Scratch That: Notes on Misdiagnosis

By Nicholas Duran, LMHC

Bipolar disorder is often misdiagnosed.

First it’s depression.
Then anxiety.
Maybe ADHD.

Perhaps you’re prescribed an antidepressant, and before long you find yourself spiraling somewhere you never expected—sometimes even landing in the hospital.

Eventually the correct diagnosis arrives: bipolar disorder.

For many people, it lands like a punch in the gut.

What do you do now that you know you have a chronic medical condition—especially one surrounded by misinformation, stigma, and shame?

For me, what woke the sleeping dragon was trauma.

Within a year, I was in the throes of my first manic episode with psychosis. The treatments that followed have at times terrified me and saved my life. I know firsthand how exhausting the journey can be.

Finding the right medications was winding, like it is for so many of us.

Lamictal.
Latuda.
Abilify.
Risperdal.
Vraylar.
Seroquel.
Zoloft.
Xanax.
Klonopin.
Hydroxyzine.
Gabapentin.

Yes—quite a list. Quite a road.

Now, deep into this journey, and without a mood episode since 2017, I can say something I once thought impossible: my bipolar disorder is in remission.

But the story didn’t end there.

The bipolar brain and nervous system are different—specific, nuanced, complex. And in my case, that complexity came with an added mystery.

Seizures.
Tremors.
Loss of control of my body.
Shivering and crying.
Slowing down, retracing every step.

Awake in the middle of the night with an impending sense of doom—the feeling that I am dying, that everyone I love is dying, and that somehow I am doing everything wrong.

What is happening?

I saw specialist after specialist. Each one puzzled. Medications were added. Others were removed. I was referred again and again.

I tried everything from DBT to electromagnetic brain stimulation. Benzodiazepines that did nothing except make things worse.

Finally—after years of searching—I found a clinical team that took the time to really listen.

They paired careful curiosity about my lived experience with knowledge of an underrecognized condition that often appears alongside bipolar disorder:

Functional Neurological Disorder.

Have you heard of it?

I hadn’t.

Functional Neurological Disorder, often abbreviated FND, occurs when the brain has difficulty sending and receiving signals properly within the nervous system. The brain itself is structurally intact, but the communication between brain and body becomes disrupted.

The result can look like many neurological conditions: seizures, tremors, paralysis, movement difficulties, or sensory changes.

The symptoms are real. They are involuntary. And they can be profoundly disruptive.

Historically, conditions like this were misunderstood. In the late nineteenth century, physicians such as Sigmund Freud described similar presentations under the diagnosis of Hysteria—a term steeped in gender bias and misunderstanding.

For decades, patients were told their symptoms were “all in their head.”