Diagnosis

• Bipolar disorder can be a difficult illness to diagnose, especially in minority communities, where cultural misunderstandings can arise between doctor and client. For example, African-Americans may be more reticent to discuss personal issues with psychiatrists. In turn, a psychiatrist may misconstrue this behavior as "secretive" and associate it with a form of psychosis (for example, schizophrenia) instead of symptoms pointing to bipolar disorder. According to Dr. Lawson in "Picture This," 90 percent of African-Americans who seek treatment with symptoms of bipolar disorder are misdiagnosed with schizophrenia.
  
  

Cultural Beliefs

• Cultural beliefs or norms specific to certain ethnic communities can interfere with people receiving treatment for bipolar disorder. In addition, immigrant communities may hold different spiritual beliefs that mental health providers incorrectly perceive as odd (for example, belief in spirits) and this may negatively impact the diagnosis and treatment of the disease.
  
  

Drug Treatment

• Proper management of mood-stabilizing medications, such as lithium, and other drugs, like anticonvulsants (for example, carbamazepine), help treat mania and depression in bipolar patients. However, older generation bipolar medications tend to cause more side effects, like tardive dyskinesia--repetitive movements and tremors--in minority communities.
  
  

Language

• According to McMan's Depression and Bipolar Web, the United States has the fifth largest Spanish-speaking population in the world. Language barriers in diagnosing and treating nonnative bipolar patients can affect the ability of a person to seek appropriate care for symptoms.
  
  

Considerations

• Cultural competency in treating bipolar disorder refers to the ability of the mental health professional to be aware of a patient's culture and be sensitive to cultural norms, beliefs and practices when treating the disease. Most important, addressing cross-cultural issues between bipolar patients and mental health providers can decrease the aggravation of psychosocial stressors, depression and mania, which present differently across cultural communities.