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ultramar · Oct 12, 2013, 11:50 AM

Is Bipolar Disorder Overdiagnosed? A Conversation with Mark Zimmerman | Psych Central Professional

I think the above article (actually from here at PC) sums it up very well. A study, the reasons for overdiagnosis and the implications of the same. I've seen lots of other articles expressing similar concerns.

If Bipolar Disorder Is Over-diagnosed, What Are The Actual Diagnoses?

Above, interview of same researcher re Bipolar vs BPD diagnoses.

Someone who lives in Europe (?) here mentioned once that in her/his country depression with hypomania (I guess assuming it's a mild form) are generally diagnosed with depression rather than Bipolar II, unlike here. This makes sense only insofar as in many cases of Bipolar II, depression is most frequent and what is truly debilitating (greatly affecting functioning, etc.) and by this logic, it is the depression that needs to be addressed. Assuming the hypomania (or hypomania-type moods) do not affect one's functioning to the point of necessitating treatment with medication (instead of for example treatment in the form of therapy for mood regulation), then the focus (medically) is depression, and thus the diagnosis of depression. But I guess, it seems, that the threshold in the U.S. for what necessitates medication (and in a sense diagnosis) is far lower. You could argue the extent to which depression (of a milder sort) is medicated, is likely far higher in the US as well; in any case, I've read this to be the case.

I'd venture to guess that only 'major' depression is medicated in many other countries, just as only 'major' mania (for lack of a better term -i.e. mania as opposed to hypomania) is medicated. And diagnoses tend to correspond with what is considered needing to be medicated.

This leaves the problem of those who may initially present with hypomania who eventually go on to experience mania. I don't know what they do with that; perhaps close monitoring and crossing that bridge if they ever come to it.

But those who live in other countries would be in a better position to explain the differences. I'd be curious as to what the pdocs abroad have to say.