The estimated prevalence of bipolar disorder is over 3 per cent of the population of the United States. This may only be a part of the picture as many patients who currently take anti-depressant medication for depression, screen positive for bipolar disorder symptoms. For example, in one study, over 21 per cent who screened positive for bipolar disorder had not been diagnosed as such. The characteristics of this particular sample were that they tended to be white, single, lived alone and were more likely to be unemployed (Hirschfeld et al, 2005). The fact that two thirds of a sample of patients screened were found to be positive for bipolar disorder suggests a situation of underdiagnosis and undertreatment.

A more recently reported study by Stang et al (2007) extends further the merits of screening as a tool for helping with diagnosis, identifying those at risk of suicide as well as illuminating the impact that bipolar disorder has on social activities and employment. This particular research was conducted with a sample of 59 volunteers. On average, the sample had experienced bipolar disorder for just over nine years. Twenty two per cent experienced mixed episodes, 5 per cent manic-predominant episdodes, 12 per cent hypomanic-predominant and 46 per cent depressive-predominant episodes. The results of the study found that two-thirds of the sample, "were at substantial risk of suicide, and bipolar patients in this study reported substantial problems with employment/employability and social functioning" (p.42).

Paul Stang and his colleagues indicate that a number of studies report, substantial underdetection of bipolar disorder in screened samples of primary care patients. More forthright action is needed in terms of both the recognition and the treatment of bipolar disorder. As the authors point out, most patients with bipolar disorder go for treatment during the depressive phase of their illness, rather than the manic or hypomanic phases. This probably explains why diagnosis is mostly based around an assumption of unipolar depression.

Bipolar Disorder and Work

This study reflects the findings of several previous studies, with regard to the specific impact of bipolar disorder on employment. In this particular study, 17 per cent of participants stated they were unemployed due to, "emotional disability". A further 8.5 per cent were unemployed for other reasons. Citing results from the National Depressive and Manic Depressive Association Surveys, the authors suggest that around 85 per cent of people with bipolar disorder feel that their condition affects their ability to work as well as their performance at work.

Reference:

Stang, P., Frank, C., Yood, M.U., Wells, K., Burch, S, (2007).Impact of
Bipolar Disorder: Results From a Screening Study. Journal of Clinical
Psychology. 9 (1), 42-47.

Jerry Kennard is a psychologist & co-founder of www.embarrassments.co.uk