxiety. Anxiety and depression go together about 70% of the time, and both are seen in bipolar disorder. Depression is obviously at one end with mania on the other. What most people don’t understand about mania is that it’s not always feeling like Superman. Mania can also be high levels of irritability and anxiety. This also occurs in hypomania that’s seen in bipolar II disorder, but at a level that may go unnoticed. That’s the danger of misdiagnosing bipolar disorder; it’s often unseen.

Even if a correct diagnosis of generalized anxiety disorder is given, bipolar disorder should not be discounted. More than half of bipolar disorder patients also have at least one additional anxiety disorder.

So what do you look for? There is more to both generalized anxiety disorder and bipolar disorder than just a constant, anxious feeling. There are other psychological symptoms as well as physical symptoms to consider. A lot of them appear to overlap, especially with hypomania, so the diagnosis lies in the subtleties of the symptoms:

Generalized Anxiety Disorder

  • Consistent worry that is out of proportion with a situation whether small or large
  • Restlessness or feeling on edge
  • Irritability
  • Difficulty concentrating
  • Fatigue
  • Trouble sleeping

Bipolar Hypomania (Dysphoric)

  • Hyperactivity
  • Racing thoughts/difficulty concentrating
  • Irritability/Agitation
  • Anxiety
  • Impulsivity
  • Fatigue
  • Trouble sleeping

Bipolar disorder generally goes in phases, so that can help in getting the correct diagnosis. However, rapid cycling bipolar disorder should be considered in these cases as well. Bipolar disorder only affects about 1% of the population, a much smaller percentage than the rate of anxiety disorders, so a diagnosis of anxiety disorders is more likely. However, when bipolar disorder goes undiagnosed it can cause serious problems for the patient.



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Misdiagnosing Bipolar Disorder as Anxiety

LaRae LaBouff

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APA Reference
LaBouff, L. (2015). Misdiagnosing Bipolar Disorder as Anxiety. Psych Central. Retrieved on June 5, 2020, from


Last updated: 26 Nov 2015
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