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This is a very important question. One that I hope I understand. Diagnoses can change in psychiatry, and mostly because there is uncertainty about what exactly is going on.

Bipolar disorder is a condition with recurrent patterns of altered mood, behavior and thoughts that affect work, socializing, pain or all three together. The classical syndromes are depression and mania, but anxiety is commonly part of the depression for sure.

Anxiety is quite common in patients with bipolar disorder, and can manifest as fear of another episode, panic attacks, social anxiety (fear of humiliation or embarrassment) or Generalized Anxiety Disorder (worries that are excessive) and last, but not least, Post Traumatic Stress Disorder PTSD (exposure to life threatening even like rape, serious car accident, combat, or on a controversial note, maybe even a severe depression or manic episode).

These syndromes can coexist, but occasionally the original diagnosis is incorrect (easier to determine over time, the reason why in the olden days, psychiatric consults occurred over 2 visits, and the best is when people close to the patient are interviewed also). It would be uncommon for the diagnosis to go from bipolar disorder to anxiety, but it is certainly possible.

I think it is important for doctors to always be wondering about their diagnoses, it shows they have an open mind, and that they know that our knowledge is limited. For an excellent article that is a bit technical, but also important, read the American Journal of Psychiatry two months ago for an article on the role of genetics and diagnosis by Dr. Kenneth Kendler.

Thanks, and I hope this helped.