Patient, clinician and illness factors leading misdx of bipolar as unipolar

I’m reading the textbook “manic depressive illness: bipolar and recurrent depression” by Frederick Goodwin and Kay Redfield Jamison. There’s a table I thought I’d share for those, like I, who are learning the difference btw bipolar and unipolar depression.

Patient factors:
Lack of insight with regard to mania
Impaired memory during depressive state and or memory selective for past depression
Experiencing of nymphomaniac as normal "good times"
Cultural positive feedback for manic/hypomanic symptoms

Clinician factors:
Failure to include a family member in dx evaluation
Structure of dsm which “from the top” separates bipolar from all depressions
Inadequate knowledge of manic criteria
Intuitive “prototype” approach to dx
Practical desire to make a dx
Lack of awareness of high population rate of bipolar

Illness factors:
1st episode of illness is often depression,not mania
Dysphoric depression is not conceptualized as a mixed state
Depressive episodes last longer than the often fleeting hypomanic states