I sometimes think they do go a little overboard in diagnosing every aspect of your MH as a separate disorder. I do think my substance use disorder is really part of the bipolar disorder but dropping it as a condition would seem too much like saying it isn't a problem so if I am ever stabilized (seems less likely every year that passes) I can start drinking again. Hyperacusis seems physical to me but the audiologist is pretty certain it is not. Again, one of the possible causes (according to the DSM) is bipolar disorder. I was socially awkward and sometimes said inappropriate things well before my first major depressive event; now the term is "on the spectrum". Back then I was just weird. Before you know it, they will be diagnosing people as neurotypical and treating them for it...