Uncertainty around disability benefit cuts is triggering bipolar symptoms, experts warn

As Labour prepares to cut billions from the welfare budget and push employment rates up to 80% from the current 75%, many people living with bipolar are feeling anxious. Welfare reforms often fail to consider the specific needs of people with serious mental illnesses like bipolar, and this anxiety is only compounded by dismissive rhetoric about self-diagnosis and ‘sick note culture’.

Former prime minister Tony Blair recently added fuel to this fire by claiming that more people are now self-diagnosing mental health conditions and putting additional strain on already overstretched services. These kinds of comments not only increase stigma but also distract from the real issue: people with bipolar aren’t getting diagnosed in the first place.

As a charity, we are concerned that many people living with bipolar are being neglected due to a systemic lack of focus on condition-specific treatments.

Bipolar is a severe mental illness characterised by significant and sometimes extreme changes in mood and energy, which go far beyond most people’s experiences of feeling a bit down or happy. Manic episodes involve elevated or irritable mood, increased energy and a reduced need for sleep, while depressive episodes are characterised by feelings of sadness, hopelessness and a loss of interest in activities.

Bipolar can have a significant impact on someone’s ability to work and live independently, costing the UK economy £20bn a year. People with bipolar want to work but, without the adequate support to stay well enough, many become trapped on benefits.

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The debate around welfare reform is missing a crucial point: the rapid expansion of disability benefits for mental illness is a direct consequence of the NHS’s failure to diagnose and treat these conditions in a timely manner.

If someone goes to their GP with a suspected physical condition, they are assessed and referred for specialist treatment. However, this doesn’t happen for most people with bipolar. Instead, they are referred to a generic mental health team. Imagine a world where all physical health conditions were treated by the same consultant, where anyone with suspected cancer, asthma or diabetes were referred to a one-size-fits-all expert.

Many NHS Trusts won’t even accept referrals for a bipolar assessment unless someone is in crisis. This means there often isn’t even a formal waiting list. Instead, there is a vast, uncounted pool of around 500,000 people with undiagnosed bipolar in the UK who are struggling without any condition-specific advice or treatment. Without a diagnosis, people cannot get access to the right medication, support, or workplace adjustments – leaving many unable to work and reliant on welfare.

Clinicians who are reluctant to diagnose mental health conditions often refer to concerns about stigma and the complexity of distinguishing between different conditions. But as a society, we challenged the stigma around cancer and, in doing so, revolutionised early detection and treatment. The same needs to happen for bipolar. People with bipolar wait, on average, 9.5 years for a correct diagnosis. This delay has profound consequences, with a third reporting attempting to take their own life because of it – with many more losing jobs, friends and family.

In too many postcodes, mental health services do not accept referrals due to limited resources. The result? Only people in total crisis are receiving care. This deals with the immediate situation, but doesn’t address the underlying causes and help to prevent future episodes. Others are left with generic, often ineffective options such as antidepressants and talking therapies.

A study by King’s College London in 2022 found that of 371 patients using talking therapies for anxiety and depression, 30% met the threshold for bipolar. The total spent on these generic talking therapies for people with undiagnosed bipolar could now be well over £100m. Surely this money could be put to better use on specialist care that would be significantly more effective?

More worryingly, studies have shown that between 7.6% and 12.1% of people receiving antidepressants go on to get a bipolar diagnosis. This is critical because people with bipolar shouldn’t be prescribed antidepressants without a mood stabiliser, as it can trigger dangerous mood episodes. Our community tells us that taking an antidepressant without a mood stabiliser is one of the most common triggers for an episode. Since 2018, antidepressant prescriptions in the UK have increased by 34.8%.

It doesn’t have to be this way. With early diagnosis, treatment and support, people living with bipolar can thrive. The majority of people with bipolar are working. If just a fraction of the current welfare budget and generic mental health services budget was directed towards diagnosis and the specialist treatment of bipolar, the country would reap the rewards many times over.

Simon Kitchen is the CEO of Bipolar UK.

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