People with bipolar disorder wait for an average of 13.2 years before they are diagnosed, and often spend years receiving treatment for other conditions, a survey of sufferers has found.
Bipolar campaigners and psychiatrists say the delays are "staggering" and are worrying because those with the illness are 20 times more likely than the general population to take their own lives.
In a survey of 706 people with bipolar, it emerged that the average wait until someone was correctly diagnosed was 13.2 years. While 15% of participants did get diagnosed promptly, the other 85% experienced difficulties in having their illness identified.
Most of those were wrongly told they had depression. Among the 85% whose diagnosis was delayed, 71% said that their symptoms had become worse as a result of receiving inappropriate treatment, such as antidepressants or sleeping pills.
"A delay of this length has a significant impact for individuals and families, with sometimes devastating consequences, as bipolar has the highest rate of suicide of any psychiatric illness," said Suzanne Hudson, chief executive of Bipolar UK. It conducted the survey along with the Royal College of Psychiatrists and Bipolar Scotland in order to highlight the often lengthy delays in diagnosing the condition, to coincide with Wednesday's first National Bipolar Awareness Day.
Bipolar disorder is one of the most common causes of lost years of life and health in those aged 15 to 44, ahead of war, violence and schizophrenia, according to the World Health Organisation. Research suggests that between 1% and 2% of the population become bipolar at some point. As many as 1 in 20 people is on the bipolar spectrum, Bipolar UK says.
Doctors and patients are both to blame, Hudson added. "It could be GPs or psychiatrists that fail to diagnose when they can. But a lot of the time it's patients themselves not telling the doctor their full symptoms. If we're in a hypomanic state, coming out of a stable phase and starting to get high, we rarely present to a GP then, which makes it more difficult," she added.
Alison Cairns, chief executive of Bipolar Scotland, said people with the condition are more likely to visit a GP when they are depressed and not reveal the full extent of their mood swings.
Participants usually began to experience their first symptoms of bipolar disorder aged 23, while half said they first noticed signs of it when they were between 11 and 20.
Dr Danny Smith, a consultant psychiatrist, said that "getting the diagnosis right in the early stages of bipolar disorder can be very challenging". Many survey participants felt that GPs and other medical professionals needed more help in identifying it correctly, he added.
A separate survey of 460 mental-health professionals carried out by the three organisations found that while 89% said they screened those with symptoms of depression for any history of mania as well, 43% never talked to a relative or carer to build up a full picture of the person's history.
One sufferer said: "I wasn't aware of bipolar until the age of 47, when a GP who was treating me for depression and a severe episode started to reconstruct a history of behaviour going back to my teens." Another said: "I hid my symptoms from my GP. I never revealed the true extent of my illness, albeit I did not know what I was doing was necessarily part of being ill. My partner intervened and explained things to my GP, which resulted in an assessment referral."
One patient's partner said a doctor had wrongly taken her partner's bipolar disorder to be a depressive disorder because he only visited his doctor when he felt suicidal. "If the doctor had asked about any periods of high moods, agitation, irritability and sleeping and eating habits, he would have had a clearer picture of my partner's overall moods rather than prescribing for the symptoms on the day of the appointment", she added.
*From The Guardian