Bipolar disorder is often difficult to diagnose, and in many cases it is mistaken for major depressive disorder. This is because individuals who suspect they might need to see a psychologist or psychiatrist often seek help for symptoms of depression first. Additionally, patients with bipolar disorder often experience episodes of depression before they start having manic episodes. According to the National Depressive and Manic-Depressive Association (DMDA), an overwhelming 69% of bipolar patients in a survey were initially misdiagnosed, and out of these, a third had to wait 10+ years for an accurate diagnosis.
New Research Discoveries
Research coming out of Chongqing Medical University in China reveals a new and objective method for diagnosing depression and bipolar disorder. Medical researchers in the Department of Neurology identified a panel of six metabolites in urine that could distinguish between bipolar disorder and depression with an accuracy rate between 89 and 91%. This discovery will aid in the development of an objective laboratory test for more accurate diagnosis in the future.
One of the metabolites discovered to be a marker in this urine analysis is called propionate. Propionate is a metabolite produced by microbial fermentation in the gut that plays a role in lipogenesis, satiety and a reduction in carcinogenesis. Metabolites are products of metabolism and examples include acetic acid, lactic acid, ethanol and glutamic acid. Analyses of metabolites in urine are also used to reveal drug use, diabetes, nutritional deficiencies and metabolism disorders. To learn more about the panel of metabolites recognized in the study, see the article recently published in the Journal of Proteome Research.
Medications for Bipolar Disorder vs Depression
Misdiagnosis of bipolar disorder can be fatal. Risk of suicide in bipolar patients is substantially higher than those with major depressive disorder. Giving these patients the wrong medications, such as SSRIs like sertraline or fluoxetine can greatly increase this suicide risk. This is why it is so important to develop an accurate and objective test for diagnosis.
Pharmacotherapy for bipolar differs greatly from the course of drug treatments that are prescribed to treat depression. Bipolar disorder is often treated with mood stabilizers such as lithium and valproic acid and antipscyhotics such as Seroquel and Latuda. Anti-depressants are sometimes prescribed during depressive episodes, but these must often be taken along with mood stabilizers or antipsychotics and bipolar medications.
Hope for the Future of Mental Illness
Up until now, diagnosing bipolar disorder has been mostly a guessing game involving interviews and evaluations. Patients’ answers aren’t always accurate and the interpretation of those answers is highly subjective. The results of these urine analyses are an indicator of how mental disorders like depression and bipolar disorder can affect the body as a whole, and they also give hope for a future where several mental illnesses can be easily identified with something as quick as a urine test.
For more information about bipolar disorder including treatments, management and medications, visit our Bipolar Disorder Condition Page.