- Published
When Kimberley Atkinson was told she had depression, the diagnosis made sense to her.
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diagnosis → publish → her
She had struggled with her mental health since she was a teenager and hoped being prescribed antidepressants would improve things.
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prescribed → struggle → things
"My mood had always been up and down, and my emotional regulation was never very good," Kimberley said.
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Kimberley → say → ?
She said the impact it had on her life was awful, with depressions that felt like "sinking into a dark hole", leaving her stuck in bed and not able to face the day.
For 14 years, she assumed these were all the symptoms of her depression until her behaviour started to change dramatically.
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behaviour → say → depression
"I started becoming really erratic in my thinking style, having delusional ideas, speaking really fast, becoming very irritable," Kimberley said.
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Kimberley → start → ideas
One night, while she was studying for a PHD at the University of Edinburgh, she drove to London after seeing a news report that someone was in trouble and becoming convinced she was the only person who could save them.
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who → study → them
She also became convinced her moods were causing bad weather.
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moods → become → weather
Friends and family became concerned and she was eventually admitted to a psychiatric ward against her will.
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she → become → will
It was here that doctors finally realised she had bipolar disorder.
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she → realise → disorder
Studies have suggested that a significant number of people with severe/recurrent depression could actually have bipolar, with some research putting it as many as one in five, external.
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research → suggest → external
Prof Danny Smith, chair of psychiatry at the University of Edinburgh, told the BBC that better "screening" was needed by health professionals, such as asking about symptoms like mania and if patients had a family history of the condition.
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patients → tell → condition
His call for screening guidance to be urgently updated is backed by the Royal College of Psychiatrists and charity Bipolar UK.
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guidance → update → Psychiatrists
They say better screening could be "life-saving" as medication for depression can often make people with bipolar more unwell.
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people → say → depression
During Kimberley's three-month stay in hospital, psychiatrists looked beyond her depression for the first time.
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psychiatrists → look → time
At first she didn't want to accept her bipolar diagnosis but she said years of symptoms eventually made sense.
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years → want → sense
"When I think about how my life was before my diagnosis, it was so chaotic," Kimberley said.
"Whereas now I'm stable, which is in large part due to the medication."
What is bipolar?
Formerly known as manic depression, bipolar is a mental health condition that causes extreme changes in mood.
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that → think → mood
During 'high' periods, known as mania or hypomania, people with bipolar often feel very excited and creative or have unusual amounts of energy.
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people → know → energy
They often experience racing thoughts, a reduced need for sleep, and being very irritable.
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They → experience → sleep
In severe cases, mania can cause a break from reality.
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mania → cause → reality
It's not known exactly what causes bipolar, but people with it appear to have physical changes in their brains and it often runs in families.
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it → know → families
Treatments can involve mood-stabilising medication like lithium and talking therapies, helping people go long periods without symptoms.
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people → involve → symptoms
Jacqui Armstrong also spent years being treated for depression before receiving the correct diagnosis.
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Armstrong → spend → diagnosis
The 64-year-old began treatment on various antidepressants from her teenage years and over the next three decades her depressions led to several hospital admissions and a suicide attempt, all while she worked as a teacher in a primary school then a nursery.
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she → begin → school
"I couldn't even get up the stairs, I was just broken," she said.
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she → get → stairs
"I just felt like a huge failure the whole time, thinking 'why can't I get well?'."
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I → feel → failure
Jacqui said that during one episode, she was even given electroconvulsive therapy – a treatment that uses an electric current to induce a controlled seizure.
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that → say → seizure
But she said the signs of bipolar were always there.
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signs → say → bipolar
As well as frequent depressive periods, she experienced 'hypomania' episodes, spurts of unusually high energy, activity, or mood that were less severe than full mania.
"I would suddenly feel like a confident person, and I had all these ideas, and I was very sociable, thinking how many things can I fit into my diary," she said.
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she → experience → diary
"And then I would energise myself into a breakdown."
It was only during her final hospital admission for depression that a psychiatrist asked Jacqui if she'd ever experienced symptoms of hypomania.
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she → energise → hypomania
She was then assessed further and diagnosed her with bipolar II – more than 30 years after first seeking help for her mental health.
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She → assess → health
Meanwhile Kimberley, who had experienced a "full" manic episode that resulted in a break from reality, was diagnosed with bipolar I.
Experts say bipolar II is even harder to diagnose because it involves more frequent depressions and the manic episodes are not as severe, which is why they are dubbed hypomania.
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they → experience → depressions
Experts such as Smith believe bipolar disorder is significantly underdiagnosed.
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disorder → believe → Smith
He said about one in 100 people receive a diagnosis during their lifetime but research suggests the true figure could be closer to one in 50.
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figure → say → 50
Studies also suggest patients in the UK typically wait almost a decade between first reporting symptoms and receiving a diagnosis.
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patients → suggest → diagnosis
Smith said the long delays suggest that people are not being routinely screened properly for symptoms of hypomania or mania which should result in a referral to a psychiatrist to rule out the possibility of bipolar.
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which → say → bipolar
While existing UK-wide guidelines, external say doctors should already do this, Smith said updated and better-publicised screening tools are "really important" because research suggests this is routinely not happening.
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this → exist → this
"It's understandable because GPs are often confronted with depressed patients and therefore they're very focused on diagnosing depression correctly," he said.
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he → confront → depression
"People obviously don't go to the GP and say 'Help doctor, I'm really energetic and I've got lots of ideas and I don't need much sleep.'
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I → go → sleep
"
While awareness for the condition has increased in recent years – with high-profile figures like Stephen Fry and Chappell Roan being public in their diagnosis – charity Bipolar UK said too little attention is being paid to the illness, and delayed diagnosis is "costing lives".
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diagnosis → increase → lives
Smith said it's important the public knows that bipolar is a "highly manageable" condition when diagnosed, and that people who get proper treatment can "do really well" with normal families and successful careers.
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who → say → families
…and 11 more, not listed.
The Aporia
