More often than people wish to think, folks go to mental health specialists and receive a misdiagnosis. This isn’t entirely the professional’s fault as they are bound to the diagnosis they choose by the symptoms and traits described in the Diagnostic and Statistical Manual of Mental Disorders (DSM) which is currently in its fifth edition.
This article will focus on how two mental health disorders, bipolar disorder, and complex post-traumatic stress disorder (CPTSD), and how the latter is often misdiagnosed as the former.
Bipolar Disorder
Everyone experiences high and low times in our lives, but in bipolar disorder, these peaks and valleys are much more severe and can be debilitating. Bipolar disorder brings major changes in mood, thinking, energy, and behavior patterns from the highs of mania to the extreme lows of depression. These cycles may last for days or months and the mood changes are so intense that they interfere with the person’s life, damage relationships, and disrupt their ability to function.
The causes of bipolar disorder are not well-understood, but it is believed to be inherited genetically. The symptoms of bipolar disorder are sometimes subtle and confusing so many people with bipolar disorder are misdiagnosed causing unnecessary suffering. Bipolar disorder will worsen over time without proper treatment.
One phase some people experiencing bipolar disorder is mania. Mania has common feelings of heightened energy, creativity, and euphoria. One may talk fast, experience insomnia, and be hyperactive. Someone experiencing mania may also feel all-powerful and destined for greatness. While it feels good to be manic at first, mania spirals out of control as the person behaves recklessly. The person may become angry, irritable, aggressive, and lash out at those they love destroying their relationships. Some people experiencing mania may also become delusional and hear voices.
Some other common signs of mania include:
- Unrealistic, grandiose beliefs about themselves
- Racing thoughts
- Unable to concentrate
- Impaired judgment
It is called bipolar disorder because it has a flip side to mania, depression. This depression is distinctly different from that experienced in major depressive disorder especially when it comes to treatments. Antidepressants can make bipolar disorder worse and trigger bipolar depression, rapid cycling, or interference with other mood-stabilizing drugs.
Bipolar disorder is likely to involve irritability, guilt, mood swings, and restlessness and with bipolar depression, one might move and speak slowly. Also, people living with bipolar disorder might lose contact with reality and have major problems at work and in their social functioning.
Some other common symptoms of depression include:
- Feeling hopeless or sad
- Inability to experience pleasure
- Fatigue
- Physical and mental sluggishness
- Appetite changes
- Weight loss
- Sleep problems
- Memory problems
- Feeling worthless
- Thoughts of death or suicide
Clearly, bipolar disorder is a diagnosis that is on its own in the world of psychiatry.
Complex Post-Traumatic Stress Disorder (CPTSD)
By now most people have heard the term post-traumatic stress disorder (PTSD). We hear it in conjunction with military personnel and first responders who have faced traumatic events on the job. However, many have never heard of complex post-traumatic stress disorder.
CPTSD is a developmental trauma disorder quite different than PTSD in that it forms in children who experience chronic sexual, psychological, physical abuse, or neglect. As we shall see, CPTSD also has many symptoms in common with bipolar disorder but differs in some key areas.
The following definition given by Beauty for Ashes says it best:
“Complex PTSD comes in response to chronic traumatization over the course of months or, more often, years. This can include emotional, physical, and/or sexual abuses, domestic violence, living in a war zone, being held captive, human trafficking, and other organized rings of abuse, and more. While there are exceptional circumstances where adults develop C-PTSD, it is most often seen in those whose trauma occurred in childhood. For those who are older, being at the complete control of another person (often unable to meet their most basic needs without them), coupled with no foreseeable end in sight, can break down the psyche, the survivor’s sense of self, and affect them on this deeper level. For those who go through this as children, because the brain is still developing and they’re just beginning to learn who they are as an individual, understand the world around them, and build their first relationships – severe trauma interrupts the entire course of their psychologic and neurologic development.”
It is obvious that the causes of CPTSD are far different from those of bipolar disorder which is believed to be inherited.
The symptoms of complex post-traumatic stress disorder include:
- Losing or reliving memories of traumatic events
- Difficult regulating mood
- Rage
- Sudden mood swings
- Depression
- Suicidal thoughts or actions
- Feeling detached from oneself
- Feeling ashamed
- Feeling guilty
- Difficulty trusting others
- Feeling different from others
- Becoming obsessed with revenge for the perpetrator
- Difficulty maintaining relationships
- Seeking or becoming a rescuer
- Being hyperalert
- Feeling a loss of spiritual attachment
- Depending on religion for self-worth
Comparing the symptoms of the two disorders, bipolar disorder, and complex post-traumatic stress disorder, one can see some symptoms do overlap. However, there are many major differences.
Why the Problem with Misdiagnosis?
With such glaring differences in the two diagnoses, one might ask why then the problem with CPTSD being misdiagnosed as bipolar disorder? The answers are unsettling, but the truth needs to be told.
Psychiatrists and other mental health professionals in the United States are paid using diagnosis codes from the DSM-5 that lists each mental health disorder and the criteria to meet them. Currently, complex post-traumatic stress disorder is not in the DSM-5 so mental health professionals are left in a quandary, they cannot diagnose their patients with CPTSD and get paid for treating them. This leaves doctors and therapists no choice but to choose bipolar disorder or some other mental health challenge as their client’s diagnosis.
Another challenge to receiving the diagnosis of CPTSD over bipolar disorder is that many mental health professionals either do not have any knowledge of CPTSD or refuse to believe in its existence even in the growing evidence that it does. Indeed, research conducted by the National Libraries of Medicine, National Institutes of Health showed that the World Health Organization (WHO) is adding complex post-traumatic stress disorder to its upcoming eleventh edition of its International Classification of Diseases (ICD). Even the National Center for PTSD, a government-run website, has a page dedicated to CPTSD.
What You Should Do
What do you do if you believe you have been misdiagnosed by a mental health professional? The first thing to do is not to panic. Although we look up to doctors, they are the only people with diplomas. They are fallible and sometimes make mistakes such as giving the wrong diagnosis. If you feel your doctor has made a mistake, ask for a second opinion outside of that doctor’s clinic. Most insurance companies allow this maneuver and even if yours does not it is worth the peace of mind.
Second, make sure to be totally upfront and honest with your clinician. A mental health professional’s diagnosis is only as good as the information you give them. If you hold back facts from your childhood or other information you are hurting yourself and become more likely to be misdiagnosed.
Last, if you do not feel your mental health professional is a good fit and that your diagnosis is wrong, seek out someone else for help. Take advantage of websites that help you find specialists who deal with complex post-traumatic stress disorder to find a good match.
Misdiagnosing CPTSD as bipolar disorder is dangerous and will not help the person experiencing symptoms to heal. Definitely, reach out to a mental health professional when you need help but keep in mind that misdiagnosis can and does occur.
“Believe in yourself. You are braver than you think, more talented than you know, and capable of more than you imagine.” ~ Roy T. Bennett
If you are a survivor or someone who loves a survivor and cannot find a therapist who treats complex post-traumatic stress disorder, please, contact CPTSD Foundation. We have a staff of volunteers who have been compiling a list of providers who treat CPTSD. They would be happy to give you more ideas about where to look and find a therapist to help you. Go to the contact us page and send us a note stating you need help, and our staff will respond quickly to your request.
Are you a therapist who treats CPTSD? Please, consider dropping us a line to add you to our growing list of providers. You would get aid in finding clients, and you would be helping someone find the peace they deserve. Go to the contact us page and send us a note and our staff will respond quickly.
Shortly, CPTSD Foundation will have compiled a long list of providers who treat complex post-traumatic stress disorder. When it becomes available, we will be putting it on our website www.CPTSDFoundation.org.
Make sure to visit us and sign up for our weekly newsletter to help keep you informed on treatment options and much more for complex post-traumatic stress disorder.
If you or a loved one live in the despair and isolation that comes with complex post-traumatic stress disorder, please, come to us for help. CPTSD Foundation offers a wide range of services, including:
- Daily Calls
- The Healing Book Club
- Support Groups
- Our Blog
- The Trauma-Informed Newsletter
- Daily Encouragement Texts
Free Winter Holiday Support 2020
60 Days of CPTSD Strategies
One email a day to help you through the holidays!
- Does the thought of the upcoming holiday season cause you anxiety?
- Could you use some help with healthy boundaries, self-care, and making your healing a priority, amidst the chaos?
- Maybe you could just use some extra encouragement during the upcoming holiday season?
- Would a single email per day, containing a video, audio, inspiring quote, or encouraging thought, be something you would find helpful?
If you answered “YES” to any of these questions, then why not join us for Winter Holiday Support?
The Healing Book Club
Today, CPTSD Foundation would like to invite you to our healing book club, reading a new book that began in September. The title of the latest featured book is The Body Keeps the Score by Bessel van der Kolk.
Led by Sabra Cain, the healing book club is only $7 per month, the fee going towards scholarships for those who cannot afford access to materials offered by CPTSD Foundation.
Should you decide to join the Healing Book Club, please purchase your books through our Amazon link to help us help you.
All our services are reasonably priced, and some are even free. So, to gain more insight into how complex post-traumatic stress disorder is altering your life and how you can overcome it, sign-up, we will be glad to help you. If you cannot afford to pay, go to www.cptsdfoundation.org/scholarship to apply for aid. We only wish to serve you.
My name is Shirley Davis and I am a freelance writer with over 40-years- experience writing short stories and poetry. Living as I do among the corn and bean fields of Illinois (USA), working from home using the Internet has become the best way to communicate with the world. My interests are wide and varied. I love any kind of science and read several research papers per week to satisfy my curiosity. I have earned an Associate Degree in Psychology and enjoy writing books on the subjects that most interest me.
Hello Shirley,
Thank you for the post comparing Bi-Polar mania, to CPTSD.
I’ve commented on prior posts, but have a question.
In my situation, I was married to my narc ex-husband for 10 years. We had two children, 21-months apart, a daughter, now 20, and a son, now 18. We’ve been divorced for 10 years. Both children are thankfully in college, so geographically removed from their narcissist father, and his equally gaslighting wife, whom he married right after our divorce was final, because he has never supported himself, let alone our children, financially. He needed wife #3, to maintain his blissful, suburban standard of living.
I paid a total of $227,000 in child support over 10 years. He saved none of it for the kids’ college, telling them that I would pay their way. I learned this after repeated messages in several forms (texts, emails, court inquiries), asking for an honest discussion about how we would manage the college finances. I know now why he never responded. The kids would have learned that I fully expected him to pay part of it. He and his wife used my inability to fund the kids’ educations, 100%, and in a single check to each child, for $120,000 a piece, as the final coup d’etat. When he informed them that I would not, (and could not) finance their educations, both of my babies told me in extremely cruel and cold-as-ice terms, that they never wished to speak to me or see me again. It has been a year and a half since I last spoke to them… I’m destroyed..
Your article touches on the notion that CPTSD is mainly rooted in childhood/early teens. As the breadwinner, I worked long hours, so the divorce judge gave my ex, “residential” custody, and us both, joint custody. THAT is a sham, in my opinion. My ex was able to exclude me from any and all information related to our kids, starting right away, while also covertly abusing them through criticism, guilt, shame, control, you name it.. Our son attempted suicide twice. The first time, my ex never even called to tell me. I learned from the insurance company, since I was paying for my son’s inpatient stay. The second attempt, my ex described as “just a cry for attention. He doesn’t mean it..!”
My question: how do young adults, who are still engaged in the Stockholm-Syndrome/fight or flight fear for their survival- like behavior, where they must lose their own personalities, to adopt the opinions their father wants them to exhibit, or face his rage, abuse, or shaming, while still relying on him to a point, but less and less, for their basic needs, ever come to see his sickness and his horrific abuse, to the point where, even if presented with factual information to the contrary, they’d still be stuck in cognitive dissonance… How do such young adults ever come to realize that I am NOT the villain, that I love them as much as I always have, and always will..??? I still pay their health insurance, by choice, but I’ll admit, their treatment of me, the disrespect, and the easy dismissal of me as their mother, has part of me wondering whether I should end their insurance coverage, and let them go…. Can young adults of a narcissistic father, ever see the other side???
Thank you..
First of all I’m very sorry you are going through this. It sounds extremely painful.
Your children might recognize the problem as their narcissist father in the future especially now that they are exposed to other young adults who have a different point of view of the situation. You might have CPTSD as well from the mistreatment you have received down through the years. You might consider seeing someone for a while to help you cope with all your pain. Shirley
Shirley,
Thank you for the thoughtful and insightful reply. It gives me hope that perhaps my children will, in fact, meet other peers who might help them become aware of their father and the dysfunction he created. I had not thought about that!
Also, I’m happy to say that I AM in therapy, for the likely CPTSD I suffer from, after having to engage with a narcissist for 20 years. I feel amazing, and have my power back. I live for the day when the kids will, too..
Take care during the holidays, and again, thank you for the phenomenal resource this site provides..
K.
Hypomania is NOT the depressive episode of bipolar. It is a milder form of mania common in bipolar II. It’s so important to get facts straight before posting articles, especially on something like mental health. Anyone that doesn’t know the simple fact about bipolar disorder should definitely not be writing an article about it!
I deeply apologize I thought I had fixed that problem. Shirley
Hypomania is NOT the depressive side of Bipolar Disorder. Mania is part of Bipolar Disorder I and typically involves psychosis. Hypomania occurs in Bipolar Disorder II and is a more mild form of mania that does not involve psychosis. It is NOT the depressive stage of either Bipolar Disorder I or Bipolar II. The depressive side of either version of Bipolar Disorder is, not surprisingly, called “depression.” It’s impossible to take anything in your article seriously when you don’t know something so basic.
Thank you! I was coming here to say this.
I have just read an article about ADD and ptsd and it struck a note ! I dont know why but i booked a session a session with a psychic medium on 2nd feb this year, my mother who was psychic and a man who i had just walked up to and said “you are a chronic alcoholic and have had problems all your life were contacted by the medium along with my fathers father this left me thinking. The psychic medium then said all my memories would now come back to me and within two weeks it was getting very strange. I started to experience a very bad startle response so looked up the symptoms of trauma and a huge light bulb came on in my head I suddenly realised and remembered i had been traumatised 5 times as a child and three times in adulthood. I am a highly sensitive person and have the symptoms of attention deficit disorder all my life. I believe that this was caused by heavy metal poisoning as a child. I had tried to tell my doctor about this in 2017 but was threatened to keep my mouth shut and go away ! I had cured my severe asthma and copd overnight by doing three things. I am highly intuitive and have the sixth sense they talk about in ADD. I believe that i had dissasociated many times in my life. after my seventh trauma I didnt speak or get a chance to i was told all the tests had been done as far as i was concearned there wernt any that i could remeber. I was diagnosed with a probable bi polar condition in 45 minutes ???? I never spoke about what had happened. but i left notes with the psychiatrist about my attacker who i thought was a narcissistic aspergers.
I had been eating a loaf of white bread a day and this had caused severe diabetes/hypoglycemia which i believe had made me psychotic. when i told the health service that i thought i was diabetic i was told to go away as i was psychotic. I was only psychotic once hearing voices and thinking i could hear the telephone ringing at night. then when i got away from my attacker it went away. I also have high functioning autism which i inherited from my father but there was noone in our family with Bipolar disorder. I think i may have been diagnosed but when i told the health service they threatened me with intimidating phone call and told me to go away and keep my mouth shut about what had happened.
I dont know what to do. There is a lot more to this story but it would take a long time to tell it. My obsessive interest with Autism is Mental health and i have nearly one hundred books on mental health conditions and psychology
You are very intelligent in your intuition, although I can tell you are suffering a mental crisis, your body is leading you to greater insight. Please see Gut And Psychology Syndrome. GAPS diet. Dr Natasha cambellmcbride
Yes thank you I have that book
Its EMDR for me next
Thank you !
Howard Kelly
Hi Shirly,
The existence of the CPTSD Foundation, and the resources it offers is much needed, and hopefully will help establish the diagnosis in the United States as well. As a clinician, I have found that people can have both bi-polar disorder and PTSD. The PTSD or CPTSD establishes the source often of the bi-polar cluster of symptoms, which can then include additional, trauma related behaviors and symptoms. I have often noted that clients with CPTSD/bi-polar disorder have come from families with mental health and/or addiction problems, which, as you note, dysregulate the neuro-biology as it is developing in children. This seems to produce more of a ‘nurture’ than ‘nature’ cause of problems with regulating anxiety and depression which are components of both CPTSD and bi-polar disorder.
Let’s throw another complication into the mix here. Where there has been alcohol during pregnancy, we often see most of these symptoms plus a few more. Fetal Alcohol Spectrum Disorders affect 5% of our population; half of foster kids; a third of incarcerated people. It CAUSES symptoms of ADHD, Bipolar Disorder, Autism…and is also rarely diagnosed. And naturally where there is trauma in a household there is often also alcohol, mamas included.
Yes, thank you. You are right. Shirley
Hi Shirley,
Good job!
Thank you for this article, very helpful and informative.
I m am writing a literature review on CPTSD and Bipolar disorder. I will appreciate if you can share your references with me to help in my literature review.
Thank you
hello Remi.
I’m a student who currently is writing a big essay about the relationship between bipolar disorder and PTSD.
I know you posted that comment two years ago but I would like to ask you for the name and where can I find the literature review you have wrote, I would like to use it for my essay as it would help me a lot.
thank you very much, Shahaf.
Here are two links that will help. Also, if you use Google Scholar, you can put the names of these papers into its search and it will come up with a citation for each as well as related articles. Good luck with your paper.
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1399-5618.2004.00151.x?casa_token=rqPsmoWkh_sAAAAA%3AYvvyM67wsBsejtM_fILhDSj7865yMnzneeLuUWAW0ICoORJyVdTzM96uoySrpYBOz13D4k0UgfVf8Q
https://repositorio.ufba.br/bitstream/ri/13468/1/1-s2.0-S0165032709003498-main.pdf
My whole life, my parents, doctors, society, etc have told me I have “anxiety, depression, bipolar, etc…” but never discussed trauma or complex PTSD. Meanwhile, the medical system profited from my symptoms as I was running around with a dysregulated nervous system. I shared this with my primary care doctor recently, and I could tell she saw some truth in it.
Did you know that in 1980, the DSM III contained a foreword that acknowledged that it was so imprecise it should never be used for forensic or insurance purposes, but that this was erased in future revisions?
Did you know that in 1994, a group of clinicians including Judith Herman proposed a revision to the DSM IV to include C-PTSD but it was rejected by the DSM committee? Childhood abuse and neglect which leads to complex-PTSD is often the root of symptoms such as anxiety, depression, bipolar, borderline, and many other disorders.
Did you know that in 2013, the National Institute of Mental Health (NIMH) director Thomas Insel announced his agency could no longer support DSM’s symptom-based diagnosis? Yet mental health clinicians still continue to use this handbook to diagnose and “treat” mental health disorders which are actually a result of colonial capitalist patriarchal abuse inflicted on the nuclear family unit.
I believe that I was diagnosed with bipolar when in fact it was CPTSD. I TOOK THE MEDS BECAUSE THEY HELPED ME SLEEP WHICH WAS ALL I WANTED FROM PDOC. AFTER 6 YEARS OF taking zyprexa + 3 other meds I came down with very serious “anxiety “. Which I have come to believe was akathisia without the need to constantly move. It was overwhelming. After a few months the mouth movements started and I ditched the pdoc because she was still insisting that I was seriously ill. In 2017 I began taking Ingrezza. Within 2 weeks the constant restlessness (anxiety) subsided suddenly and my mouth started feeling a bit better. After 6 years on Ingrezza I have developed Parkinsonism ,OMD, GAIT & balance disorders. I have been classified as severely disabled Imam now 77y/o
Great to hear this being discussed.
By the way there are a couple of typos – 2nd para has an extra “how”.
Later this sentence – Although we look up to doctors, they are the only people with diplomas.
I think you need to delete “the”. But also “diploma” is not the correct term for a medical qualification. A diploma is a short qualification typically 1 full time year or equivalent. It takes a lot longer than a year to qualify as a psychiatrist or psychologist or even just a general medical practitioner.
I was diagnosed with Bipolar 2 when I was finishing up college in my last semester, keep in mind that last semester I had a very bad car wreck that caused a concussion and eventually led me to have my first psychotic break. I only gave my symptoms at the time of my episode but never told my psychiatrist about the abuse I recieved growing up as a child, my siblings and I were beaten heavily until my dad finally went to therapy, and at my new school from 4th-12th grade I was constantly lied about even my so-called “friends” made up rumors that ruined my will to live, at the age of 16 I was raped and groomed by a 23-year-old classmates uncle that led me to become slightly overweight and I OD’ed a month after our first interaction (I didn’t realize what truly happened until I went to therapy years later), relationships I have struggled with especially when betrayed by my last love when he cheated and then continued to lie about me. I felt as if maybe I was bipolar and that is why I viewed things differently and couldn’t seem to fit in (that I was delusional). Some of my family and friends mentioned that they didn’t think I was completely bipolar but maybe I was just a victim of constant betrayals. I just have a hard time accepting that because I have never once gotten an apology from anyone besides my father… I feel as if I am truly the problem and that is why I can’t seem to be normal. How would I deal with something like this if I couldn’t even get the people in my life to see my pain and understand it? I am now medicated but the pain never seems to end