My concern goes even deeper than yours. I want to see far greater caution before applying any psychiatric diagnosis to any patient. There are so many factors involved -- insurance only pays when there is a diagnosis; certain categories, "major mental illness" presumed by the system to have a biological basis, are covered differently than are lesser diagnoses; the adjustment disorder category and the V codes which include marital problems are often not covered by insurance at all -- and all push to diagnostic categories which may not be warranted in the first place. Add to the mix biases toward specific disorders learned in training and the whole diagnostic enterprise can begin to be seen as the madness that it is. Or how about some of the new ones like oppositional defiant disorder, where the child becomes the patient though most often in my experience the parents are the problem?

That a person, once tagged with a psychiatric diagnosis, cannot reasonably ever hope to lose that tag is alarming and disturbing. That there are legions of children being so tagged is more so.

The system is corrupt, broken and the best that can be said is that reasoned criticism is beginning to gain some traction. But where to begin to attempt to fix it? All of the players are implicated and so far, none see much of a problem.

This may be a silly question, but how do rates of diagnosis in America (and Canada, if it's on par) compare to rates of diagnosis in Europe? How about other comparative industrialized economies? How about less-industrialized economies?

What I'm getting at is that if these disorders are truly a human condition, the rates for diagnosis should be relatively flat across populations regardless of economic / industrial activity. However, as we've discussed before, I'm wondering if there's something unique about America in which the cognitive dissonance between the idealized and actual version of the country we live in CAUSES these psychological issues.

If you find Minot's perspective refreshing (as I do) I think you'd be interested in the psychiatrist Dan Fisher and his organization, the National Empowerment Center. www.power2u.org
He'd say that all the disorders are "cockeyed and ginned-up." Or something similar in different words. Basically, his perspective is that it is wrong (ethically and scientifically) to assume that any of these disorders are long-term, when many studies and his own experience (as well as that of others) prove that it simply isn't true.

Why do you need a doctor to tell you that you'll never be well or redeemed? Aren't you, by making your recovery dependent upon their approval, giving them the very power you question?

No answers, but a comment a psychiatrist told me re: the new DSM; said that it will broaden all dx's into a larger [and easier to medicate]spectrum, and words such as "schizophrenia will be gone within 5 years." That the dx will be called something else, and the only reason to give it now is for gaining social services.

I often heard that bipolar burns itself out with age, and personally I feel that if this is happening with people, it is because with age brings widsom, and most people have learned who they are and what makes them tick so to speak. Ones who are mindful can make this work for them. Not saying there are no cases of bipolar, not at all. Just saying for some people.

I'd say it's cockeyed and ginned-up.

What's being done now with the bipolar dx is in line with what pharma did with heartburn. They took heartburn, which can be managed in all sorts of ways, and created a Disease called "GERD" which supposedly requires ongoing "treatment" with a proton pump inhibitor medication. Voila! Suddenly people have a Disease that needs a prescription maintenance drug, and the drugs do remove the pain. The long-term side-effects are another story, but people are looking for a quick fix for all that ails them.

The expansion of the bipolar net, is catching all kinds of new consumers, and surely that is driven by pharma $$$. I recommend the book _Generation RX_ by Greg Critser for anyone that hasn't yet read it. It's a real eye-opener.

That's damned good work in a minefield of crap! Fairy Tales are taken as fact when medical doctors medicate their characters. The whole illogical mess actually has medical standing. I didn't say scientific standing.

I'll sleep a bit better knowing that some one out there still can think.

I do agree with quite a few here, I call for caution. But I also know that lithium made my life bearable even though I don't qualify for the diagnosis according to DSM III.

By the way, I'm european and although a bit more cautious, we're not far behind you when it comes to softening bipolar disorder.

Excellent. "Psuedoscientific trashcan diagnosis" indeed. And this is what all science says, and yet nothing changes which is scary. As for Puckett's theory that living in the US causes the behaviors such as anger, unhappiness and rage, the behaviors which get labeled as biological defects, I'd say exactly. I'm going to repeat my new pet theory again, in the 70's and 80's and to some extent the 90's, obesity was marketed as a metabolic problem some people were born with and medical remidies such as Meridia (remember that class action), amphetamines, and gastric bypass surgery were marketed as solutions. Finally as obesity becomes such a huge problem, society begins to realize that it's not the person, it's the fact that the food our society makes affordable to the vast majority of its citizens causes obesity, and so we're on the brink of getting affordable, healthy opitions. The lawsuits against McDonalds didn't have a huge impact, education of the public did. Now selling healthy food is becoming a money making opportunity as the public becomes aware that it's not a metabolic disorder that's causing their kids to be fat, it's the food.

Optomistically, I see the same thing happening in the "mental health" field. More and more people are being labeled, refusing meds, and refusing labels for their kids. And direct to consumer advertising is begining to be distrusted. In ten years nobody will be taking ssri's, everybody will realize that it was the horrible state our nation was in that caused all of these people to get stuck in a shrinks office in the first place, at least I hope this is how it goes.

I share your concerns about the field of psychiatry, however, I would argue that what we're seeing has almost nothing to do with a "norming of America".

In fact, prescription drugs exist because consumers want to buy them. I am a consumer who recently made a break away from psychiatric care. The reason? I was certain that the very medications I was taking were causing the problems I was being prescribed medication for. I feel better, mentally, than I have since I began taking psycho pharmaceuticals some 8 years ago.

The truth is that there are individuals out there who are able to function quite well in the world only because these medications are available. The truth is also, in my opinion, that the vast majority of individuals taking these medications would function much better without them. The first group I mention here is small. The second is enormous and provides the bulk of the cash flowing in to the hands of psychiatrists and drug companies.

We human beings seem to be drug-seekers by our very nature. We gravitate towards quick fixes. The fact that these medications and labels are being mass-marketed in the way they are reinforces this behavior, but that's nothing new.

Eventually, science will understand as much about medicating the brain as they do about the rest of our bodies. Until that happens I don't expect the situation to change much.

two types of people with mental differences, whatever label, say BP:

#1. i SUFFER from bipolar: doc, give me meds to fix me!

#2. i AM bipolar: doc, stay the fuck away from me and let me work out my issues.

the major arguments among bipolars is because #1 and #2 types will NEVER get along and agree and all pharma has to do is sit back and enjoy them tearing each other apart.

it's called divide and conquer.

the pharma has read lao-tse's art of war, bipolars have not. i haven't either, i'm just rambling, but i hope y'all get my point.

NO ONE WANTS TO TAKE MEDICATIONS OF ANY KIND, REALLY.

but people on psychotropic drugs and other (legal) mind altering drugs believe more than anyone else that they do. for life.

what better business model for the pharmas than a lifetime consumer? recurring revenue, piling on top of recurring revenue, pill added to pill, cocktail to cocktail, it's a DREAM COME TRUE business model the pharmas have.

the pharmas are the envy of ALL BUSINESS WORLD.

bigger than the auto industry.

if GM could tear down railroads to make people buy cars, you think the pharmas will have a problem tearing down scientology altogether if it becomes a problem for them?

NO.

it's a lost cause unless those who are doing this wake up and realize there is a HELL out there, even if you're a devout scientific-materialist/atheist whatever.

they will burn in terrible hells for a long time for what they're doing, especially to kids diagnosed these days.

broken record me, i conclude by saying that the laws should be made such that if you medicate a #2 without consent or with consent obtained under drugging of any kind, you should be on trial for rape!

i would rather be literally fucked in the ass in a jail every day than obliterated on liquid zyprexa / thorazine every time i get dragged into a mental ward because a bloody cop pulled me over doing 80mph on the freeway, pulled up my record and decided since i had another 5150 (involuntary committment before), why, i must be road raging and about to kill someone, thus i need to be hospitalized.

to presume that those in category #2 need to be calmed down, made better, because the ones in category #1 claim so or because society believes on a whim they might cause HARM to self or other and then proceed to recommend and administer lifetime medication is CRIMINAL, because once on drugs, you no longer realize what you're consenting to.

to sum up: when you are against a multi billion dollar system that is out to prove to you that your brain is terminally ill and put you on super profitable drugs that DESTROY YOU SYSTEMATICALLY, i think it's easier to win the lottery than come out ok.

sorry for the rant/ramble, didn't doublecheck the flow, i'm in a hurry, but i hope i made the point, yet again AND again AND again, in hopes other lost medicated souls begin to wake up.

For a psychiatrist. U have been seeing a psychiatrist for 10 years and I have not seen any improvement. I have chronic depression and anxiety.
Would you quit the psychiatrist if he is not helping you?
Thanks for your opinion.

CHarles Rose, PhD

Great article and comments; I seek out critical articles about bipolar wherever I can find them.

I've been diagnosed (after 6 or 7 previous diagnoses) for 10 years, and have taken many different medications in that time. I know I have emotional disturbance and a childhood that brought on PTSD; and PTSD definitely is a huge force on it's own.

The whole bipolar label is a stigma, but it's also an insult to me. If I contest it, it won't be un-diagnosed, I'll just be shifted into another loose category of bipolar. I agree with everyone who says once you get that label, it's hard to get a second opinion.

I'm 26 now and live alone on disability, also being seen by my local CSB. I've seen so many therapists and psychiatrists, they don't even have the ability to know me; just to see me 2 hours a week and make their dubious assessments.

The caution of diagnosing children as bipolar is that many of them end up as frequent flyers and grow up with an institutionalized mentality.
I am one of those who has spent half my life in wards and state hospitals. All it does is give you a victim mentality and a warped sense of identity.

I was persuing the internet tonight, and came on to see who was commenting and saw this posting, which I never read before. Fascinating posting, Mr Dawdy. Will the following outrage, or amuse, or otherwise?

One of the reasons, in my opinon, that Bipolar disorder is being overdiagnosed these days is because I feel that there is a lot of characterological dysfunction going on that psychiatrists will not spend the time trying to consider, because it is not amenable to meds or reimbursement from insurers. This is a nice way of saying that there are a lot of personality disorders out there that have "mood lability" or mood swings, that are related to personality struggles that meds won't touch. I'll be the asshole in implying some of this is what occurs here at this site, and if that annoys or angers Philip, I'm truly sorry to write this, but it needs to be said. It really is consistent with what I write about often: it is about therapy first, because if you come to terms you are struggling with people as one of the issues that causes impairment, what drug is going to fix this?

Just an opinion, just a thought.

The internet is an addiction. Again, anyone out there know of an equivalent to bloggers anonymous?

therapyfirst

TF said "The internet is an addiction. Again, anyone out there know of an equivalent to bloggers anonymous?"

Excellent idea, TF. You could really use some help.