Bipolar disorder is often confused with other conditions that share mood swings or emotional intensity. This misdiagnosis can delay proper treatment and worsen symptoms.

Borderline Personality Disorder (BPD) is the most commonly misdiagnosed as bipolar. Both involve mood instability, impulsivity, and relationship struggles. But BPD mood shifts happen quickly—often within hours—and are tied to interpersonal stress. Bipolar episodes last days or weeks and aren’t always triggered by external events.

Major depressive disorder (MDD) is another frequent mix-up. If a person only shows depressive symptoms and hasn’t had a clear manic or hypomanic episode, doctors might miss bipolar II. Antidepressants alone can even trigger mania in undiagnosed bipolar cases.

ADHD also mimics bipolar, especially in teens. Restlessness, distractibility, and risk-taking appear in both. However, ADHD symptoms are chronic and steady, while bipolar includes distinct mood episodes.

Schizoaffective disorder, PTSD, and even anxiety disorders can look like bipolar too. Substance use—like stimulants or cannabis—may also create bipolar-like symptoms temporarily.

Accurate diagnosis requires a detailed history, mood tracking over time, and sometimes input from family. A single visit isn’t enough. Psychiatrists look for patterns: duration of mood shifts, triggers, sleep changes, and family history.

Misdiagnosis rates for bipolar disorder are high—some studies suggest up to 40% of cases are initially labeled incorrectly. That’s why second opinions and thorough evaluations matter.

If you’ve been diagnosed with bipolar but treatments aren’t working, consider a reassessment. The right diagnosis leads to the right care. And whether it’s bipolar, BPD, or another condition, effective help is available with the correct approach.