Comments? If 'psych prof' means psychologist, then it all makes sense.

In some ways is it really the point to determine whether a disorder is underdiagnosed or overdiagnosed? Where does the diagnosis really get you anyway when you think about it? A diagnosis of bipolar 1, 2 or 3 -- what difference does it make? Of course it does make a difference as far as labeling the individual as a lifelong customer (woops, patient) but I mean in terms of treatment. We have treatments that were formerly for schizophrenia being used for bipolar and now we have those bipolar treatments being used for depression and even GAD. All this rumination over diagnosis might mean something if treatments really were different for each disorder and something/anything was demonstrated to be clinically effective long term (which it's not) but frankly in psychiatry it's all for one and one for all. By that I mean all meds for any diagnosis and any diagnosis for all meds. There needs to be a whole different way of looking at the symptoms and what they mean for that particular individual -- forget the diagnosis and probably the meds. Furthermore these disorders are on a spectrum and shouldn't really have separate names as if each one was some distinct "disease."

have argued that since the kids they diagnose with bipolar disorder respond to antipsychotics and other meds then that proves they have child bipolar disorder

who wouldn't "respond" to a sledgehammer over the head?

Oh they haven't responded to antipsychotics; they were just given the standard "cocktail" that Biederman's Mafia dreamed up.

1. One or two mood stabilizers (Depakote & Lithobid were popular a decade ago while Biederman was researching Risperdal on children for ADHD in 1999)

2. One anti depressant (Zoloft was popular a decade ago, then Strattera)

3. One antipsychotic (Risperdal, Zyprexa were number one picks a decade ago)

Most doctors fell for that Biederman cocktail trap, and so did the wildly popular parent support group site CABF. They promoted that 3 med cocktail and still do, and Biederman's on their professional advisement board: BUT he refuses to do public interviews. I wonder why?

Think he will now? I would LOVE to know who spoke at a San Diego Conference in late-Summer, early -Fall 1999. Because, that is the conference the inpatient psych who treated my daughter and said, "just came back from and I've been told cases of OCD in children are actually Childhood Bipolar disorder". And that is how my daughter's journey began. With an immediate addition of Depakote, Risperdal and Zoloft. The Zyprexa replaced Risperdal due to side effects. In an 11 year old in 1999.

Looks like we have gotten no where fast alerting parents to this nightmare, and it's only to become worse as full blown anti psychotic use will prevail as the number one choice to drug these kids, and it will be for ADHD/Bipolar. Mark my words.

I agree it's suspicious that this trend is coming at the same time as the rise of antipsychotics. Maybe psychiatrists felt like they had to be more careful when the only options were lithium or anticonvulsants, because those are pretty much useless for anything but bipolar disorder. But now that Seroquel and Risperdal can supposedly cure anything, everyone goes into the same antipsychotic soup, so what does it matter to them?

I just heard the tail end of a story on "All Things Considered" discussing this study this afternoon, ironic seeing as I got in and read your entry on the Infinite Mind.

In my private practice as a psychologist, I frequently find people misdiagnosed with Bipolar disorder. If someone has an anger problem, they often end up diagnosed as Bipolar. This happens frequently by family doctors and also psychiatrists. In my opinion, it's really often a matter of justifying the meds they want to prescribe (most often an antipsychotic). I'd say, anecdotally, that the level of overdiagnosis I see is pretty consistent with the studies results (50-60%). I do evaluations for people seeking disability based on mental illness diagnoses, so I frequently see people labeled as Bipolar. More often than not, the diagnosis is more consistent with a cluster B personality disorder (erratic, unstable, and hyperemotional personality traits). But once you diagnose someone as being Bipolar, you can pretty well throw any class of psychotropic medication at them that you want to.

Yes, Parapraxis that's exactly what the psychiatrists told me 10 years ago about my daughter. "What's the difference what we call her the meds are all the same treatment".

That's BS! and THAT is why kids and adults are over dx and over-medicated.

Honest to God, get your head out of the DSM!

This one-size-fits-all meds approach supports the notion that the Pharma industry has no idea what the underlying mechanism is for these drugs. What they seem to do is sedate, dull, or knockout, regardless of diagnosis.

If one of the pivotal symptoms for bipolar disorder is agnosia (lack of insight into the disease), for instance, then a successful medication "treatment" would effect a change in that symptom, leading to the patient's becoming aware of their disease, to the extent that they would see the usefulness of their medication. The volume of dropouts from bipolar medication suggests that this clarifying effect is not being achieved, and one wonders if most of those who remain on medication are simply being pressured into it because it "quiets" them.

The point I am making is that unlike diabetes, the docs have no idea what blood constituent to measure to see if their medication is successful. The only indicator they have is the patient's and family's self-report, and they have to discount the former because of the way they've defined the disorder (with agnosia).

I once took a tour of a Pharma company, and one of the most interesting parts was their "High-Throughput Analysis" section, where they had a robot machine testing thousands of samples of different reagents a minute to see which one got a reaction. This type of dartboard thinking is what is producing these medications, only now the patients are the targets.

Susan, I am among those people who do experience a "clarifying" effect from bipolar medications without feeling sedated or dulled - on the contrary - so I don't think you can paint the picture with such a broad brush. (I do not take antipsychotics, however.) The patients' subjective experience of mood is, by definition, the central characteristic of a mood disorder. So if doctors really are disregarding patients' self-reporting in diagnosing bipolar disorder, that points to a big deviation from the original concept and, in my opinion, another failure of the profession to set adequate guidelines for its members.

"doctors--you know, those rational, god-like creatures who do things based on Science--"

Yeap!
On Science, common sense, paying attention on the patients words, learning from their practice and experience, fighting hard to find the "origin" off the disease...
We all KNOW!

I haven't read all of the comments above, but, enough to finally read what I feared for at least 5 years now the over diagnosis of 'fad' mental illnesses. When my son was in the 5th grade, (1990), his teacher insisted that he had ADHD and insisted further that I take him to the doctors and have him evaluated. I did, the Doc said, "Oh, yes, he is classic ADHD, get him on meds so that he may fit in socially". I looked up the side effects to Ritalin and decided I would get a second opinion. In the meantime more and more kids were getting a diagnosis of ADHD. Families I met were wearing badges of adult ADD or ADHD. I had a bad feeling about this. When my son went on to the 6th grade, the PTA had a special parents conference about ADHD. I attended the seminar. A well spoken doctor led the meeting. He scared the hell out of me, really! I argued that I did not like the fact that so many school age children were being diagnosed left and right and parents were running to the pharmacy to fill the scripts for Ritalin. One parent said I was irresponsible and pretty much every one else chimed in. I told my sons 6th grade teacher I had no intentions of following the crowd on this one, because, what I was seeing were little zombies running around the neighborhood on Ritalin. I told him, "He is my son, I will tough this out with him." Surprisingly, he agreed. Then a few years later teenagers were being diagnosed with depression and parents were running to the pharmacy again for Prozac. Teenagers were committing suicided across this nation as a result. Then came the 21st century and Bipolar Disorder. Once again, people scrambled to the shrinks and the ever profited pharmacy's for more medicines. My Daughter was diagnosed with Bipolar Disorder 5 years ago. Two months after beginning Abilify, she got pregnant by her husband and so then she was off the meds until she gave birth to her son. She had a very emotional pregnancy and the minute she gave birth she was back on her meds. Okay, but then something happened when she was given anti-psychotics, she began to hear voices, terrible voices. I told her husband that I thought she was misdiagnosed and that some people actually present symptoms of a disorder if they are on the wrong meds. He said I was in LaLa land and an irresponsible parent (heard that before). All the confusion and overmeds were crippling for her and after 3 years of one cocktail after another from a psychiatrist that did not believe in therapists, she took a hand of Trazadone. She almost died.
I feel now, as I felt 18 years ago, that no doctor or psychiatrist should diagnose or treat with a medication a disorder that is hard to reach if the person is abusing substances of any kind; If a persons brain chemistry is alerted by weed, alcohol, cocaine or if that person, like my daughter, is in an abusive, mentally & emotionally, marriage, then the diagnosis will not be accurate...how could it?
My son has grown up into a fine man who is married has a son of his own and maintains a steady job and he does not suffer from any side of effects of a medicine that could have had ramifications on his heart or liver had I gone along with scare tactics of the 90's by doctors and communities alike about ADD or depression. My sweet daughter who has been to hell and back, is finally away from her abuser and she may have a long road back to health, but her new psychiatrist states that he can help her tone down the Bipolar, help her rid herself of her anxiety's and will most likely be removed from most of her cocktail of 4 meds, 3 being anti-psychotics.
Everyone should get more that one opinion on this new fad of a diagnosis, Bipolar, Borderline or Dissociative Disorder. I know some people need life saving meds, but, for your own sake, for the sake of your family and for gods sake, for the literal lives of the ones you love try to resist the pressure and be unafraid to question the "gods of medicine". A truly responsible doctor will listen and weigh the consequences with you.
Mary

I think many family problems get masked by diagnosing the kid bipolar. Personal opinion.

JD Stottlemire, author
You me and Apollo: Hope Beyond Bipolar Disorder
http://www.youmeandapollo.com