Why is BP so overdiagnosed in the US?

I think that it's fair to say if you become manic on an ad then you're bp. Just because an ad showed your real struggle doesn't mean anything. A lot of bp started off dx as mdd. I know my first stop was my gp as is most and initially they try 1 or 2 ad's before sending you to a psychiatrist. Gp no longer dx children. There is always a lecture and the crisis line given just in case. We don't believe in hospital care for longer than a few days. So observation of that intensity is not possible, nor would be acceptable here. If you're not a threat to your self or others someone needs your bed. We're lucky to see our pdoc more than 4x a year For 15 min. Therapist are just as busy seeing clients 2-4x a month if that there are to many people needing services. Waiting with Serious mental health issues is not an option. We have a de instationalize policy. We're unless you're a prisoner you'll be out in about a week no matter the issue as long as your stable.

wouldn't that count as drug induced symptoms?

I know this is a common practice, but I think it's sorta BS. So many people get "manic" on stimulants or ADs and instead of ditching them, they simply add more meds and often their coctail blows up to something monstrous.

I was a threat to myself and others - hence being there 3 months the first time round. I am thankful I got the best observation and data for them to correctly diagnose and treat me. I realise this is not an option for many so I feel blessed that I had the best possible care. Cost over $40,000 but I had the insurance. Even had I gone through the public system here it wouldnt have cost me much at all and they HAVE tried to involuntary commit me for long periods of time in the public system, luckily I argued my case and can be admitted to a private clinic for correct treatment. Not dosed to the eyeballs and thrown out the door. Given routine, healthy meals, group therapy daily, group walks, supportive nurses (mostly), pdoc appointments 3+ times a week plus psychotherapy weekly.

I nearly got taken to the public system in the last few days, 3 times they threatened me with calling an ambulance to transfer me to a locked ward as I was so dangerous - so I am certainly not taking a bed from someone else who needs it more. My doc has said I am better off staying in long term (as in a month or two) rather than going in and out and in and out because that is far more disabling for a functioning life. But your life is far from functioning normally so I dont expect you to agree with me. I was allowed to work and go to uni from here too but as I have become more unwell I am no longer allowed leave on my own. If I discharge myself my insurance and pdoc would drop me and I would need to repay the $10,000 or so I've already racked up. That is how they are "keeping" me in a voluntary clinic.

I do not believe AD induced mania should be a diagnosing factor in Bipolar. Thats like smoking a cone and getting psychotic - its drug induced and would not have happened had they not had the drug. Not the case for all , but the case for many sadly.

And as mentioned even though I have had full blown mania, and mixed the diagnosis of BP2 stands as my depressions are very very severe and the mixed seems to come after periods of hypomania or hormone problems.

Still no answer - who drinks soda more than once a week? Who runs on caffeine yet has anxiety issues? Who is overweight (because of meds or otherwise) and does not have a healthy lifestyle? ALL of these things should be the first thing pdocs recommend.

It is an appalling practice to diagnose after very few sessions and even worse if they diagnose and medicate on the first appointment!

So so so so so blessed that I am here, because I'd surly not be around if I had to live like you miguels mom.

Well, I live in the US. I don't drink soda anymore unless it's a special occasion like my birthday and I'm eating out. I drink water all day, sometimes flavored with Crystal Light which is 0 calories. I also started exercising everyday.

I'm stable and have been a long time before I started eating healthy (which I just started recently)

Anyway, it took a long time to get diagnosed. I was first dx'd with MDD when I was 14 after a suicide attempt and stayed in a ward for a month, eventually started doing really good on ADs, specifically Zoloft. I did well for several years and stooped taking the meds. Then fast forward to when I was 18 or 19 (I'm almost 21 now) I started showing symptoms of Bipolar disorder with psychotic features. After a episode where I was up for an entire 4 days and manic I was diagnosed with Bipolar. Then that got changed to Schizoaffective Bipolar Type on my 20th birthday (nice present)when I had psychosis constantly even outside of mood episodes.

I am doing amazing, I am back in college and doing great. 4.0 GPA. I have no symptoms anymore on the following meds:
Invega Sustenna 117mg IM once a month
Paxil 50mg
Zyprexa 5mg
Depakote 750mg
Hydroxyzine 50mg 3x a day
Trazodone 100mg prn

I still don't really believe I have a disorder regardless of all my hospitalizations, police getting called,etc. I'm just doing so well now that it doesn't seem possible. I went into the clinic one day and demanded they give me proof that I have this disorder, they just brushed me off.

They took a long time to diagnose me, I was seeing them for nearly a year before they dx'd me

I'm saying this is not an option here. I don't like the personal judgement of my life . If I could go months I might but 4 days is long here. Remember I was discharged asap. Still halusinating and delusional and that's normal here. We have a stablize and release policy. Hence over medicated.

I question that US hospitals accually stabilize people before they are released. They just bring symptoms down to where other people don't find them intrusive. Yes over medicated and barely functioning is good enough to get you out the door. If people were kept long enough to really stabilize it would save billions in re-hospitizations and give people a chance for a better quality life. As for healthy lifestyles when I was going in and out with multiple drugs I was still managing to be a vegetarian with no soda in my life, not that the docs care about my lifestyle outside of whether nor not I was sexually promiscuous. They do care more now though but I'm no longer a vegetarian.

I was diagnosed bipolar after ad induced mania. I don't think it would be a correct diagnosis based on that alone. However, considering the horrible bouts of depression (lasting months over the last 15 years), the hypomania, and (possible trigger I think?? New here, sorry) the eating disorder that all were going on prior to the ad induced mania.. I feel like it's an accurate dx and hopefully something I can finally get under control. No cure I realize... But im grateful that there are meds and that I can potentially get to a somewhat stable place. There are a lot of people who have suffered without a diagnosis for far too long, as well as people who are given a diagnosis when they have a few ups and downs. Its kind if a messed up system.

I apologise, I was heavily medicated and agitated last night so I did not word myself correctly. You have coped very well with your situation, and what I meant by my comment is that I would not have coped and would have had I been in your situation.

I find that appalling that it is "normal" to release people who are hallucinating badly or delusional dangerously. I am aware there are people who can live with these symptoms daily but if it gets to the point the symptoms are too horrible to bare it is unfortunate that their only option is to be drugged and turfed out on the street again.

Whats the difference between states? It seems some people can have long admissions but others cant? Is this a difference between states or a difference in the level of insurance cover?

There are similar treatments here with those in the public system with being medicated to zombielike state and after the 72 hour hold they discharge - but have found the people I know who have gone through this system tend to be more of a danger and usually end up back in the ER within weeks. I have had friends sui over that type of treatment as they didnt have the insurance and options I did.

On the other hand I have also have friends go through the public system voluntarily - but again its not really voluntarily because they threaten you with the locked ward if you try to discharge yourself before "they" think you are ready. I have a few friends who have been in this situation, hated it but stayed the distance (2-3 week admissions) and those friends have not returned to hospital.

I might do a poll on healthy lifestyle choices but I have come to realise many on this forum do not know their lifestyle is unhealthy so I do not expect to get accurate results. (not indicating that posters in this thread are like that).

Sidestepper and bluebird, thanks for your replies, you are two that I admire for your strength and constantly battling with all your skills and healthy lifestyles to get through.

Supanova

Thanks for the kind words. Right now my lifestyle isn't all that healthy, the last depression I had I pretty much lived on what I could get from pizza delivery. I didn't leave the apt except once a month at 2-3 am so no one would see me. I didn't see any docs and I blew all my friendships before that so there wasn't anyone who cared. Just as long as the put the rent check in the deposit drop no one knew. I was too depressed to be actively thinking about offing myself. Now thanks to that I'm fighting cravings I never knew I had.

Thank you
Usually depending on insurance, your state, the place you seek treatment, If you are still a threat to yourself or others, and over crowdedness.

Overcrowding is a huge issue. You have to be a major threat to yourself or someone else before inpatient is even consider, no matter how badly somebody needs it, and they get rid of you fast.

Also the docs personal bias. I'm white from a slightly above middle class and I get held longer than minority's and men especially when I was younger and the PTSD was paramount.

Prescription drug advertising is a *moderately* recent development. Most of my life, there wasn't. I was appalled at first sight.

I'd had about 25 years of prolonged depression and (definite) hypomanic stretches before ever having been given an AD. So, not surprisingly, when given one, I went from lowest low to bouncing off the walls before 2 days were out.

In a sense, the AD experience did "lead" to the BP diagnosis, but only indirectly and as merely a speck amongst the real evidence. (And for many months, even that didn't happen, as the clueless GP didn't even recognize the need to re-evaluate her dx of MDD --despite immediate big red flag and having only "screened" for BP with 3 words ("so, no highs?" -- I had no clue what she was talking about). I didn't know why all hell was breaking loose, because I didn't know about BP at the time. When I did learn what it was, I cried. It was my life story. Thing after thing after thing came back in waves. My (Pdoc) dx did come quickly at that point, but it had decades of clear-cut evidence behind it, with other explanations ruled out. And was rather amusingly confirmed at a later appt. at which I was sit-bouncing on the couch, talking a mile a minute, scoffing at the idea of meds. Imagine her lack of surprise at my desperate call about a month later when the bottom was falling out hard and fast.

Thing is, that despite decades of textbook symptoms (that indeed were very problematic in my life), I'd dodged the psychiatric system (many, many years without a GP or insurance of any kind either.). As the older folks here can attest, there was a giant rug under which all things psychiatric that could possibly be swept, WERE swept, thankyouverymuch. Also, I moved a lot and didn't keep contact, so who's going to notice a pattern, or have my "normal" to compare to? (except my ex, who can vouch for a book's worth. BF not only suggested my ex be nominated for sainthood, but would also love a good story-swappin' session. Lol.)

As for health stuff... A bit underweight. No eating issues. Soda, I've recently gotten into having a can most days. For many, many years didn't, and as a kid it was a treat for sure. I ate super-healthy for a decade or so, to mostly healthy, to… not so much, but not terrible. In severe depression, it's pretty bad if no one looks out for me.

Upon receiving a Bipolar 1 diagnosis 4.5 years ago I have reflected on my entire life. If I think back to my adolescence I definitely had some kind of mood disorder. I never wanted to do anything as a child, never wanted to go to school, play with others, do homework etc. Then there were periods of time where my grades would rise and I did really well, but then I would get tired again and feel like I "couldn't do it," and wouldn't. It's very difficult with children however since it's normal for children to have say, a delusion of grandeur. Childhood imagination vs. mental problem? I'm sure it's also not good to put a child on a drug like lithium or seroquel. Just my thoughts.

All psych meds here are prescribed-only and prescription only medication here in the UK is not legally allowed to be advertised in any way, although it can be promoted to healthcare professionals in meetings and with leaflets.

So no ads of the type here. If it's over the counter it can be advertised if approved but anything stronger than 8/500 cocodamol in terms of pain killers is not available over OTC. And anything more powerful than Kalms (hherbal sleeping aid) is also not available over the counter (OTC)

My first psychiatrist saw me once a week over a six week period before he made a diagnosis. I was relieved when i heard bipolar because it explained so many things and i thought it was the first step on the road to a full recovery. 25 years later i am still juggling meds and on benefits. It's been a big adjustment -- from expecting a full and rewarding life to accepting life on the margins.