Hey, a decent and interesting article at Slate about an issue I hadn't really been aware of:
Today there are about 3.3 million Americans with a bipolar disorder diagnosis. Many experts think that this figure is an undercount of the true number of people living with the condition. As with any disorder, some diagnosable people are never seen by a clinician. And many patients who wind up with the label of bipolar disorder are initially misdiagnosed with unipolar depression.
But some psychiatrists think that the bipolar diagnosis has actually gone too far—that there is a large contingent of patients who have been slapped with a trendy label, the definition of bipolar having drifted far beyond its original meaning. Research indicates that false positives for bipolar disorder may be alarmingly common. In a landmark study published in the Journal of Clinical Psychiatry in 2008, more than half of bipolar patients who were reevaluated were determined to have been misdiagnosed. It’s possible that misdiagnosis and underdiagnosis are widespread issues—but the field continues to be divided on whether misdiagnosis is an issue at all.
Perhaps no topic in 21st-century adolescent psychiatry has been more controversial than pediatric bipolar, a diagnosis that can be applied to kids as young as 5 who have severe problems with emotional control. Critics say the label pathologizes normal but challenging parts of growing up. Proponents say it’s a needed intervention for kids not helped by other means.
No matter their age, when a patient receives the diagnosis of bipolar disorder, they are usually routed toward prescription drugs and can be blocked off from other diagnoses—and therefore other avenues of treatment. Borderline personality disorder, neurodivergence, and ADHD can all be misdiagnosed as bipolar but have vastly different treatment regimens. The first two are often treated without meds.
The rest of the article, about how bipolar diagnoses really had a huge growth phase, but is now getting some pushback, is very interesting. I hope it doesn't go behind a paywall...
1 comment:
Psychiatry and psychology are littered with problems. While the anti-psychiatry movement and groups like Mad in America are way over the top in criticizing psychiatry it is also obvious that psychiatry needs to undergo a serious critique. Francis Allen, head of the taskforce for DSM IV, wrote "Saving Normal", an insightful critique into the dangerous of DSM V. The medical model betrays a fundamental misunderstanding of human behavior. Psychiatry adopted that model because it was envious of the much more empirically grounded specialties.
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