As I was reading through older blogs to see what has been covered I came across one on bipolar that caught my eye. Bipolar has become an interesting phenomenon in the mental health world. It used to be known as “Manic-Depressive Disorder” and was considered to be rare. Then the new diagnostic criteria came out, and all of a sudden I started seeing it diagnosed more and more. I started hearing “I’m Bipolar” as a reason for behaviors. Children started carrying the label, even though they truly did not meet the full diagnostic criteria. My colleagues and I started questioning what was going on. Was the disorder under-diagnosed previously, or is it being over-diagnosed now? Can children really be bipolar, when their emotional regulation abilities are not even fully developed yet?
There is a lot of research going on regarding bipolar disorder that hopes to answer these questions and more. But the research can’t explain general trends in mental health. Over the years working at an inpatient psychiatric unit, we noticed patterns in diagnosing based on where patients lived. For example, all youth that came from one particular country had the diagnosis of Bipolar Disorder. We decided to look into this a bit, as it seemed odd. What we discovered was that all of the staff at the country mental health facility went to a training on childhood bipolar disorders. After that, every youth with difficult behaviors was given the label “bipolar”.
We had seen this before – a diagnosis catches on and starts to crop up frequently. Some think that way about Attention Deficit Hyperactivity Disorder (ADHD); it appeared to be a catch-all for behavior problems and a lot of people have made a great deal of money off its diagnosis and treatment. So I can’t help but wonder when another popular diagnosis pops up what is driving it. I worry that those who truly suffer with these disorders don’t get taken seriously because of the watered down approach to diagnosis.
There are great blogs that describe Bipolar Disorder and the symptoms one would experience to receive the diagnosis. However, I would caution people that it is easy to see ourselves in just about any mental disorder, since most are “exaggerations of normal”. We all have mood swings; it is when those mood swings interfere with our daily functioning that we have to look to professionals.
When I took the course to learn how to diagnose my professor warned us that we will all see pieces of ourselves in a variety of diagnoses. It was a normal part of the process, and she dedicated some class time to letting us discuss what we came up with to ensure we understand the difference between normal and not.
Unfortunately, when commercials and various internet content talk about “symptoms”, there is no professor there to walk you through what is normal. They list a bunch of symptoms, and encourage you to talk to a doctor. Then you go to the doctor and mention the symptoms you read about. Of course you walk away with a diagnosis, and often an answer to questions you have always had.
This is not to say the diagnosis is not real. There are real people with serious disorders who can only be helped when those in the mental health field have the right tools to ensure proper diagnosis and treatment. However, there is a lot of controversy in the field about whether or not bipolar is over-diagnosed or under-diagnosed. Researchers disagree, with both sides very firm in their beliefs. This shows me that people in the field may not have all the right tools. This makes it very important for patients to not go into a therapist’s office with a pre-determined diagnosis. While an educated patient is a good one, that education should come as a result of a diagnosis, and not the other way around.
So, if you think something is wrong get help, but don’t allow commercials and such to influence the presentation of symptoms to your therapist or physician. That is a sure way to get an inaccurate diagnosis and possibly put on medications that you don’t need.