Is Bipolar Overdiagnosed ?

I went to my hair salon yesterday and I told her I had bipolar. And she laughed and said 6 out of 10 people have that! Everybody's got bipolar.

I have noticed an increase and I am wondering if it is being Overdiagnosed. When I was dxed 15 years ago it was called manic depression and hardly anyone one had it. And in the deep south where I was at the time, you did not talk about it.

Now I am noticing people on these boards who 'think' they have it but have never been to several comprehensive interviews with a Pdoc to get a proper diagnosis. Or also, second and third opinions which is what i did..Mostly out of Denial. I didnt want it. It's like people want to have bipolar cuz they think it's cool. I dont get it. It aint. You can have mine!

But I also wonder if the stigma is gratefully being reduced and more people are opening up about it. Therefore, it seems like more people have it.

I also marvel at bipolar being diagnosed in children when the onset is late teens to early 20's. I was in my late teens when I knew something was wrong but I didn't know what it was. No one talked about mental illness. My 20's were a disaster but that's when I got dxed. I was normal as a child and all children are up and down.

Alcohol and drug use look alot like bipolar. The depressing hangovers, the elated binges. I believe if a person wants to truly know if they have bipolar they need to be clean and sober a few months or more to see if bipolar symptoms persist.

Also are the drug companies pushing the meds on the pdocs who are in turn handing them out to patients who really don't have bipolar but may have the usual ups and downs or even hypochondria where the patient learns about bipolar and thinks they have the symptoms and tells a dr about them?


Anyone else notice that everyone's niece or son or uncle or best friend has bipolar now? What are your thoughts on this? Also, I know there are varying degrees of bipolar where some can lead a fairly normal life, work a job, go to school, have a family...etc. then there are the ones like me who have had numerous hospitalizations, suicide attempts, numerous med changes, therapy, but have tried so hard to do normal life things only to run a rather haphazard course through life.

I have been successful at art and my marriage is now good but I've been hospitalized three times just this year.

Do you think bipolar is being over diagnosed?

I feel like it probably is. I'm guilty of- until very recently, being in the first group you described, sort of. At the same time there were many people- t and inpatient staff- that thought I had bp but didn't have time or resources to test me fully.

I agree with waiting till late teens to dx. Sure there are some kids who will legitimately be having symptoms, but it's better to teach them coping skills then label them and every other kid who has their ups and downs and force feed rx's.

Just my opinion.

I talked with my pdoc about this earlier in the week. He said there were 2 groups of people misdiagnosed as BP: people sensitive to antidepressants who have mania associated with their ADs and BPD people misdiagnosed as BP (often because its more palatable a diagnosis).

There are certainly more people diagnosed since they broadened the diagnosis to include BP 2 and there will be more if you include soft bipolar or BP spectrum disorders.

I have BP 2 and was misdiagnosed as MDD for 7 years back before BP was common.

Why should you believe anything about this? I don't mean to be rude, but when licensed professionals all over the world are accurately diagnosing bipolar disorder in people who use drugs of different kinds, there really is no need for you to have an opinion on this matter. Are you a scientist or professional? Are your arguments against diagnosing people who are in need of treatment even on that level of discussion? I can assure you, not all drugs mimic bipolar, and sound diagnoses can be made even under less than optimal circumstances.

I really don't know if bipolar is being over-diagnosed.

Mandrec...

The reason I said this is because a licensed professional Pdoc told me to quit drinking for three months and don't come back to him before that. I was honest about my drinking to my Pdoc and I don't think most people are. But he said that drug use and alcohol use must be cleaned nd cleared away to see if those substances were causing the moods wings and if the mood swings were still occurring aft that to come back. I didn't like him telling me that but I knew it was true. I did what he said and still had major symptoms at which point he dxed me as Bipolar 1. I went to ten different pdocs to get different opinions and they all said the same thing. Bipolar1. I was in denial. I thought maybe it was just a problem with alcohol. Now I have two diseases bipolar 1 and alcoholism and I work very hard at staying sober nd stable. It sounds to me like you are a professional who knows about diagnosing. Are you? I certainly am not but I've been at this Bipolar/drug/alcohol or more commonly called dual diagnosis experience for 15 years.

I fit into that category of people who "think" they have it. I've thought I've had it since I was 16, I'm almost 29 now. At 16 I was able to identify it as being "wow, that's me... oh damn" and had recognized it in the years prior. I don't think that it's cool, and I've tried my best to ignore it for the past 13 years. If I do have it then it is definitely BP2 and I function quite normally most of the time.

It might be getting overdiagnosed, it might not. I wouldn't know. I guess I just felt like posting in here because it felt like you were signalling out people like me who have came to the forum to start looking for answers... either before or during their decision to seek help. Almost like you're telling us that we're imagining it.

Which I don't really think you are saying, at least I hope not.

I'm one of those persons who have known they have it, been diagnoised and lived in denial about having it. I'm not sure how all docs handle it but I wish my first pdoc would have told me that if I pretend to ignore this my life had a very high probability of ending up screwed up by me. I'm not blaming him, but I just wish he would have come clean to me about how bad it can get. Pdoc's get into their own personal feelings about and beliefs about bipolar and it's VERY hard to find anything consistent between 1 doc and the next. I'm confused enough without their help. I'll probably end up sounding like a broken record on this site but when I read Fieve's book on bp2, it sounded like it was a script of my life. I don't know if Bipolar in and of itself is being over diagnosed or just the spectrum of MOOD disorders is being more understood. Where was this information when I really needed it. I would at least liked the chance to turn it down.

I was misdiagnosed with it. In my opinion, yes it is over diagnosed. I think mood disorders period are over diagnosed.

I don't really know if it is or if it isn't. But that question is exactly why it took me so long to seek any kind of help. I actually didn't even know what it was until a few years ago.

When I was 19 I took a psychological test which was written (primarily) and took about 2 hours. It was actually kind of an accident because I was taking a psychology class at the time and they were paying people to take it so that the doctorate students could get "real world experience" before they graduated.

After the exam the lead professor called me into his office and told me that I showed very strong indicators of "manic depression". At the time I literally had NO idea what it was and when he gave me the paper of three psychiatrists to call later that week I threw it away. Not really taking his suggestion seriously... at all.

It wasn't until about 5 years later that I started to believe him. About the same time I linked "manic depression" with this new "bipolar" word that people kept talking so much about.

I don't know about it being over diagnosed.

But as for bipolar disorder not happening in kids that's not true. I've had bipolar disorder since I was a kid. I knew I was different when I was about 7, knew something was seriously wrong with me by the time I was 9.

There were lots of doctors appointments and lots of specialists and therapists trying to figure out what's wrong with Bunni.

I was having severe, feel like my heart is going to burst, trying not to hyperventatlite anxiety attacks almost daily starting around 12 years old. I had a therapist. I told him, I get in situations and it feels like I'm having a heart attack. He said. Kids don't get heart attacks.

I went from deepest depression thinking about kiling myself all day every day, of being so depressed I would just sit or lay in one position for hours, unable to respond to anyone or do anything. Going to the bathroom was a monumental task. A shower was like thinking about doing a marathon. Going to school was....horrid. I had nightmares of being in war through out that time. EVerything was war.

And this alternated with extreme rage. I would have hysterical melt downs that were like a toddlers tantrum when they are too tired. ANd then I'd have the black rages - the anger and I would lash out, trash my room, say nasty things to classmates when I was in school. I remember wanting to bust all the windows in the house. Another time I got a hold of some matches and went to a corner of our 2 acres and set flowers on fire. To destroy things.

I fought with my mother, my brother, my dad. My brother never wanted to have friends over because I was a time bomb, and would go off.

Then ther ewas the hypersexualiation. I won't go into details.

I never had the creative positive experience with bipolar disorder that some people have. It's all been destructive. Racing thoughts, paranoid thinking, obsessive thoughts

The closest I got to a diagnosis was "atypical Depression" when I was 16 and when I was 17 I got some lithium to deal with my rages. Because I was driving and road rage was becoming an issue.

I've always had racing thoughts. I've always talked fast, at times so fast no one could understand me. I went over spend but I'd go to the library and check out all the books on a subject and read about it obsessively thinking I would write a book or go to college and become a whatever. I made plans. Grandiose plans.

I was dx'd with bipolar disorder in 2001 after I tried to kill myself. Since then every doctor and therapist I've talked to has said 1) I have bipolar disorder for sure and 2) and how I describe (or how my parents because a couple of therapists talked to my parents ) my childhood is consistent with bipolar disorder.

I took the quiz to that's attached to Psych Central as I am now. I score about 24. I took it again for my life before I was diaganosed and I got a 56. Mom is visiting me so I had her help me score it for when I was a kid and I got a 56 again.

My shrink told me once, "There's no such thing as textbook anything because textbooks have to generalize, however, saying that, you are textbook bipolar disorder".

Now, my current therapist says I'm one of a few of her patients that actually has bipolar disorder , she sees more patients who were dx'd bipolar but later are determined to have Boderline Personality Disorder. So there's that. I don't know how accurate that is.

Bipolar disorder may be overdiagnosed, I don't know. I do know that kids can have bipolar disorder and it's not just "ups and downs".

I also have never used illegal drugs or abused prescription medicine (except for the suicide attempt) and only drank regularly for a few months.

I never wanted to try drugs and I didn't really want to start drinking but I finally did and hey being drunk was a good excuse for acting like an over sexed asshole. I stayed away though, because starting around the time I was 12 I wished I had access to drugs or sleeping pills or booze so I could get ****ed up and pass out and not have to deal with my life. There was no alcohol in the house, no money, and no friends and too much anxiety to try and approach anyone at school about getting drugs.

The very fact I wanted to make myself pass out was scary and it made me scared that if I tried any of them I 'd get addicted. So I didn't have my first drink until I was in my early 20s. And I did a abuse alcohol when I was manic, but it was only for a few months and only because I had started dating a loser alcoholic. I only drank at bars and never at home and, like I said, it was a way to give a reason for being weird and offputting.

I'm sorry, I didn't realize it could be that severe of a problem in children. Perhaps the dsm needs to mess around with criteria?

It's natural to have the questions that Blue Wave has, in my view. Did you all know that
93% of bipolar folks are never diagnosed or treated? So our group is part of the 7% who
are being cared for with medications and other things to improve quality of life.

My view is that there are too many folks out there who have untreated illnesses of all
kinds that could be helped if there wasn't so much fear attached to treatment. ( I think
it's the little child within that is so fearful.)

As for accurately diagnosing people with mental illness (particularly bipolar disorder),
Dr. Kay Redfield Jamison and her co-author of "Manic-Depressive Illness" both agree
that psychiatrists are often strongly challenged in their ability to diagnose properly
when patients present having problems with alcohol and other drugs. My own psychiatrist has confirmed this within the last three months.

Because doctors are human, they can make mistakes. But as a general rule, I would
say that I think they do an admirable job of trying to help people with personal problems and illnesses.

I don't believe it's overdiagnosed at all. I find it sad that the only other bi-polars I know are here on Psych Central. I don't know any in my real life. Yea, I could go to the depression and bi-polar meetings, but they meet late in the evening and I do not have a car.

It sounds like he was oversimplifying things. I have heard that alcoholism can cause symptoms that are associated with bipolar disorder, but far from all drugs do that. No, I am not a professional, but I have gotten a few professional opinions and done some research on my own. I was diagnosed while still using marijuana. All of them agreed, and while my drug use was discussed I am, and they are sure it is not the cause of my illness. It's actually very obvious in my case that it's not. But I'm sure the regular use of almost any drug could be an obstacle when diagnosing bipolar (maybe even coffee?).

To reiterate: both doctors who wrote "Manic Depression Illness" concur with the fact
that many psychiatrists are strongly challenged in their endeavor to diagnose a patient's
condition, especially when there are alcohol or other drug abuses. This view was confirmed by my psychiatrist less than 3 months ago.

So, Blue Wave, I would not think that your psychiatrist was oversimplifying anything.
He was making a strong effort to determine that your illness was not caused by alcoholism or other drug use.

Caffeine can make bipolar illness worse, especially in people who have a sensitivity to it, but I have not heard that it interferes with a diagnosis for bipolar illness. I know that it can cause brain damage to people who have a sensitivity to it when they have used it for years.

"Don't use alcohol or caffeine; they make bipolar illness worse" was the first thing my psychiatrist said to me after diagnosing the illness. Now, I've learned that caffeine is bothersome for only those who have a sensitivity to it.

See http://www.DoctorYourself.com/caffeineallergy by Ruth Whalen.

I do not think Bipolar is being overly diagnosed. I also don't buy into the thought that you must be drug and alcohol free to get a clear diagnosis. "most" Pdocs are in no hurry to "label" anyone with bipolar to begin with.

I have been able to trace back my Bipolar to the age of 6.. I am 46 now and was diagnosed a lil over 3 years ago.

Everyone has there own "recipe" to help manage there Bipolar.

This forum gets loads of people asking if they are Bipolar. Of course no one here can diagnose, and to be honest damn near every human on this planet could have a symptom of Bipolar and one point or another , Does that mean they HAVE Bipolar ? Certainly not.

Who would really want this mess?

It wouldn't surprise me at all to learn in years to come that bipolar illness is
partly caused by a severe allergy of some sort that reacts in a way that
makes it appropriate to say, in part, that it might be a "brain allergy".

Years ago, I read that bipolar patients have an extreme allergy to grains. With all the new research now on the re-engineering of grains and the problems appearing in exorphins in wheat, barley, and rye, it's quite possible that exorphins play a role in wide mood swings. Sugar certainly does, and caffeine is harmful for people who have a sensitivity to it.

Dr. William Davis confirms the exorphin problem in "Wheat Belly", but says that more research is needed to make affirmations about wheat, barley, and rye gluten (and its exorphins) in relation to ADHD and ADD illnesses.

The brain is so sensitive in bipolar illness for many of us. For those of us who are sensitive, these things are very, very important to control in our diets for feeling-well tone. I was identified years
ago as having an inherited allergy gene, and I can tell you that when I've had something I shouldn't have in my diet, I both feel it and know it within hours. You may also have that kind of sensitivity if you're bipolar.

So here goes my research! This is a study that has been disseminated quite a bit (quoted and republished on the web):

Bipolar Disorder Overdiagnosed?

I think this is from the Canadian Journal of Psychiatry (synopsis of the article): Bipolar disorder: the shift to overdiagnosis. [Can J Psychiatry. 2012] - PubMed - NCBI

Regarding the first study:

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

By the author of the study, reflecting also on his and colleagues' personal experiences in their practices:

Overdiagnosis of bipolar disorder may be worse than the illness - Taipei Times

From The Guardian newspaper (UK) with tons of comments:
The bipolar explosion | Darian Leader | Comment is free | The Guardian

Keep in mind that there are also lots of articles espousing the expansion of the diagnosis to a spectrum of mood disorders. There's plenty out there on that point of view as well.

Some of those articles were downright painful to read. I don't want to say it's the new "fad" diagnosis, but sure, perhaps (as one of the articles pointed out) it is only because some pdocs may not do a proper and thorough (hm... not sure if that's the right word or spelling... having some issues today) test before an actual diagnosis. At the same time, even in an "over diagnosis" situation, you're still going to catch people that DO suffer from it on a long term type of basis. AND it is even mentioned that the diagnosis may only be misread as Bipolar. It isn't as if completely healthy people are being handed the diagnosis.

It is unfortunate I think at the same time. It's something that IS a long term and very recurring thing. (At least... for ME personally it is. It's kind of a constant uppy downy kind of situation. It's. Awesome. Sure, I get a couple days here and there. But, I like to tell people that the last time I felt any semblance of "stable" for long periods of time was in 1994... and that's no lie.) Anyway... sidetrack... To rush into a diagnosis leaves more people feeling helpless that it's something they'll have to deal with for their entire lives, which may simply not be the case. I find THAT part to be the most unfortuante thing.

It sort of reminds of the rise in Autism. But with that people are blaming vaccines or non organic food, or whatever else they like to blame. (Don't misunderstand... I prefer to eat organic food... but not because I think pesticides lead to autism.) In the last 10 years the diagnoses of autism has EXPLODED much like Bipolar. But that's only because the spectrum of the disorders have (both) been significantly widened. Is this a bad thing? Who's to say. It could probably be argued either way.

With the rise in Bipolar diagnoses, it seems that they love to blame US. Like we are entirely capable of controlling these severe mood shifts and we are flat out choosing not to. This is at best comical, and at worst incredibly insulting.

Someone asked me once how I would describe having Bipolar. I said "It's like ruining your own life. Repeatedly. And usually in an embarrassing way. And here's the kicker: at the time you will feel like you are doing exactly the right thing." As Christina said... who would want that mess? I mean... if you're offering to clean up after me after I've had a particularly bad episode, then sure... be my guest.

For some reason my jaw dropped wide open when I read that. That is a perfect way to describe my own life! I consistently self-sabotage and I'm always like "wtf did I do that for?!?!"

I saw a news piece on 60 Minutes maybe (couple yrs ago) about BP and Children. Some psychiatrist wrote a book about BP and Children in the early 2000's and since then they said that BP diagnoses among children has gone up some staggering amount like over 1300%. (I don't know the Doctor's name.)

I think it's very dangerous to put children on psychotropic meds because they screw with everything in your mind and body.

Better detection and social acceptance of mental illness could give the impression of over diagnosis.

It could also be a trend, just like BPD was in the 1990s.

People looking for answers.

With the rise in Bipolar diagnoses, it seems that they love to blame US. Like we are entirely capable of controlling these severe mood shifts and we are flat out choosing not to. This is at best comical, and at worst incredibly insulting.

I think citing the statistic that it's diagnosed a ton more here than in many other countries isn't an indictment of Americans' lack of control over mood, but ammunition in the argument for overdiagnosis in the U.S. (true or not).

I think she meant "US" as in "those of us with bipolar" and not "United States". that's how I read it anyway!

Yes, I even read that back and thought, "man, someone's going to think I mean America with this". But yes, Cheshire is right, I meant "us" as in "we". I have a really bad habit of using all caps when I'm trying to stress a word... because I'm too lazy to use to the "bold" function.

Foiled by the English language again!!