When is Bipolar Disorder Not Bipolar Disorder?

August 30, 2011 Natasha Tracy

By now we know the symptoms of bipolar disorder - wild mood swings from euphoria (mania or hypomania) to depression. We know that bipolar disorder comes in lots of variants, bipolar 1, bipolar 2, cyclothmia, rapid-cycling and so forth.

But when are the symptoms of bipolar disorder not bipolar disorder? Are there other illnesses that can account for bipolar symptoms?

When is bipolar disorder not bipolar disorder?

Diagnosing Bipolar Disorder

There are a number of steps that are gone through to diagnose bipolar disorder. This is known as the history and mental status examination.

And some of those steps involve ruling out other disorders with medical tests. The ones that immediately spring to my mind include:

  • Complete blood count
  • Thyroid test

But I'm not a doctor, so there may be others that are common too.

Doctors run these tests because they want to do a differential diagnosis: They want to find the best diagnosis that fits with your symptoms. Normally with a history and mental status exam, it's pretty easy to diagnose bipolar disorder (for a trained professional) but that doesn't mean it couldn't be something else.

If Not Bipolar Disorder, Then What?

According to Medscape Reference, the differential diagnoses for bipolar disorder include:

  • Cushing Syndrome (caused by prolonged exposure to elevated levels of glucocorticoids, a type of steroid)
  • CB107895Head Trauma
  • Anxiety Disorders
  • Hyperthyroidism
  • Hypothyroidism
  • Multiple Sclerosis
  • Neurosyphilis
  • Schizoaffective Disorder
  • Schizophrenia
  • Posttraumatic Stress Disorder
  • Neuro-ophthalmic Perspective Migraine Headache
  • Pediatric Attention Deficit Hyperactivity Disorder
  • Systemic Lupus Erythematosus (an inflammatory connective tissue disease)

What, no one ever told you that?

You Probably Don't Have Any of Those Things

Now, understand, I'm not suggesting that there are a whole lot of people out there walking around with a bipolar disorder diagnosis that really have neurosyphilis. Most of the disorders on that list can easily be ruled out by trained professionals with a few questions. (Being incorrectly diagnosed with one mental illness when you have another is shockingly common, however.)

Nevertheless, it's worth keeping in mind that there are other causes of bipolar disorder symptoms. If treatment isn't working, it's possible that's one of the reasons why - really you aren't correctly diagnosed.

Talk to Your Doctor

And if you haven't had your thyroid checked or you've had head trauma and no one's ever asked you about it, it might be worth a discussion with your physician. It's not about being a hypochondriac, the doctor may have hit the diagnosis on the head, it's just about making sure you're in the right box. Because if they don't have the illness right, getting the treatment right is much less likely.

You can find Natasha Tracy on Facebook or GooglePlus or @Natasha_Tracy on Twitter.

APA Reference
Tracy, N. (2011, August 30). When is Bipolar Disorder Not Bipolar Disorder?, HealthyPlace. Retrieved on 2024, May 19 from

Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate, and author of Lost Marbles: Insights into My Life with Depression & Bipolar. She's also the host of the podcast Snap Out of It! The Mental Illness in the Workplace Podcast.

Natasha is also unveiling a new book, Bipolar Rules! Hacks to Live Successfully with Bipolar Disorder, mid-2024.

Find Natasha Tracy on her blog, Bipolar BurbleX, InstagramFacebook, and YouTube.

Naomi Bel
July, 16 2019 at 2:50 pm

Historically, they were called SHAMAN. It's the same symptoms. They were spiritual healers. It is a disorder when psychiatrists made it up. They persecute them because for the most part psychiatrists are psychopaths and sociopaths. Being bipolar is not a disorder. It is the way the emotions of a Shaman fluctuate in a society full of abuse and abusers. If you are like this, you can learn to control it and only receive the good parts of it. Remember for decades Psychiatrists would 'cure' people by giving them a lobotomy- most obvious indicator for them being psychopaths and sociopaths. Psychopaths and Sociopaths use the opposite parts of their brains as people that are bipolar, so since they already developed into their perspective, they can't be happy and need to feed off the self-esteem of others because they lack the ability to feel good by themselves. So, they enjoy telling people that being bipolar is a disability. The symptoms are: being happy, creative and energetic. Does that seem like a disorder? Its the biggest lie. Maybe some Psychiatrists don't know, so don't judge them all- but be assured, its not any type of disability. We're healers.

July, 16 2019 at 4:30 pm

Hi Naomi,
You're certainly welcome to that perspective but the reason why mental illness (any type) is an _illness_ isn't because someone "made it up" (the symptoms of bipolar disorder have been in medical textbooks since the beginning of medicine), it's because it dramatically adversely affects the lives of those who have it. For example, people with untreated bipolar disorder lose jobs, loved ones, become addicted to drugs, die by suicide and so on. That is the work of an illness, a disability.
I can't comment on shamen, what I can comment on is the millions of people who have been helped by bipolar disorder treatment. These people have an illness and these people have been helped to lead happier, functional lives again.
- Natasha Tracy

May, 16 2012 at 8:52 am

Interesting article. I think it is very common for most patients to have issues with their thyroid and also have bipolar disorder. When I first got diagnosed back in the day, no medical tests where ever done on me to rule out any other possible medical conditions. Which I had always read is what they are supposed to do. Guess what? not all doctors do! if any. If you find one that does, or did, consider yourself lucky. I was originally misdiagnosed as having unipolar depression the first time, and treated with an antidepressant and that pushed me over the edge and I had a full blown manic episode with psychosis. then yrs later I was told I was bipolar type 1, after having a mixed episode with psychosis. a few yrs after that, my doc had changed my diagnosis to bipolar disorder NOS. now somehow my current diagnosis is bipolar type 2 with rapid cycle (but he claims the rapid cycling has stabilized over the past few yrs) im confused how my diagnosis can go from type 1, then to NOS, then to type 2, all in the time frame of 8 yrs...? i really dont know what to make of it lol. the type 2 diagnosis seems to fit me in that I am more prone to recurrent episodes of depression, and very rarely get mania, but everything else in my past history does not fit the rest of the diagnosis, I have been full blown manic before, I have had a mixed episode, and I have had psychotic symptoms. supposedly you cant be type 2 bipolar if you have been psychotic, or manic. so what gives here? im confused! is my bipolar getting better, is it getting worse, staying the same, whats up? regardless im always gonna be bipolar but the geeky side of me wants to understand the reason for the change in diagnosis. my pdoc is kinda hard to communicate with so he will probably never tell me.

August, 30 2011 at 7:06 pm

When I was hospitalized the first thing they did was bloodwork. They assumed that since I'm a larger woman, have thin hair and dry skin, that I had hypothyroidism. The bloodwork came back near perfect, no sign of hypothyroidism or any other blood-related ailment. I'm pretty sure my diagnosis is correct (though it took my psychiatrist months to admit that I was right and that I was experiencing true hypomania and depressive episodes... a**hole...).
I guess I got lucky, kind of.

August, 30 2011 at 4:37 pm

Agreed, you do not want to leave any stone unturned. Get everything tested if you can. Find medical professionals your are comfortable trusting too. It does not hurt to get second opinions or revisit diagnosisis if you are not satisfied you are recovering to your satisfaction.

Natasha Tracy
August, 30 2011 at 4:19 pm

Hi Nullfuture,
I suspect you are not alone. As far as I know, thyroid problems are the most common issue on the list so it's unfortunate that hasn't been tested for you. And really, any time there is an illness, a general blood count seems worth doing.
But like I said, I'm not a doctor.
- Natasha

August, 30 2011 at 3:27 pm

I think I'm around about 10 different diagnoses atm and none of the above was ever mentioned (except ADHD although it was never suggested pediatric). Never seen results of a blood test etc. So... I think it just illustrates how much overlap there is between various conditions.
As things stand... it's pot luck depending on the doctor you see, their particular thoughts and how you present in that session. Not much we can do about it although fMRI etc are starting to have (controversial) results which may help solve the equation.
Till then we live in hope.
If we're lucky

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