Congratulations on getting the chance to be heard in what I have to assume is a pretty prestigious forum and for saying some important things!

Philip, it's about time you received some serious and thoughtful recognition and respect in the mainstream press. This is a fine interview, but then I follow you everyday, so nothing surprises me.

You make very strong and well-supported statements and the last paragraph shows how thorough and committed you are to fighting forces that are seemingly insurmountable.

Psychology Today is read widely by a lot of people who are over-prescribing and misdiagnosing – people with blinkers on who somehow don't know what's happening in other parts of the world or refuse to treat people young and old like human beings, with contexts, with issues, with traumas and emotional problems. We are not just chemicals, we're people and your empathy and dedication, your humanity, shines through whatever you write.

Bravo. Whatever happens, and I hope some lightning bolts flash and a few people get hit and wake up, you've deserve the intelligent questioning and the solid reporting by Christopher Lane.

Good for you, my friend. At last. Maybe more press like this will come your way. You deserve it. And a great deal more. Who knows!

Sandy

Terrific interview, Phillip! I couldn't agree with you more.

Philip,

I only read your bit about Bipolar II diagnosis. I'm glad I did. I agree with you that the *name* Bipolar II is completely misleading and damaging. I know there was a shift from "manic-depression" to "bipolar I" as a way to destigmatize the condition, which might have been a good idea, but the further shift is hurtful. I have cyclothymia and somehow it feels much "better" to say that rather than "Bipolar III" or whatever marking is proposed. Maybe we should return to manic-depression for Bipolar I and use Bipolar name purely for non-manic versions.

But I disagree with you on the nature of Bipolar II. What today is called Bipolar II is not just depression with occasional ups. For me, hypomania is in fact a bigger problem than depression as it leads to exhaustion, overcommitments (which look ok on the outside) and depression. From my extensive reading, it's the case for many other people as well and hence differentiating between unipolar depression and depression+hypomania is very important.

Great interview, Philip. I enjoyed it. They need to have more interviews with you instead of those stereotypical interviews they have with doctors or medication pushers. The stuff they show in abnormal psychology is very inaccurate about how the mental health world really is.

Very well spoken, Philip. I agree with Princess. This is so much better than the pap that passes for "informative interviewing" most days.

Congratulations Philip! I am so happy that you are getting a little of the recognition you deserve. I feel like you in particular have opened my eyes to a lot of what goes on in psychiatric research and bad assumptions that go on in research in general.

What a great, great interview, Philip!

A "NAMI cheerleader" type is out attacking Philip on the PT blog and letting us all know "treatment" saved her/his life. Ah, no matter that people become disabled and debilitated from these treatments; it's all worth the unbridled enthusiasm of those who have been "saved" -- but for how long is the question? How long is that window of being "better than well" really going to stay open and, when it closes, will the victim even realize it in their spellbound state? Sorry, folks, I know I sound bitter but I really am. Things have come to a sorry pass in the world of mental health treatment when people have to defend their paradigms not with evidence but with venom.

Good job, Phil. Wiped from spending the evening with families who lost one or BOTH sons/husbands/brothers to 1. Iraq War and 2. polypharmacy from Seroquel, SSRI, Clonazepam...latter category dying in their sleep.
All the families from W. VA. A reporter spent dinner with us - she has been following this story. Let's hope this time the truth gets OUT.
They will be testifying tomorrow as Astra Zeneca appeals to FDA to expand Seroquel XR use. HOPE AND PRAY THAT A LOT OF PRESS COME AND THAT FDA GETS EXPOSED AS A TOTAL FRAUD.

I've biene folowing your blog for quite a while and I must say that it is an important source of information on what's going on in the mental health fealth.

Excuse my poor english, my mother tongue is french, but I realy appreaciate your contribution.

I'm working for a federation of community groups in mental health in Quebec city, Canada.

I must say that in France they are more critical of the american way of thinking mental issues, because they still have a very strong psychoanalysis influence. We must also be critical of psychoanylystes, but at least they don't have the economics that blur things out.

Best regard,

Charles Rice

This was an AWESOME interview! I'm your newest dedicated reader. Thank you for your awesome service.

Great interview! Congrats! Just this:

"...the rest of the world has not embraced these diagnostic and treatment paradigms..."

Not quite true, unfortunately. Since the 1980ies "ADHD" has been a diagnosis of growing, during the past five to ten years actually exploding, popularity in Denmark/Scandinavia, too. With Ritalin & Co. being first line "treatment" - "Since we know, medications are effective." Also during the past five to ten years it has become increasingly common to diagnose children with "depression", "social anxiety", "OCD", and "bipolar disorder" - "Since we now know, that also children can be mentally ill." - and drug them, first thing - "Since we know, medications are effective.". Another trend around here is that also growing numbers of adults get diagnosed with "ADHD".

Critical voices like yours or Christopher Lane's, or like those heard in the U.K., are virtually absent in this country (Denmark). Biopsychiatry rules.

I had no idea that was going on in northern europe. arg.

Well, as someone who has been diagnosed with and medicated for ADHD, I can surely say that... um... what was it? Can't remember now.

But seriously, great blog and great work.

Bless you Philip for having the cajones to say this.

You rock

First, let me say again that I think bipolar disorder is overdiagnosed in children, and that Bipolar II is overdiagnosed in general. I also think that the direction the pharmaceutical companies are taking regarding their marketing is immoral. That said...

As for bipolar disorder in kids (meaning pre-teens and younger), it's simply not an issue in the rest of the world. The bipolar child is a purely American phenomenon, as big a metaphor of our times as credit swaps, subprime loans, and government bailouts.

Bipolar disorder in children has been studied at least since 1952 (that's the earliest study I could find), and not just in America. I found studies from England, Italy, Denmark, Germany, France, Canada and Czechoslovakia, all from before 1970. I'm sure if I'd dug through more than 3 pages of the 152 that my search returned I could have found studies from many more countries, from the 1950s all the way up until the present day.

The most prominent features of BP2 are depression (and that covers the vast majority of a person's time who is diagnosed with BP2) and bursts of energy, broadly understood.

This is one of the most misleading oversimplifications I've seen in a long time. "Bursts of energy" doesn't even come close to describing the actual experience of hypomania, and if that's what you understand hypomania to be, no wonder you're suspicious of the Bipolar II diagnosis. If you're ever interested, I'd be happy to tell you what my own hypomania is like. I do think that Bipolar II is vastly overdiagnosed, but I promise you -- it's real, and though it has depression as a component, it is not depression.

Philip, you do a good thing here by bringing a lot of important issues to light, but I think that too often you come across as a baby-with-the-bathwater kind of guy, and that does a disservice to the causes you hold dear. Just a little research and reflection would strengthen your arguments immeasurably. And I really do mean that respectfully.

Addressing the BP2 dx is important because of the permanent label that comes with it. Doctors would be more prudent to label someone depressed if they are to label someone at all. Once you get bipolar attached to your file red flags go up in medical situations, ER's and jobs etc.

It goes with the territory of "once diagnosed, never undiagnosed". That is TRUE.

I am no longer a bipolar I II III IV or whatever (am in my sixties now ) and GUESS WHAT??? I have a burst of energy!!!! I want to live and am going to Weight Watchers, exercising, having fun.

Life is short; w/o the haze of psychotropics clouding one's eyes, and it can be lived to the FULL!!!

Addressing the BP2 dx is important because of the permanent label that comes with it. Doctors would be more prudent to label someone depressed if they are to label someone at all. Once you get bipolar attached to your file red flags go up in medical situations, ER's and jobs etc.

Addressing the BP2 diagnosis is one thing, but saying it either doesn't exist or is a form of depression is quite another. Labeling BP2 as a form of depression might indicate that it should be treated like depression, and it's pretty well established that antidepressants can make it worse.

In my own experience, it wasn't until I found a doctor who approached my treatment from a top-down perspective (with mood stabilizers) rather than from the bottom-up (with antidepressants) that I really started to stabilize. I find that if I can avoid the waves of hypomania in the first place, then I can avoid much of the depression that invariably follows them.

As far as the label goes, the only reason I care about it at all is because it's the diagnosis du jour, and I don't like anyone thinking I'm the kind of person who would fall for that kind of thing. Otherwise, I really couldn't care less. I also have "alcoholic" on my permanent record (sober for a long time, thankfully), and I think that sends up even more red flags than BP2.

"Philip, you do a good thing here by bringing a lot of important issues to light, but I think that too often you come across as a baby-with-the-bathwater kind of guy, and that does a disservice to the causes you hold dear. Just a little research and reflection would strengthen your arguments immeasurably. And I really do mean that respectfully."

I second that.

Christopher Lane chimes in re: DSM-V on Slate, "Bitterness, Compulsive Shopping, and Internet Addiction
The diagnostic madness of DSM-V."

http://www.slate.com/id/2223479/