Gaps Exist In Public's Understanding Of Bipolar Disorder

National Survey Validates Need For Better Education, Improved Diagnosis

Jul 01 1999

Chicago, IL - A recent benchmark survey reveals that significant gaps between people's perceptions and attitudes toward mental illness and, in particular, manic depression, also known as bipolar disorder, still exist. As a follow up to an initial survey conducted in 1995, Opinion Research Corporation* polled 1,008 Americans on behalf of the National Alliance for the Mentally Ill (NAMI) and the National Depressive and Manic-Depressive Association (National DMDA), and found that manic-depressive illness is still largely misunderstood.

While general awareness of the physiological nature of mental illness has increased over the past four years (63% vs. 36%), there has been little improvement in people's understanding of manic depression. For example, only 33 percent of respondents know that manic depression is characterized by wide swings in emotion or mood. The latest survey also confirmed that social stigma continues to dictate many people's attitudes toward mental illness - 44 percent believe people with manic depression are often violent, and another 25 percent think people who have mood disorders, or who have manic-depressive illness, are very different than others.

"These statistics are particularly alarming because persistent stigma and ignorance toward bipolar disorder means many people aren't getting proper treatment," says Laurie Flynn, Executive Director, NAMI. "Under-diagnosis of manic-depressive illness represents a true crisis in the United States that demands action."

Although fewer people (11% vs. 22%) view mental illness as an emotional shortcoming than previously, the latest results suggest that many Americans don't realize manic depression, like heart disease or diabetes, is a physical illness requiring medical treatment. In fact, a majority of those surveyed believe people can prevent mood disorders, such as manic depression, by adopting "self-help" techniques, including positive thinking. Additionally, only 35 percent would consult a mental health professional themselves or for someone else experiencing symptoms of manic-depression.

These results are especially disturbing because, if left untreated, manic-depressive illness can have a devastating impact, robbing a person of his or her job, friends or family and leading to reckless behavior, including excessive spending and promiscuity. Manic depression affects more than three million Americans, but only one-third of those affected receive proper treatment.

"We must recognize manic depression is a medical illness, not a character weakness," says Lydia Lewis, Executive Director, National DMDA. "Also, we need to make people realize it is a potentially fatal illness. In fact, if left untreated or mistreated, more than 15 percent of those afflicted will take their lives."

In an effort to address the under-diagnosis and misdiagnosis of manic depression, NAMI and National DMDA have teamed up with leading psychiatrists to form the Bipolar Disorder Diagnostic Aid Advisory Committee (BDDAAC) that will develop strategies to encourage faster, more accurate treatment of the illness. As part of its commitment to increasing diagnosis and helping patients receive proper treatment, BDDAAC currently is researching and developing a diagnostic tool, The Mood Disorder Questionnaire, for physicians and patients to use to assess symptoms of manic depression. BDDAAC representatives will unveil the preliminary findings of the diagnostic tool at NAMI's national conference in Chicago this week.

"Early intervention makes all the difference in the world," says Robert M.A. Hirschfeld, M.D., and Chair, Department of Psychiatry and Behavioral Sciences at the University of Texas Medical Branch at Galveston. "We hope the Mood Disorder Questionnaire will encourage early and expeditious identification and, ensure that mental health professionals and patients have the capability to more effectively diagnose manic-depressive illness."

Medication is an essential part of successful treatment for those suffering from manic-depressive illness. Currently, only two medications are approved by the Food and Drug Administration (FDA) for the treatment of manic episodes associated with manic-depressive illness: lithium and divalproex sodium (Depakote®).

With more than 210,000 members, NAMI is the nation's leading grassroots advocacy organization solely dedicated to improving the lives of persons with severe mental illnesses including schizophrenia, bipolar disorder (manic-depressive illness), major depression, obsessive-compulsive disorder, and severe anxiety disorders. NAMI's efforts focus on support to persons with serious brain disorders and to their families; advocacy for nondiscriminatory and equitable federal, state, and private-sector policies; research into the causes, symptoms and treatments for brain disorders; and education to eliminate the pervasive stigma surrounding severe mental illness. NAMI has more than 1,200 state and local affiliates in all 50 states, the District of Columbia, Puerto Rico, American Samoa and Canada. NAMI can be contacted at 800-950-NAMI (800-950-6264) or on the Web at

National DMDA is the nation's largest patient-run, illness-specific organization. Founded in 1986 and headquartered in Chicago, Ill., National DMDA has a worldwide grassroots network of 275 chapters and support groups. Its mission is to educate patients, families, professionals and the public concerning the nature of depressive and manic-depressive illnesses as treatable medical diseases; to foster self-help for patients and families; to eliminate discrimination and stigma; to improve access to care; and to advocate for research toward the elimination of these illnesses. 

The survey was funded by Abbott Laboratories.

Fact Sheet

Taking A Closer Look

Survey Reveals Myths and Misperceptions About Manic Depression

Results from a recent mental illness awareness survey echo initial findings uncovered in 1995 - a significant gap exists between people's perceptions and awareness of mental illness, and in particular, manic depression, also know as bipolar disorder. The Opinion Research Corporation survey* of 1,008 Americans, conducted on behalf of the National Alliance for the Mentally Ill (NAMI) and the National Depressive and Manic-Depressive Association (NDMDA), found that general awareness of mental illness has increased, but manic-depressive illness remains a commonly misunderstood condition. The following highlights point out the gaps in understanding that still exist and must be overcome:

More Education Needed

  • The good news - awareness of mental illness has increased significantly over the past four years. In 1995, only 36 percent of Americans correctly identified the true nature of mental illness; however, by May 1999, more than half the respondents correctly attributed the true nature of mental illness to physical/chemical imbalance (42%) or inherited disease (21%).
  • While awareness of mental illness has risen since 1995, 67 percent of those surveyed were unable to accurately describe manic depression. Only 33 percent correctly characterized manic depression as wide swings in emotion or mood.
  • Thirty-three percent (33%) incorrectly believe manic depression is a more serious form of depression and only 43 percent were able to identify symptoms of mania.

Misperceptions Persist

  • Social stigma continues to dictate many people's attitudes toward mental illness - 44 percent agreed people with manic-depression are often violent, and another 25 percent think people who have mood disorders or who are manic-depressive are very different than others.
  • Twenty-one percent (21%) of those surveyed said they would feel uncomfortable being in the presence of a manic-depressive person.
  • Unfortunately, some people erroneously believe that mental illness is a personal failure, not a physical disease. Nineteen percent (19%) of those surveyed feel depressed or manic-depressive individuals are personally responsible for the development of their own mood disorders.

A Friend In Need

  • Forty-six percent (46%) of those surveyed said they know someone who exhibits signs of manic-depressive illness.
  • When asked if they have ever approached this person about seeking help, 40 percent said no.

Going It Alone

  • Ninety-three percent (93%) of respondents agreed that manic depression is a medical condition requiring professional treatment. Yet, only 35 percent would consult a mental health professional themselves or for someone else experiencing symptoms of manic-depression.
  • Although the majority of respondents (54%) accurately stated manic-depressive illness most often occurs in teens and 20s, this age group was the least likely to seek help. An overwhelming 81 percent (81%) of those aged 18-24 said if they were experiencing symptoms of manic-depression they would rather solve the problem themselves than consult someone about symptoms. Forty-two percent (42%) of those aged 25-34 would avoid asking for help because they wouldn't want to admit there was a problem.
  • Twenty-five percent (25%) believe manic depression can be self-controlled.

Seeking Help

  • An overwhelming 81 percent agreed that people suffering manic-depressive illness are often misdiagnosed.
  • When asked about treatment options for manic-depressive illness, 56 percent mentioned medication, 53 percent said consultation with a therapist, psychologist or psychiatrist and 21 percent noted group therapy.
  • Fifty-six percent of those surveyed said that treatment for manic depression includes taking medication of some sort.

*Survey results are based on telephone interviews conducted among a national probability sample of 1008 adults comprising 504 men and 504 women 18 years of age and older, residing in the US. Interviewing was completed during the period May 20-23, 1999.