Selena Gomez Talks About Mental Health Struggles: Why Bipolar Disorder Diagnosis Is So Difficult

Selena Gomez recently spoke about her mental health struggles. She had earlier revealed that she had been diagnosed with bipolar disorder. In the debut episode of her husband Benny Blanco's new podcast, Friends Keep Secrets, she shared that she had been "misdiagnosed" before she received her bipolar disorder diagnosis. Speaking about her condition, the 33-year-old singer and actress said, "I knew something was wrong, but I think I was misdiagnosed." She added, "People were just assuming, and I would try multiple therapists. And that's why it's hard. It's actually really hard when we're talking about these things. And for me to go get a therapist, all of it is so f---ing complicated."

Gomez also shared that she went to four different rehabs and numerous therapists. She said that she has now learned to recognize the moment when she is about to enter a manic phase and that Blanco provides a support system. Speaking about her manic episodes, Blanco said, "She'll start to realize she's having it after it's happening, and sometimes she doesn't even remember when it's happening. It's such a delicate thing because you're not supposed to technically talk to that person about it while they're deep in it. And it's like, even dating her and she's so hyperaware, she'll be like, 'I think I'm feeling a little manic.'" Gomez added, "It is helpful to have a partner that will understand where the temperature is at and meet you where you are."

What Is Bipolar Disorder?

It is a mental health condition which causes extreme mood swings. The person suffering from bipolar disorder can have emotional highs and lows. Emotional highs are known as mania or hypomania and lows are known as depression.

Mayo Clinic says that when you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania, you may feel very excited and happy (euphoric), full of energy or unusually irritable. "These mood swings can affect sleep, energy, activity, judgment, behaviour and the ability to think clearly. Episodes of mood swings from depression to mania may occur rarely or multiple times a year. Each bout usually lasts several days."

According to the World Health Organization (WHO), an estimated 37 million people (or 0.5% of the global population), including approximately 34 million adults, were living with bipolar disorder in 2021. While the condition is usually seen among working-age people, it can also occur among youths. The prevalence of bipolar disorder among men and women is approximately equal, however, available data indicate that women are more often diagnosed.

Why Is It Difficult To Diagnose Bipolar Disorder?

Diagnosing bipolar disorder can be challenging due to its symptoms and overlap with other conditions. Here are some reasons that explain why it takes several years to diagnose this mental health condition.

Symptom Overlap

People with bipolar disorder have extreme mood swings between mania (or hypomania) and depression. However, patients only seek help during depressive phases. This causes initial misdiagnosis as manic episodes may not be reported or recognised, hence doctors miss the full cycle. Symptoms like irritability or low energy mimic anxiety disorders, ADHD, or even schizophrenia.

Delayed Onset Patterns

Many cases begin with depression before mania occurs, following a 'Depression-Mania-Interval' pattern. Without prior hypomanic history, diagnosis relies only on recall, which patients often forget. Only about 20% receive a correct diagnosis in the first year. The average delay is 5-10 years which worsens outcomes.

Subjective Assessments

There's no objective biomarkers and diagnosis depends only on self-reports, clinical interviews, and DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) criteria like energy shifts rather than mood alone. Incomplete histories, stigma around mania, or substance use paint a hazy picture. Antidepressants can also induce mania in undiagnosed cases, causing further confusion.

Subtypes and Variability

Bipolar I (full mania), II (hypomania), cyclothymia, and spectrum disorders vary in severity and frequency. Certain symptoms evade strict criteria, while individual differences in presentation may need several evaluations.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.