You couldn’t sleep—your mind was buzzing at 3 a.m., ideas racing and energy surging. A few days later, that same mind felt like it had collapsed under a lead blanket. You couldn’t move and didn’t care. Nothing seemed to matter.
Doctors called it depression, handed you a prescription, and sent you on your way. But what about the highs? The sleepless nights? The days you felt invincible—until you weren’t?
If this cycle feels familiar, you’re not imagining things. And you’re far from alone. Many people with bipolar disorder spend years cycling through symptoms without ever hearing the right name for what they’re experiencing.
Let’s take a look at why bipolar disorder often goes undetected for so long, what you can do to push for answers sooner, and how the team at Raleigh Oaks Behavioral Health in Garner, North Carolina, may be able to help.
Why Is Bipolar Disorder So Frequently Misdiagnosed?
People with bipolar disorder are more likely to seek help during a depressive episode, when symptoms like low mood, fatigue, and hopelessness are most visible. Without a full picture of manic or hypomanic symptoms, clinicians may mislabel the condition.
The high-energy periods may not always look like the dramatic mania shown in movies. Hypomania—common in bipolar II—can feel like productivity, confidence, or simply “feeling better.” Without disruptive behavior, people simply may not report these periods as problematic.
The most common misdiagnoses for bipolar disorder include:
- Major Depressive Disorder. If someone only reports depressive symptoms and omits or downplays periods of elevated mood, clinicians may treat them for depression without realizing the mood disorder has another side.
- Attention-Deficit/Hyperactivity Disorder (ADHD). In both children and adults, bipolar disorder can involve restlessness, distractibility, and impulsive behavior—traits also seen in ADHD. Without careful evaluation, especially of mood fluctuations over time, it’s easy to confuse the two conditions.
- Borderline Personality Disorder (BPD). People with bipolar disorder may be misdiagnosed with BPD due to intense emotional swings, unstable relationships, and impulsive behaviors. While both conditions involve mood instability, BPD is more associated with moment-to-moment emotional reactivity, whereas bipolar episodes typically last days or weeks.
Getting an accurate diagnosis requires a detailed history of how symptoms affect your life over an extended period. Unfortunately, healthcare systems with rushed appointments and fragmented care make it easy for important patterns to go unnoticed.
How Long Does It Typically Take to Get the Right Diagnosis?
Mayo Clinic research suggests it can take an average of 10 years from the onset of symptoms to obtain a bipolar disorder diagnosis. During this time, people may cycle through different providers, medications, and explanations—without relief.
One major factor is the episodic nature of bipolar disorder. If someone is between mood episodes when they seek care, their symptoms may not align with any clear diagnosis. Add in stigma, denial, or lack of awareness, and patients may underreport the highs or attribute them to stress or personality quirks.
What Are the Warning Signs of Bipolar Disorder That Often Get Missed?
Many early signs of bipolar disorder are either dismissed as “normal mood swings” or attributed to other causes. Recognizing these red flags can make a big difference:
- Unusually high energy or confidence. People may experience bursts of energy where they feel unstoppable, talk much more than usual, or leap from one idea to another. They might need very little sleep yet feel fully rested. These periods are often mistaken for a “good mood” or a productive streak, rather than early signs of mania or hypomania.
- Impulsive behaviors. Making big decisions without thinking them through—like going on an unplanned shopping spree, engaging in risky sexual activity, or quitting a job on a whim—is often a symptom of a manic or hypomanic state.
- Irritability and agitation. During manic phases, some people don’t feel euphoric—instead, they become easily annoyed, argumentative, or aggressive. This irritability can be confused with anger issues, stress, or a short temper, leading to misdiagnosis or overlooked symptoms.
- Inconsistent responses to antidepressants. One of the lesser-known red flags is when a person prescribed antidepressants begins to feel worse—more anxious, agitated, or erratic—or enters a manic episode. This reaction may indicate an underlying bipolar disorder that was not initially recognized.
How Can You Advocate for Yourself?
If you suspect you may have bipolar disorder, here’s how to advocate for yourself and help guide your care team toward a more accurate diagnosis:
- Track your symptoms. Use a mood journal or app to log your energy levels, sleep, emotions, and behavior patterns.
- Share a full history. Include details about any periods of unusually high energy or risk-taking, even if they felt positive at the time.
- Ask about mood disorders specifically. Mention your concerns and ask if bipolar disorder has been considered.
- Get a second opinion. If treatment isn’t working or feels misaligned with your experience, don’t be afraid to seek a second opinion from a qualified mental health professional.
Getting the right diagnosis is the first step to finding an effective treatment plan. Mood stabilizers, therapy, and lifestyle strategies can dramatically improve your quality of life when tailored to bipolar disorder—not just depression.
You’re Not Broken—You’re Becoming
At Raleigh Oaks Behavioral Health, we see beyond the diagnosis. We see your strength, your courage, your questions, and your hope for a better future. Whether you’ve just been diagnosed, were misdiagnosed in the past, or are still searching for answers, we’re here to help. Contact us today for a free, confidential assessment.
