Make Sure Your Bipolar Disorder Diagnosis Is Real Before You Lose Your Security Clearance
Bipolar and related disorders are serious mental health conditions that can affect a person’s mood, behavior, and—most relevant to the national security world—judgment, reliability, and impulse control. Because of this, individuals with a diagnosis of bipolar disorder are often subject to increased scrutiny during the security clearance process. However, an inaccurate or unsupported diagnosis can cause unnecessary problems. That’s why it’s essential to confirm the accuracy of the diagnosis before it puts your clearance—and your career—at risk.
Why Accuracy For Your Bipolar Disorder Diagnosis Matters
Security clearance decisions are governed in part by Adjudicative Guideline I: Psychological Conditions, which states:
“Certain emotional, mental, and personality conditions can impair judgment, reliability, or trustworthiness.”
While having a mental health condition is not disqualifying, unresolved symptoms or untreated conditions can lead to an unfavorable determination. For bipolar disorder specifically, the stakes are high: symptoms such as impulsivity, impaired decision-making, or periods of psychosis—especially if untreated—may raise serious concerns.
Unfortunately, bipolar disorder is also frequently misdiagnosed. Research suggests that up to 40–60% of individuals diagnosed with bipolar disorder may have received an incorrect diagnosis at some point in their treatment history (Zimmerman et al., 2008; Hirschfeld et al., 2003). Misdiagnosis can happen for several reasons:
- Inadequate clinical interviews (e.g., a diagnosis made after a 15-minute visit)
- Confusion with other conditions (e.g., borderline personality disorder, PTSD, ADHD, or substance-induced mood symptoms)
- Failure to rule out medical causes (e.g., thyroid dysfunction)
These issues matter because a misdiagnosis not only delays appropriate care, but may also raise unwarranted red flags during your security clearance review.
What Bipolar Disorder Really Is
The DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision) describes bipolar and related disorders as involving periods of abnormally elevated or irritable mood (mania or hypomania) alternating with depressive episodes. Symptoms during manic episodes may include:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- Rapid speech or racing thoughts
- Increased goal-directed activity or agitation
- Engaging in high-risk behaviors (e.g., spending sprees, reckless driving, risky sexual behavior)
During depressive episodes, individuals may experience:
- Persistent low mood
- Fatigue or loss of energy
- Feelings of worthlessness or guilt
- Difficulty concentrating
- Thoughts of death or suicide
To meet diagnostic criteria, these symptoms must cause clinically significant impairment and cannot be better explained by substance use or medical conditions.
What You Can Do If You’ve Been Diagnosed With Bipolar Disorder
If you’ve received a diagnosis of bipolar disorder—especially if it was made quickly or without a thorough evaluation—you should seek a second opinion from a qualified mental health professional. A proper assessment usually includes:
- A detailed clinical interview
- Corroborative history from a spouse or close family member (when available)
- Structured diagnostic tools (e.g., SCID-5)
- Psychological testing
- Review of medical records and lab tests to rule out mimicking conditions
If the new provider determines that bipolar disorder is not an accurate diagnosis, they can provide a written clinical opinion clarifying your condition. This document can be submitted to your security office or adjudicator to help mitigate the concern under Guideline I.
Even when the diagnosis is accurate, clearance is still possible. The most important factors in the adjudication process are:
- Stability of symptoms
- Consistency with treatment
- Compliance with medical recommendations
- Evidence of good judgment and functioning in daily life
If your condition is well-managed and you are transparent about your mental health history, there is a strong chance you can obtain or retain your clearance.
Our Role: Helping You Get Your Diagnosis Right
At ClearancePsych, we specialize in psychological evaluations related to security clearance eligibility. If you’ve received a diagnosis of bipolar disorder—or any other condition raising adjudicative concern—we can help:
- Confirm or clarify your diagnosis using best-practice assessment methods
- Provide targeted evaluations to address specific adjudicator concerns
- Offer coaching and treatment plans designed to mitigate risks under Guideline I
- Support your reapplication if you’ve previously been denied or revoked
The Bottom Line About a Bipolar Disorder Diagnosis
Don’t let a questionable or outdated diagnosis put your clearance at risk. If bipolar disorder has been mentioned in your mental health history, make sure it’s real, accurate, and well-documented. If it’s not, getting the record corrected could save your clearance. If it is, know that with proper treatment and documentation, you still have a path forward.
References
- Hirschfeld, R.M.A., et al. (2003). Screening for bipolar disorder in the community. Journal of Clinical Psychiatry, 64(1), 53–59.
- Zimmerman, M., et al. (2008). Why is bipolar disorder so frequently misdiagnosed?. Journal of Clinical Psychiatry, 69(9), 1413–1419.
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).
Dr. Scott Edwards is President and Chief Psychologist at ClearancePsych. He is a licensed, board-certified psychologist with more than 30 years of experience. ClearancePsych connects security clearance professionals, attorneys, and applicants with psychologists who understand the clearance process. We provide psychological evaluations, coaching, and targeted treatment designed to help mitigate adjudicative concerns and support your clearance eligibility. Find us online at https://clearancepsych.com.