Brief history of bipolar disorder diagnoses that are now common. This isn’t a brief history of the illness itself – that would be very difficult to research (the illness was present long before psychiatrists gave it a label, ancient Greeks got there first) and impossible to complete in a single blog post.
And if I was going to attempt a short overview of the history of the illness, I would need to use the term Manic Depression, not bipolar disorder.
The term bipolar disorder does not indicate Manic Depression specifically – but a whole range of mood disorders psychiatrists created categories for beginning in 1980 via the DSM-3.
I’ve wanted to spend more time researching the issue for a while. Even though I get the basics I do not understand the issue fully.
In writing this post I waded through a lot of ‘history of bipolar disorder’ articles online plus a few books. And I discovered even some doctors don’t get it right. The below is quoted from an aritcle in Psychology Today (June, 2012) by Neel Burton, M.D.
“The term ‘bipolar disorder’ (or ‘bipolar affective disorder’) is thought to be less stigmatizing than the older term ‘manic–depressive illness’, and so the former has largely superseded the latter.”
“However, some psychiatrists and some people with bipolar disorder still prefer the term ‘manic–depressive illness’ because they feel that it reflects the nature of the disorder more accurately.”
Source: A Short History of Bipolar Disorder.
What’s wrong with the above? The term ‘bipolar disorder’ is DIFFERENT in meaning and usage than the diagnostic term Manic Depression that was used prior to 1980.
To clarify, Bipolar 1 Disorder is equivalent to the illness Manic Depression. The term bipolar disorder now encompasses a whole spectrum of mood issues – such as the new Bipolar 2 Disorder diagnosis.If Psychiatrists Cared about Stigma, They Would Not Create New Categories of Mental Illness to… Click To Tweet
And I think the ‘stigma’ concerns are a pile of doggie doo. If psychiatrists really were so concerned about such a thing, they never would have created a bunch of new categories that labeled a larger segment of the population with a mental illness.
The categories – and expansion of the classic manic-depressive illness diagnosis – correlated with drug patents expiring and a need to find target populations to prescribe new antipsychotic medications to, make a ton of cash, keep university research funding flowing in.
Related post: Testing for Bipolar Disorder – What Your Doctor May Not Know.
It’s complicated, and a bit confusing, so doctors like Dr. Burton often revert to just using the terms interchangeably even though they are not and pussyfoot around the issue of the lie of the Chemical Imbalance Theory and psychiatry as a whole being in bed with pharmaceutical mega-corporations.
Manic Depression Reflects the Nature of the Disorder More Accurately
Another error from the above quote… the term manic-depressive illness does not “reflects the nature of the disorder more accurately” – it IS the illness as it has been known from its inception.
The term bipolar disorder is a nwe hodgepodge of categorized illnesses. And it is more of a category than a term for a specific illness.
And that is where the confusion lies. The term ‘bipolar disorder’ now means many things (BP-1, BP-2, Cyclothymic) and encompasses a very broad range of mood experiences.
A little hypomania is nothing to run to the doctor for… but if you do, you will most likely get diagnosed with a form ‘soft bipolar’. Another confusing term.
The below is a quote from a Journal of Psychiatry Investigation paper:
“One can see, after all these distortions, that the bipolar disorder concept is very different from manic-depressive illness.”
New Definition of Manic Depression introduced in 1980 with DSM-3
The below is quoted from the book “Surviving Manic Depression: A Manual on Bipolar Disorder for Patients, Families and Providers” by E. Fuller Torrey M.D. and Michael B. Knable D.O. (March, 2005).
“… a person had to have experienced at least one episode of mania and the episode had to have lasted for at least one week. Individuals with depression alone no longer qualified for the diagnosis.”
“The category of manic-depressive illness (bipolar disorder) now included individuals with manic episodes alone as well as those with a mixture of manic and depressive episodes.”
Dr. Torrey claims this made the definition of the illness ‘more restrictive’ – absolutely not true. And an EXCELLENT example of how dishonest and unethical many of these physicians are.
If the new defintion was ‘more restrictive’ then the diagnosis would become less common (historically the illness has actually been rare) and a decrease in diagnoses rather than more common and diagnosed in more people.
The ugly connections between medications, side effects – that psychiatrists turn a blind eye to avoiding malpractice litigation – and the creation of iatrogenic illness (medical care created your symptoms) rather than biological is also conveniently not acknowledged.
Dr. Torrey also conveniently left out a primary change that went along with the new DSM-3 expanded category – a new classification of bipolar disorder in children. A new target population for pharmaceutical mega-corporations was born and drugging children with brain-disabling medications given legitimacy: despicable.
The below is from an article on the National Institutes of Health website:
“Since 1980, DSM criteria have specified that adult criteria can be used to diagnose mania in children, with modifications based on differences in age and developmental stage . Consequently, by the early 1980s, there was an increasing acceptance that children could present with bipolar symptoms.”
That’s not ‘more restrictive’. It’s an intentional expansion of the very complicated serious medical condition Manic Depression into a broader generalized category bipolar so as to get to prescribe more psychotropic medications to a larger segment of the population.
And possibly to be able to prescribe antipsychotic medications to patients who do not exhibit psychosis. So that if they have side effects from antidepressants (depression is the most common mental illness), psychiatrists can give a new label and more meds.
Bipolar Disorder Onset From Antidepressant Medication
Many have been diagnosed bipolar (usually Bipolar 2 Disorder) after taking antidepressants. Whether the medication somehow triggered a biochemical vulnerability the patient had all along contained within their genes, or the symptoms are simply side effects from the medication and therefore should lessen and remit with careful tapering of the med – is rarely discussed.
They are labeled bipolar and that’s that, the 20 minute $200-$400 office visit is over. A prescription is given for more medication and along with it a whole new set of potentially disturbing side effects.
As some spiral down and become increasing ill, even though they are compliant with treatment, they become understandably more distressed and hopeless.
This can be when a sufferer loses their life to suicide. But the connection to treatment and side effects from medications gets shoved under the rug. The doctor is not held accountable and keeps on prescribing the meds to more and more patients.
There are many studies linking suicide and suicidal behavior to antidepressants.
Why the public is not better informed – besides being conditioned to think most physicians are ethical and acting in the patients best interest – is because the data that is unfavorable to the drug company paying for the research gets omitted from published results.
“According to published material, there was only one suicidal act in the trials of Zoloft in children. Yet it was later revealed that the Food and Drug Administration had documented six suicidal acts in the trials, according to the Center for Drug Evaluation and Research. Additionally, 17 children dropped out of the trial because of serious adverse events.”
Source: Suicide and Antidepressants.
More Bipolar Diagnoses Created in 1994 with DSM-4
This is where Bipolar 2 Disorder came into being from my understanding and hypomania made a symptom of illness though by definition it usually leads to an increase in functioning and does not disrupt the person’s life.
Not to mention it is often clinically made a problem as the result of a person being in treatment, put on an antidepressant and then suffering side effects.
The condition is iatrogenic i.e. created by the treatment.
Doctors Get to Drug More Folks with the DSM-5
They are so worried about stigma… those psychiatrist-types, the new categories added to DSM-4 were not enough. For the 2013 DSM-5 bipolar disorder was now viewed as running rampant in the population.
Those who suffered side effects from antidepressants and became irritable, anxious, hyper, etc. from the drug could now be diagnosed bipolar and there were thousands who needed to be corralled into treatment, many more children to drug.
They go back and forth, back and forth with this stuff. Here’s a quote from a write up in the International Journal of Bipolar Disorders about DSM-5:
“For depression, for example, recurrent brief depression and even short-duration depressive episodes (4 to 13 days), as well as 2-week episodes with insufficient symptoms, now have their place.”
You read that correctly. Having an off week, feeling low? Recovering from a medical procedure, car accident, trauma, significant loss? If you don’t snap out of it within 4 days you can be diagnosed as ‘depressed’ and fed some pills.
If you react to those pills, like many do, then you can be told you have Bipolar 2 Disorder. Then get ready for a lifetime of psychotropic medications and many more serious disabling side effects.
It’s medical malpractice. There is no identifiable chemical imbalance in the brain, these medications have been repeatedly shown to have little to no effect over placebos for mild to moderate depression.
More changes to allow more persons able to be given a BP-1 diagnosis:
“The DSM-IV diagnosis of bipolar I disorder, mixed episode, requiring that the individual simultaneously meet full criteria for both mania and major depressive episode, has been removed.”
“Instead, a new specifier, “with mixed features,” has been added that can be applied to episodes of mania or hypomania when depressive features are present, and to episodes of depression in the context of major depressive disorder or bipolar disorder when features of mania/hypomania are present.”
More Bipolar Diagnoses to Come?
Depends on how much money they need to make, when drug patents expire, how much ‘altered’ (by omission or intention) data they can get published in medical and scientific journals without being brought to light and researchers held accountable.
As long as they can get away with making people sick, lying about an identified chemcial imbalance in mentally ill person’s brains (no such thing proven scientifically… though makes good sense as a hypothesis) we most likely will see more.
And more suicides, more acts of mass murder by teenagers who are on antidepressant medication or were recently in treatment, more children being brain damaged and stigmitized for life… you add in what you want here.
It’s a very complicated situation that I still don’t fully understand – but I did put a few more pieces of the puzzle together in researching for this post. The sickest thing to me is the targeting of children via 1980 and the new ‘Bipolar Disorder’ classification system.
But that’s just me. You may feel and think differently.
Some Doctors are Sane – There is Hope
I missed another ‘bipolar disorder’ term above… “Subthreshold Bipolar Disorder”. Seriously, are these people mental? I think if you fart in the morning or burp at least once a week… you are bipolar. That’d make as much sense as what they’ve come up with.
But there is hope. The below is from a May, 2011 Psychology Today article.
“At present, we are unaware of any convincing evidence that persons who fulfill the research definition of “subthreshold bipolar disorder” respond to “mood stabilizing” treatments.”
“On the other hand, we are aware of many patients coming to emergency rooms and clinics who claim to have “bipolar disorder” and who are being prescribed a large number of psychiatric drugs for vague and unclear indications.”
“Is it possible that by broadening the label of bipolar disorder to include “subthreshold” bipolar spectrum, psychotropic drugs are being overused?”
Yes, psychotropic medications are definitely being overprescribed and vague and unclear diagnoses the name of the game. And the reason? You tell me… I’m beat.