Is Bipolar Overdiagnosed ?

I honestly didn't read all the comments, so excuse me if I'm restating someone else's view. I am confused by those who think they have bipolar disorder but have not been diagnosed. I had multiple diagnosis for over 7 years before I finally accepted it. Because of a heart condition I have I have also been exposed to a lot of people with crazy levels of health anxiety and I have to wonder if self diagnosed BP people have HA instead. IDK.

In my struggle to accept the BP II diagnoses, I had to accept it as a spectrum mood disorder first. Basically this was me accepting that just as any other aspect of health (diabetes, cancer, Alzheimers, MD) there are stages or levels. I do believe this to be true. The thing is that Psychs and insurance companies don't operate within these grey levels, but in black and white. Either you have it or you don't. That's where you see the uptick in diagnosis. You may have a severe case of the disorder and mine may be slight, but for the sake of medication and insurance we have the same thing. Does that make sense? It's more about what meds work than what the actual label is, but the "system" can't comprehend that.

I also think our society is demanding more and more and increased stress can lead to increased brain dysfunction which can lead to increased mental disorder.

As for alcohol. I hear you, however....I'm a heavy as hell drinker. Have been since late teens and I'm 33 now. Recently I accepted that BP diagnoses and started taking Lamictal ( I had been on AD's for 12 years for depression. Didn't work). Upon taking Lamictal, I no longer feel the compulsive need to constantly drink copious amounts of alcohol. Magic. It is astonishing. Now I truly understood the term "self medicating"...or from my perspective over the last 15 years...effing surviving the rollercoaster of emotions, mostly mania. This makes me believe in the diagnoses even more and believe that I wasn't an alcoholic, but an unstable person with a mood disorder that was looking for reprieve.

It's not to say that alcoholism can't lead to mood issues. It can. I had a neurology exam not long ago and neurologist felt like after I was sober awhile I should recheck and see if I'm really BP. Maybe I won't be, but I doubt it. I think this it's possible to be comorbid -BP and A, but I think more frequently its BP then A.

All that said, if you are in AA (which I've tried multiple times) you will likely deny the possibility left and right. Most AAers hates thems some mental diagnosis

I'm sorry you've had such a hard time. Thank you for sharing your story and your thoughts.

I probably was mis-dx'd, but it is too early to say, because bipolar is episodic and a long time off meds is needed to see if I was mix-dx'd.

But I think among a lot of things that contributed to the first p-doc's dx'ing me almost instantly was my mother's bp.

yet, genetics only increase the likelihood - but not to 100%

Let me rephrase that: He was definitely oversimplifying things. I fail to see how your pdoc saying the same thing (was it the same thing?) is any reason to presume it is not an oversimplification. Doctors do that all the time, especially when it comes to drugs. Now, as I've already said before, two pdocs and one psychologist agreed about my diagnosis. My drug use was not a huge obstacle to diagnosing bipolar, and I've yet to hear of one case where marijuana causes symptoms that are mistaken for bipolar. It seems like too far a stretch. To make the point even clearer: The measurable psychological effects of cannabis dissipate after 3 to 6 weeks (for some drugs it's even shorter), and I've had periods without cannabis that were longer than that with no alleviation of bipolar symptoms whatsoever. Supposing it takes the brain some extra time to "get back to normal" emotionally, which I don't think it does, it's still obviously not true that you have to live without using any kind of drug for six months to be accurately diagnosed with bipolar. Now I have talked with quite a few doctors and pdocs. Most or all of them should read up on the psychological and biological effects of drug use, because they're not up to date at all.

Edit: If you think this was harsh, then I'm sorry. But I hope you understand how basically saying that my diagnosis is bad is annoying to me. I have confidence in my own reasoning and the reasoning of the professionals who have diagnosed me. Unless all my professionals are incompetent or lying, it is safe to assume other professionals have been simplifying things a tad too much. With good intentions, I'm sure.

I don't personally think its overdiagnosed. I've seen many drs and psychiatrists and it took them about 8 years to figure out what is wrong with me. I am still trying to find meds that work rite.

I have problem with it being diagnosed in young kids. Especially when one reads blogs of NAMI-mommies. Self-centered, more issues then national geographic... they defend doping up kids with anti-psychotics cause they are "much easier to handle". And lot of "yes, there has been nasty divorce, we live erractically but it's not my fault my child has brain disorder".

It may be overdiagnosed. Who knows. At least in Hollywood it seems bipolar is new chivava in designer's purse.

The posts on this thread have been educational, honest and forthright. I have learned much more about Bipolar through your own experiences. I still don't have an answer to the over diagnosis question but I have a new appreciation of everyonne here on this board...a feeling of kindred spirits that truly understand bipolar. We're like a family here, a family who understnds and talks openly about bipolar; unlike my family of origin who remain ignorant and judgmental of my illness.

I did not mean to offend anyone. I am naturally a curious person and seeker of truth. I'm just sharing my experiences and I thank all the contributors for sharing their knowledge.

Curiousity is a great thing as long as you aren't a cat

If only there was an simple, straight-forward test to take that was a "YES" or "NO!" answer for bipolar eh? That would make life a lot easier for everyone!

My experiences-I hate the diagnosis and I hate the drugs, but when I decide I am not really in need of meds because the dx must be wrong, I get really messed up one way or the other.
As for children, I can only speak for my own. My son was dxed at 11, and is 13 now. I hate it for him, too. I can easily compare him to other 13 year olds because he is a triplet. When he grows out of his meds, we all know it is time to get to the psychiatrist!
I believe that bp is hereditary in my case. My dad had it. My mom, grandmother, brother and sister all had/have some form of mental illnesses. Life was pretty hellish growing up before I finally went on meds.
This is only my story. I don't know whether there are too many misdiagnoses or not.
Bluemountains

i read most of the comments.

lets point out some things here too about someone ACTUALLY getting a diagnosis.

am i allowed to speak here?
i personally believe its currently being overdiagnosed. i only believe this because i believe its part of the PsychFad phase. like some people said with BPD and autism and the like.

but...with overdiagnosis comes misdiagnosis. so how many being diagnosed recently ACTUALLY have it? and if there IS a misdiagnosis of bipolar we all know someones bipolar diagnosis will change. so it doesnt stay the same.

thats the thing about psychiatric labels. say 1000 people got diagnosed with bipolar. but then over the next some time period how many of them will have it changed? do they count the change too or do they count only initial diagnosis into these rise-of-bipolar-cases studies?

Problem with BP diagnosis is that it's viewed as life long thing. If you doubt it, it's often seen as "denial" or even *shuder* "your illness talking". Hard to get undiagnosed.

Hence why I'd be reluctant slapping it on somebody who is in life transforming time. Teenager. Has spiritual crisis. I would not deny 'em treatment, but I think that telling the person they need to be on hard duty drugs for life cause they went crazy during some life event... is harmful.

Reading this I realized that seeing statements that BP is over diagnosed and also that kids can't have bipolar disorder (or it's very rare and over diagnosed in kids) is kind of a trigger.

Not make me upset trigger, but it makes me...frustrated.

Because I see people (not here necessarily but out in the internet) say, "Well those kids just need discipline" or "the parents are doping their kids to make them easier to handle" or my least favorite - they just need a good spanking.

Growing up I heard from more than one source (including at least one therapist) that 1) if I loved my mother I wouldn't make her cry and 2) if I wanted to be like the other girls I could be. My problems were boiled down to self discpiline and, basically, that I was spoiled. (and maybe to bad parenting, I have no idea that was never said to my face).

Now, I don't have the greatest of self discipline so I'll admit that but my problems were so much more than that. And I looked like a spoiled brat child. There were truancy issues and I just stopped going to school my freshmen year of high school (combination of depression, anxiety of new school, anxiety over a friendship, and agrophobia - although that I realize in hindsight). I shut down.

I could be rude and obnoxious and have public meltdowns that led to lashing out, including to strangers. I remember one time I was rude to an employee at a restaurant when my mom's parents were visiting. Mom sent me outside to wait. And they lingered over eating. I sat out side and fumed and cried and tried not to draw too much attention to myself because it was so embarassing. But I still acted like a spoiled brat.

I had no filter and no off switch on my emotions and no tools of any kind to deal with it. If I had antipsychotics, my life would have been easier.

I think about that all the time, how different my life would have been if I had access to medication at a young age.

Maybe I'm an exception, but it would have done me good. I would have taken them, my parents would have gladly given them to me and it would have been the right choice.

Maybe I would have had actual friends, learned social skills from having friends, and joined extra ciruclar activities and been able to take more challenging classes in school. Maybe that change would have meant college for me, a career, a sense of self instead of having this feeling of being a blob without form or function or purpose.

I will admit there are probably kids out there who are on meds who don't need to be. But equally as sure that there are kids out there who need to be on meds and aren't.

This is a good point, it would change the statistics if they took all of that into account.

I guess the question would be, how often are people later re-diagnosed with something different -I don't know the statistics on that but it would be interesting to know. I guess it would depend on lots of things. For example, if you stay with the same psychiatrist, I supposed your diagnosis would be less likely to change. Or if you stop seeing a psychiatrist altogether, then there wouldn't be anyone to re-diagnose. On the other hand, I suppose there are those psychiatrists out there who will take the word of the previous one and not do much of an evaluation of their own, others who will want to do their own eval/make their own decision and may or may not come to a different conclusion.

People may also present differently at different times, depending on what's going on in their lives, the level of trust they have with the provider (what is shared with them), etc., and this can also lead to contradictory diagnoses.

I think sometimes, too, people get different diagnoses from different people (different psychiatrists, therapists, in-patient stays) and because they contradict, end up choosing the one they prefer, or the one they think best describes them, and continues on with that label.

From what I've read on the boards, it seems that it happens sometimes that different providers will have different opinions on the matter -so what do you do in this situation? I think some people end up in the position of having to choose one (or more) of them for themselves.

Bipolar is episodic. The most characteristic feature of bipolar is that it is episodic.

A few months can be a natural remission to coincide with being "clean and sober" (in quotation marks because I dislike the expression, on many levels, but do not want to spend the time explaining why).

I have never had alcohol or drug problems, and I have been med-free for over three months, and my p-doc is still unsure of whether I am NOT bipolar VERSUS in remission, BECAUSE THE ILLNESS IS EPISODIC. The longer I do well without medications, the more he will lean towards NOT bipolar.

So a few months is not enough - there is "observational equivalence" between a person who is in remission/in-between episodes and a person who has no DX. A few months off drugs might make it somewhat easier for the clinician, but only marginally so. I imagine that Mandrec is quite right in that clinicians are not read up on substances and their effects, and, instead of placing the burden on the patients to present back in a few months with a "clearer" picture, should place the burden on themselves and finally read up on substances and their effects.

im not sure if is or not, but if I tell someone, they say, ohh my friend son is, my daughter is, my uncle is, my sister is, my my ,my, everyone here ,there is. But my psych took a long time before he dx me with it, it also could be how the dct interpt the signs, maybe?

All I know is that America diagnoses it on loser grounds as Europe. It's both about manuals but also about attitudes. I would be seen as BP2 in USA but here I'm seen as depressed.

are you sure? We don't know how today's kids on anti-psychotics will turn up.

I am not for rough discipline. But I am not for doping kids up without much else either. Meds would not give you social skills (seriously, if there's ever pill that gives you social grace, I will nom it in handfuls). It would alone not help in the situation. It might be just another tool of your parents for not so ideal parenting. So instead of humilitating you by letting you wait outside of restaurant, they'd up you anti-psychotics.

Dealing with problem kids requires wanting to deal with them actually. My teacher sent me to ****ing shrink who wanted me medicated when I was grief stricken after my fathers death. Meds and designer's clothes would solve it, according to her.

Unlike others, I am glad I was not doped up (and dressed up in clothes made by modern age slaves). I didn't learn social skills, but I dragged myself through education. It was not easy, but eh. I learned to cope, as there was nothing else to do. I will see what comes. I try not to have what ifs. It's never to late to live anyways.

I'm with you on the issue of "everyone" having it because they have mood swings or they just think it's "cool" to be bipolar. I agree with you, it's not. So many people I know have said they were without benefit of a proper dx or even having gone to see someone. They say it because it's the new "in" thing. If they want, they can have mine. In reality, I was dx'd a long time ago, but wasn't told until I was 31, when I found out on my own. Then my father told me it had been mentioned in the report he received from the psychologist he took me to at 17. I was very angry for a while. My family has blamed me for the way my children were raised, and the way my life turned out, but I feel if I had known and been allowed to make the choice to be medicated as it was suggested all those years ago, my life would have turned out differently. There is nothing cool about being bipolar.

I didn't mean the medication would magically give me social skills. But I don't have any friends IRL except my boyfriend and a few acquaintances, but no one I hang out with on a regular basis, or could call in a crisis, or what not. I don't know how to keep and maintain friendships.

I was at the bottom of the social ladder in school because of my odd and offputting behavior. I would burst into tears at the least thing, I had some friends, but as my symptoms got worse I alienated more people. And as they got worse my behavior got more weird. I remember one time when I was in one of my rages I walked up to a girl and roared in her face. It was so bizarre (and the teacher didn't see it, I don't think she told) but it branded me a freak. And there were other instances of that.

If I didn't have those symptoms that caused me to act like that things would probably be different. Not to mention all the school I missed, as my bipolar disorder got worse I missed more and more school, I usually only made it 3 days a week and later just stopped going.

My parents weren't perfect but they were pretty good parents in a tough situation. My mom pushed and pushed taking me to doctors and specialists trying to figure out what was going on. But she always told me she loved me and supported me. My dad has always supported me as well (my parents are divorced andI lived with mom), both financially and emotionally. My parents accept that I have a mental illness and always have.

I ended up misdiagnosed with depression at 15 becuase I was severely depressed (alternating between not moving, blank affect, not responding to people, and crying all the time) and had stopped goign to school. Mom was seeing a new GP and she ended up telling him about me. He actually cleared his schedule and had Mom bring me in right then. He did a quiz (similiar to what is on this site) for depression and, of course, I scored off the charts. He didn't think about bipolar disorder, and I found out later there was some discussion of hospitalizing me, but instead I went to see a psychiatriac nurse/therapist (who wasn't that great, but was better than what I had been seeing).

My doctor told me I had a disease called depression and they weren't 100% sure what caused it, but it was a problem wtih my brain. Not with me and that I would be given medication. "It's not a magic pill." I still remember those words. He told me they would help me feel better some, but I'd need to have therapy and do a lot of work to really feel better.

It worked some, but I have bipolar disorder not depression so there were issues of anti depressants not working correctly. But I started taking medication and for awhile it did relieve the depression and it did make me feel better and medication did help the rages. But then I'd get hypomanic and stop taking the medications. Until I was taking an MAOI (nothing else was working so my therapist perscribed it for my "atypical depression") and that helped the longest.

My behavior was more better, my symptoms were more in control, but I stoppped taking the MAOI because I couldn't be strict about the diet.

I wasn't "doped up" as a teenager any more than I'm "doped up" now.

As for being humilated at the restaurant. I was. But you know what, my behavior was abusive towards the employee, made my family uncomfortable and embarassed, and was completely unacceptable. And I think the punishment wasn't unfair, because knowing me, I would have continued to act out and made things worse.

I take meds now and I'm not doped up. So I don't think I would be doped up if I had meds as a kid.

Okay, reading your story makes it read differently now.

I don't know. I still would do hella of psychosocial interventions before putting developing brains (and argh at "something wrong with your brain" line) onto mind altering substances. It seems to many parents idea of councelling is associated with "fault". I dunno... if I ever have kids I am gonna read and google like mad to learn from others experience. It's not about "fault"... it's just sometimes people don't know how to approach some things. Parenting ain't instinctive, I think.

I was weird child too, btw. I kinda wish I was taught how to deal with emotions rather then "big girls don't cry", "smile" and "be nice". Figuring it out on my own is kinda... hard. And painful.

Another fact I should point out - I started in therapy when I was about 8 years old. I was held back in 3 rd grade, not because I couldn't do the work, but because I was emotionally immature.

I was misdiagnosed at age 15. So 7 years of therapy hadn't helped, of course it was all in the same practice. Mom took me to 2 different hospitals trying to get answers, and the closest she got was a doctor who advised her to read a book about moods.

But, this was around 1982 or 1983, so no one was really taking mental illness in kids seriously.

I think it was 13 years ago today I tried to kill myself, and ended up in the hospital. And that was the first time any therapist had asked me questions about bipolar symtoms. I didn't know the phrase "racing thoughts" so I didn't know how to describe it.

I also suffered in silence alot. I never told Mom about the bullying I endured, I never told her about what the therapist said, I didn't think anyone would believe me. And I had huge anxiety over being the center of attention or possibly humiliated so I suffered in silence and internalized a lot of stuff.

My other big fear was getting arrested, it kept some of my more violent impulses in check. Like I would get frustrated in stores and end up being verbally abusive to employees or storming out and really wanting to turn over displays or knock merchandise off shelves or break things but I never would.

Making a scene probably brougth negative attention on me, but I was in my "bipolar bubble" and I couldn't see how others viewed me. Sometimes I still have this problem, I can't look at myself with detachment, so I'll act certain ways that only later I'll realize are not appropriate or are problematic. But at the time I don't have that level of self awareness.

Things are different now between when I was a kid, the fact that professionals even recognize that kids can have mental health problems is a huge positive thing. If I were an 8 year old now therapy would be a lot different. (I hope). But I don't think therapy alone could have helped some of my symptoms like the anger, hypersexuality, depression, irritability, etc.

I was also told by pdocs and therapists that they can't get an accurate reading to diagnosis ppl on drugs. Drugs mess with the brain chemistry causing an imbalance which can mimic a mental disorder. I don't think this was meant to be offensive. I am a recovering addict and bipolar. It took years to get an accurate diagnosis and sobriety.

Yes, I agree with this point. My point, however, I think (), was that different drugs mimic MI differently, and that some drugs have much shorter long-term effects than others. So it is possible to diagnose people on drugs. It depends on how they've used and what they've used.

I am too new to learning about this to have any useful input about overdiagnosis, however, I would like to state the fact that I am so intrigued by seeing this meaningful discussion occuring. It is helping me learn more and I so appreciate that! Ps. Ultramar...I love your research links...

It is also that recreational drugs are much more versatile and less standardized than prescription drugs (and, some people believe that even generic versions of brand name drugs are not quite identical (I find it hard to understand, so just stating what I have read online)).

I am taking cannabis for sleep (very small quantities) and sometime experiment with somewhat larger quantities for getting insight into self and somewhat of a psychedelic experience. Edibles only as I do not smoke.

So cannabis chocolate gives me insight that is positive and optimistic, and cannabis brownies give interesting insight which is more self-critical and pessimistic.

And if you read up on what "connoisseurs" write about the variety of the actual herb, with all sorts of strands and combinations etc., you will realize that it is not one standard substance but a whole world of ingredients available in different combinations and ratios. And since they can be mind altering in different ways, there must be a whole body of knowledge developing alongside use, and clinicians should be up to date on it. Unfortunately, legal issues make research difficult.