Understanding the diagnosis delay

Bipolar is one of the most prevalent severe mental health conditions in the UK. 

It’s estimated that one million people are affected — that’s 2% of the population. However, delayed diagnosis is common. 

On average there’s a nine and a half year delay between someone seeing a doctor about a symptom of bipolar and getting an accurate diagnosis.

Why bipolar can often be missed

Diagnosis isn’t straightforward

There isn’t a blood test, brain scan or other test that clearly shows whether someone has bipolar. Instead, bipolar has to be diagnosed based on symptoms. 

The symptoms that can be red flags for bipolar are sudden, specific changes in mood and behaviour that can’t be explained by other things, such as alcohol misuse.

It can be challenging for GPs to pick up on warning signs

In a short appointment, a busy GP may struggle to get complex mental health information from someone. They may not have time to ask all the questions they need to ask.

Misdiagnosis is very common

People with bipolar symptoms are commonly given a different diagnosis. This usually comes from doctors treating the symptoms of depression, but not realising that someone had experienced symptoms of hypomania or mania before.

Overlapping symptoms can cause confusion 

Some people living with bipolar may have another mental health condition, such as anxiety, depression, post-traumatic stress disorder (PTSD) and panic disorder. This is known as a dual diagnosis. 

Other people with undiagnosed bipolar may self-medicate with alcohol or other substances. This can mean there’s often a lot going on for them, and that can make it difficult for a GP to pick up on the red-flag symptoms in a short appointment.

Screening questions depend on you understanding symptoms

Lots of people don’t realise that periods of hypomania – where they’ve had more energy, been more productive and creative and slept less – can be a sign of bipolar. 

And if you’re looking back over the past few years, you may not remember everything that’s important to tell your GP. 

On top of that, a lot of people only see the doctor when they’re in a low mood, but don’t go to the doctor when they’re experiencing symptoms of hypomania because they don’t feel unwell, or understand that they have an underlying condition.

Lack of access to mental health specialists can cause delays 

Even if your GP realises bipolar may be causing your symptoms, it can be difficult for themto get you a referral to a psychiatrist.

A diagnosis of bipolar still carries a stigma

For some people a diagnosis can feel like the start of a road you don’t want to go down, and you may have concerns about how a diagnosis may affect your life, including your work and relationships. 

The family and cultural background you come from can also affect how you feel about being diagnosed. You may also be facing other types of stigma already — for example, because of your race, gender, disability or sexuality. This can make the idea of a severe mental health diagnosis even more challenging. 

These feelings are understandable but most people with bipolar tell us getting a diagnosis has been helpful for them.