‘Depression’ Diagnosis for 14 Years Only Replaced by Bipolar Disorder After Psychiatric Hold

For over a decade, Kimberley Atkinson was treated for depression, a label she accepted despite experiencing significant mood fluctuations. It was only after her behavior became so erratic that she was detained under the Mental Health Act that doctors identified her true condition: bipolar disorder.

Atkinson, who was pursuing a PhD at the University of Edinburgh when her symptoms escalated, described previous lows as “sinking into a dark hole.” However, her condition worsened dramatically, leading to delusional thinking, rapid speech, and irritability. In one instance, she drove to London believing she was the sole person capable of saving a stranger featured in a news report. She also developed the fixed belief that her emotional state was controlling the weather.

Following concern from her social circle, she was admitted to a psychiatric ward against her will. It was during this admission that specialists recognized the manic episodes characteristic of bipolar disorder, which had previously been overlooked.

Atkinson’s experience mirrors broader statistical trends. Research indicates that up to one in five individuals diagnosed with severe or recurrent depression may actually have bipolar disorder. Prof Danny Smith, chair of psychiatry at the University of Edinburgh, emphasized the urgent need for improved screening protocols, specifically urging clinicians to inquire about mania and family history.

Prof Smith’s call for updated guidance has been supported by the Royal College of Psychiatrists and the charity Bipolar UK. Both organizations warn that misdiagnosis is dangerous, as standard antidepressants can exacerbate symptoms in patients with bipolar disorder. Better screening, they argue, could be life-saving.

The story also highlights the experience of Jacqui Armstrong, 64, who waited more than 30 years for a diagnosis. Treated with various antidepressants from her teens, Armstrong endured multiple hospitalizations and a suicide attempt while working as a teacher. It was only after her final admission, when a psychiatrist specifically asked about periods of high energy, that she was diagnosed with bipolar II disorder.

Experts note that bipolar II is particularly difficult to detect because its manic phases, known as hypomania, are less severe than full mania and often go unreported by patients. Prof Smith estimates that while one in 100 people receive a diagnosis, the actual prevalence may be closer to one in 50. In the UK, the average delay between initial symptoms and diagnosis is nearly ten years.

Despite the long road to diagnosis, both women report significant improvement. Atkinson now works as an NHS assistant psychologist and has remained stable since her hospitalization four years ago. Armstrong describes her recent years as the happiest of her life, having raised two children and managed her career with proper treatment.

Prof Smith stressed that bipolar disorder is highly manageable with the correct intervention, allowing patients to lead normal lives. He attributed diagnostic delays to patients rarely volunteering symptoms of elevated mood, such as reduced need for sleep, during general practitioner visits focused on depression.