April 28, 2009


The Bipolar Bamboozle: With the broadening and softening of the criteria needed to label someone with bipolar disorder and aggressive marketing campaigns by pharmaceutical companies, millions of people are being told they have a severe psychiatric disorder and are being prescribed powerful antipsychotic medications. In fact, most are normal people dealing normally with everyday life issues. (STEPHEN RAY FLORA and SARAH ELIZABETH BOBBY, September/October 2008, Skeptical Inquirer)

“Bipolar disorder,” originally known as manic-depression, has been acknowledged as a problem for centuries. However, until very recently, it was considered a very rare and severe condition. Now diagnoses of “bipolar spectrum” disorders are reaching epidemic proportions. Nothing has changed in humans’ biology or natural environment to account for this rise in diagnoses. What does account for the increase is a “softening” of the criteria needed to diagnose a person with bipolar, an increase in aggressive marketing of new profitable prescription drugs for bipolar, and psychiatrists “upcoding” problems to get higher insurance reimbursement rates. A likely outcome of this increase in labeling people “bipolar” is not that more people in need of help are getting it but instead that millions of people are unnecessarily being put on powerful antipsychotic medications.

As the name suggests, people labeled bipolar are believed to alternate between the emotional extremes, or poles, of mania and depression. Prior to the publication of the third edition of psychiatry’s Diagnostic and Statistical Manual (DSM-III) in 1980, a patient would have to be hospitalized with a manic episode before a diagnosis of manic-depression was made. At that time rates of mania were estimated to be 0.4 to 1.2 percent of the population; prior to that, rates were estimated to be even lower. Currently some estimates of bipolar are as high as 10 percent of the population (Angst, et al. 2003), but rates of hospitalization for mania have not increased. What happened?

Just as a child with a hammer discovers new things that “need” to be hammered, when psychiatry finds new drugs it discovers new people who “need” to be treated with them.

Our current health care system has given us the worst of both worlds--you don't have to pay for quackery but neither does some bureaucrat have to sign off on it. Rationing of health care would be preferable.

Posted by Orrin Judd at April 28, 2009 8:37 AM
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