Long before they’re diagnosed, people living with bipolar disorder exhibit disruptive and distressing symptoms. Many of these people wait an average of six years after they first show signs of the mental illness to solicit a doctor’s assessment for confirmation of the psychiatric condition, according to findings from a major new study published in the Canadian Journal of Psychiatry, Tech Times reports.

Bipolar disorder is a mental illness marked by severe mood swings of extreme highs, called mania, and extreme lows, or depression. If left untreated, the condition can intensify over time and lead to symptoms that include suicidal thoughts, drug and alcohol abuse and social problems. Bipolar disorder currently affects nearly 5.7 million, or about 2.6 percent, of American adults.

For the study, scientists at the University of South Wales in Australia reviewed 27 studies involving more than 9,000 people living with bipolar disorder. In addition to uncovering massive delays in treatment for the condition, mental health researchers said that for young people, early treatment is even less common than among adults.

Study authors admitted that diagnosing bipolar disorder could be challenging, because its symptoms often present in other mental illnesses. In addition, researchers said, stigma, limited access to treatment and difficulty gathering a patient’s comprehensive mental health history contribute to a delay in diagnosis.

“What we should be looking at is what strategies we can develop to identify people who are very likely to go on to develop bipolar disorder and what benign treatments are there that can prevent it,” said Matthew Large, a professor of psychiatry at the university and one of the study’s authors. “I think in the early stages we really need to concentrate on more non-pharmacological methods.”

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