Misdiagnosed as BP Due to Trama ?
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Q:  Misdiagnosed as BP Due to Trama ?

My adult son was diagnosed as being bipolar shortly after returning home from over a year in Desert Storm. For years he was taking Lithium with (I think) more problems than relief.  A year ago he stopped all medication, and is back to being more like the cheerful son I had before he went to war. How likely would you say it might be that he was misdiagnosed as bipolar as a result of trauma from the stint in Saudi Arabia?  I look forward to hearing your thoughts.


Dear Judith --
(I've gotten behind on letters; pardon the brevity of this reply)
Can't say, could be either: bipolar disorder commonly has its first episode after some sort of trauma; and "post-traumatic stress disorder (PTSD), or in this case, an acute stress disorder, can look somewhat like bipolar disorder. Classic manic symptoms such as euphoria and grandiosity and increased sexual activity are not found in stress disorders; but anxiety, agitation, sleep disturbance, and irritability -- the less widely recognized symptoms of some people's mania/hypomania -- are shared by both disorders. If you completed bipolar questionnaires (here are two approaches from my site, at the end of the section on Diagnosis: the
Bipolar Spectrum Disorders Scale and the Mood Disorder Questionnaire) as though you were your son when he returned, and if the scores were very strongly positive for bipolar disorder, that might give you a bit of a clue as to what you saw.

As you must be painfully aware, the question is whether what you saw, or some other facet of bipolar disorder, could recur. So trying to figure this out now has some value regarding an attempt to predict the future -- but even the best effort now to understand what happened will only give a you a vague sense of what to expect, as trauma-based conditions can recur (often after another even more mild trauma), and bipolar disorder can occasionally not recur, or the delay could be many, many years.

Pretty vague, huh? Sorry; that's the way it is, as I see it, at least. Good luck and wishes for no recurrence.

Dr. Phelps

Published October, 2003 


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