Koichiro Watanabe, Eiji Harada, Takeshi Inoue, Yuka Tanji, Toshiaki Kikuchi

Bipolar disorder is a recurrent and episodic illness. This survey study assessed experiences and identified clinical insights of individuals with bipolar disorder. An Internet-based monitor system database was screened for patients with bipolar disorder in Japan (February and March 2013). Of 1,050 patients, 457 completed surveys, and results were analyzed with descriptive statistics. Approximately one-fourth of respondents were diagnosed with bipolar disorder on their first visit to medical institutions, although the most common initial diagnosis was depression/depressive state (65%). Mean time lag between first-time visit to a medical institution and receipt of correct diagnosis of bipolar disorder was 4 years; one-third of patients experienced more than 5 years of lag time. Three perceived reasons for lapsed time before correct diagnosis were "(patients) Did not consider manic symptoms as illness, and did not tell the doctor about them," "I (patient) did not know of bipolar disorder," and "Lack of communication between my doctor and myself (patient)." Among participants who believed that they were initially incorrectly diagnosed and improperly treated, most experienced socioeconomic problems, such as having long-term inability to work or to study (65%). Sources of encouragement for participants included "To have someone to consult with" (41%) followed by having "People around me treat me the same as before" (40%). Individuals with bipolar disorder reported a time lag of many years before accurate diagnosis, and substantial burden imposed by the illness. Encouragement should be provided for individuals to live positively with bipolar disorder.