It seems everyone is bipolar these days

[flutterby]

This is a bit of frustration.

For years, bipolar wasn't something you heard too much about. I understand that with awareness comes better diagnosis'ing and treatment.

But, it seems like everyone that goes to a psychiatrist ends up with a bipolar diagnosis.

A friend of mine has recently been diagnosis'd bipolar. I've known her for 10 years. If she's bipolar, then I'm Angelina Jolie. And then they put her on Abilify, along with her welbutrin (can you get any more stupid???). In one week, the Abilify has caused significant disinhibition.

She saw the nurse today; the psychiatrist is on vacation. She was told to continue the Abilify and if it gets worse to call. *blink* This is someone who is disinhibited enough all by herself. She doesn't need any help.

I would bet everything I own that she is borderline. Borderline and bipolar often get confused. Of course, it would take more than one 45 minute session to determine that.

But, in any case, it just seems like it is so overdiagnosed. It cannot be possible that everyone I know who ends up with a mental health diagnosis is bipolar. It's just not statistically possible. And look at the number of kids on the board who are diagnosis'd bipolar. I'm not saying none of them are, but the numbers are so high. I don't buy it. I'm not even convinced that difficult child 2 is bipolar. If he is, with the medications he's on, he should be going off the deep end. And he's not.

The first time I joined the board 6 or 7 years ago, almost no one was familiar with medications like lamictal. Now look at it.

These are powerful drugs and they are just dispensed as if it's no big deal. And then when they cause an adverse or undesirable reaction, they are told to wait it out and see what happens; or let's add this other medication to it.

I am so frustrated with the mental health services in this country. Something has got to give.

Off my soapbox now.

ETA: I was even diagnosis'd bipolar at one time. Interesting as I have never had a manic or hypomanic episode. When I went back for my second appointment and wanted to discuss this, the psychiatrist said I wasn't medication compliant and refused to see me again. If I'm bipolar, I'm the most incredibly boring bipolar patient *ever*.

 

[klmno]

I agree- my view from difficult child's experience (although I think there is a chance that he is bipolar) is that 1) bad reactions to medications can automatically land a BPdx and 2) I've had people say that I MUST be BiPolar (BP) if anxiety and depression are issues with me and difficult child has a BiPolar (BP) diagnosis- as if there can't be a spectrum of mood disorders and like difficult child had no father's genes playing into this.

As far as abilify- I have heard several horror stories- my son being one and another 14yo boy in detention who pulled a knife on his mom after a few days of taking abilify.

ETA: I think the next one coming up as being over-diagnosis'd is Asbergers (sp). It seems that now if the kid gets BiPolar (BP) ruled out, they automatically get the other diagnosis.

 

[Jena]

hi

there are tons of articles on this issue, that bipolar is highly over diagnosed. so i see your point.

yet i do think there are some out there that do have it, like anything else it all depends on the dr., their knowledge and their views and carefully observing a patient for a period of time especially when their younger to be able to diagnosis a thing such as BiPolar (BP).

 

[flutterby]

To clarify, I'm not suggesting that no one has it. I'm suggesting that it is *highly* over diagnosed.

The scary part of that is that other possible diagnosis's are being overlooked or discounted and the medications they seem to throw at people are powerful and should be dispensed only with thoughtful consideration.

 

[DammitJanet]

Well...I KNOW I am bipolar...so at least one of your friends really has it...lol. We can all argue about if I am the most laid back borderline on the face of the earth. I am probably the most unique borderline...lmao.

I can tell you why abilify is getting prescribed so often right now. They have "discovered" that adding AP's to AD's helps people with mood issues even if they dont have true bipolar or even schiz. My personal theory is that mood issues are a spectrum and if you need to add a AP then you probably have something more closely resembling a type of cycling mood disorder like cyclothemia or dysthemia than just major depression.

 

[flutterby]

Janet, Abilify is FDA approved as bipolar monotherapy. Of course, the study for FDA approval for this was 6 weeks long with adults and 4 weeks for adolescents.

Since then, other longer term studies have shown varying results, most notably for those on the depressive end - Abilify seems to cause depression.

 

[flutterby]

So, I take back what I said about difficult child 2 and his medications/diagnosis. I'm pretty sure he's in a mixed state right now and is working on going off the deep end.

 

[ThreeShadows]

Yes, Flutterby! After 35 years of marriage and a couple of years of hanky-panky, suddenly my husband is bipolar! He used to be able to control his temper and keep his raging to the home front. The medications have dulled his mind, his memory is going fast. His reaction time is decreasing. He was a national merit scholar, a valedictorian at his H.S., a graduate of the Johns Hopkins medication School. I was always amazed by his knowledge of history and science and his ability to remember facts and dates.

He has reacted badly to various BiPolar (BP) drugs. He was FALLING A LOT. He told his psychiatrist he wanted off the medications. doctor told him he would end up in psychiatric hospital. because he would be experiencing seizures and that he would end up on even more medications if he stopped. I was present at his first discussion with this psychiatrist, never once did he say "once you start, you can't stop". I'm livid. He cannot go back to work. He sits and watches CNN, he is only 58 y.o., turning into an old man, afraid of living. It's a tragedy.

 

[rdugirl]

just read a great autobiography...MANIC very good and a short/easy read!

 

[flutterby]

ThreeShadows,

You can go off mood stabilizers; you just have to taper them down until you can come off. Mood stabilizers are not a life sentence.

 

[Nomad]

I have wondered about this myself.
Since it seems to be a spectrum disorder, there is much room for interpretation.

Here is an interesting theory:
"A lesser-known system defining the types of bipolar disorder was developed by Hagop Akiskal and was published in 1999. He identified bipolar as schizobipolar disorder, bipolar I with full-blown manic-depressive illness, bipolar I as depression with extended hypomania, bipolar II defined depression with hypomanic episodes, bipolar II; as depression superimposed on cyclothymic temperament, bipolar III is hypomania caused by antidepressant drugs, bipolar III addresses hypomania and/or depression associated with substance abuse and its persistence after substance abuse ends, and bipolar IV as depression associated with hyperthymic temperament. Akiskal provided his own definitions for hypomanic episodes and cyclothymic and hyperthymic temperament, The biggest advantage in using this model is that it identifies and addresses the element of substance abuse as a cause for bipolar disorder. The popular and widely accepted reference to substance abuse in bipolar disorder is a dual-diagnosis of the two problems."

I recall a friend reading about some views on cyclothymia...her response..."this sounds like almost everyone!"

 

[susiestar]

It seems that as each disorder becomes popular then everyone seems to have it. First it was ADHD. I remember friends who moved because their 2 sons were quite literally the ONLY children in their GRADES who were not on ADHD medications. The school was turning them in to CPS WEEKLY for medical neglect because their kids were not on medications for ADHD. And there is NO WAY anyone would think these boys are anything but normal, intelligent, inquisitive boys who were bored at school. After they moved NO ONE thought the boys were ADHD.

For a while here everyone who was a little different was an Aspie. There were kids who were the stereotypical autistic - nonverbal, sat rocking all day not reacting to anything at all (one kid had a feeding tube because he was so far in his own world he wouldn't even EAT and no one could get enough interaction to figure out why), etc who were suddenly given the Asperger's diagnosis! Now most of the kids with the Aspie diagnosis are now though to be High-Functioning Autism (HFA), Pervasive Developmental Disorder (PDD) or even just autistic. While Wiz is still an Aspie, many of the other kids who were in sp ed with him are NOT.

Now it is bipolar. There are medications for BiPolar (BP) that are not generic, so the drug co's are pushing BiPolar (BP) as the new hot diagnosis.

I honestly think that the drug co's are behind a LOT of this.

And itis SAD.

 

[skeeter]

What worries me is that those that honestly do have the current diagnosis "de jur" get short changed with all the overdiagnosing. People that have the diagnosis (but don't) manage to live somewhat "normal" lives - so why can't everyone with the diagnosis?

Then you have all the alternative "therapies". Again- I'm not knocking trying all types of things, but it's very hard to figure out the crooks from the legitimate ones.

I know my daughter in law is bipolar, but the cocktail of drugs she takes - anorexia, ADD, anxiety, sleep, etc. - is scary. I really wish we could get her cleaned up, and start with a clean slate instead of the one added on top of the other, but she refuses to do this.

 

[Hound dog]

Heather

This has been something that weighs on my mind. And a pattern I've seen throughout my lifetime. ADD/ADHD is still one of the popular dxes for kids, but now we see the trend leaning toward autistic spectrum.

I was diagnosed ADHD as a kid, and honestly don't doubt that I had it. I was a super hyper child and I have vivid memories of attention span issues. But somehow I managed to get thru my childhood without medication that turned me catatonic. (scared my Mom so bad she dumped it into the toilet) Yet, odds are that if I was that same kid today....I'd have had an aspergers diagnosis as I also had many of those symptoms as well.

These dxes of the day worry me. Docs tend to plop them onto kids as casually as a new pair of socks, doleing out medications like they're candy. If one combo doesn't work, let's try another. And many times those kids haven't even had a decent evaluation to know that the diagnosis is accurate.

I had to fight tooth and nail for Travis dxes. Then I had to argue to keep him off medications he didn't need because once he had the Tourette's Syndrome and Pervasive Developmental Disorder (PDD) diagnosis that is all they wanted to do with him.

I don't buy Nichole's BiPolar (BP) diagnosis. If she's bipolar then she's the only one who doesn't go manic or hypomanic.......and her depression was mostly anger. The anger/normal is about all we ever saw. But her medications did help stabilize her during her downward spiral which I believe was severe depression complicated by Borderline (BPD).

My own BiPolar (BP) diagnosis.......well, if I have it........lol I somehow cured myself. lol But I will say at the time of diagnosis I was displaying symptoms of it, so can't really blame the psychiatrist. But it was a condition triggered by the Traumatic Brain Injury (TBI), and with research I've discovered that's not so uncommon. As the injury itself healed......those bipolar symptoms disappeared.

In my experience, good psychiatrists take their time dxing. But so many (especially those for kids) are so overworked they hear a group of syptoms and toss out a diagnosis and medications without really looking at the individual over a period of time and doing evaluations correctly. Parents who are inexperienced, uneducated on mental disorders and desperate for answers accept dxes simply because a doctor gave it to them, sometimes even when they don't really think it "fits" their child.

Dxing mental illness is tricky to begin with. You don't get to go have blood work done or have a set of MRI's, xrays ect to say.....Oh, there it is. Docs go by what information they're given, talking with the patient, and what medications work. If they're docs that are good at dxing and the evaluation process....they usually do well with dxes. If not.....well....those dxes can be mighty iffy.

This isn't just my opinion as a lay person. I've had lengthy discussions over the years with psychiatrists on the subject.

So I guess bottom line, if you don't believe a diagnosis fit's your child......get thee for a 2nd opinion, or a 3rd if necessary. Dxing mental illness takes experience and skill. Unfortunately not all psychiatrists and tdocs have that experience or skill.

medication dosing is another issue that worries me. I see kids with huges doses of a combination of medications. Some are very young. Saw this in psychiatric hospital with Nichole. And found myself wondering how much of their behavior was "them" and how much was the particular medication combo/dosages altering their behavior. Several were on higher doses than an adult is to take! Scary.

It's not that I'm against medicating kids. It's that I believe docs need to be extremely careful when they're doing it. And many aren't. Thankfully, Nichole saw psychiatrists who started off extremely low on all medications.....and she never did reach even the recommended dosage of any of them, but for her they worked wonderfully that way.

I had hoped that with the diagnosis of the Day with ADHD/ADD that docs had learned a lesson......evidently they haven't. And as long as we have that trend in mental health, we're going to have patients running around with wrong dxes.

I agree some of the "poplularity" with certain dxes is because of better evaluations and the like....to a certain degree. But I've seen an awful lot of kids recently getting handed an asperger diagnosis that no more have it than my dogs. I can't even pick out 2 or so traits of it.......sigh Instead of dealing with their Sensory Integration Disorder (SID) issues, doctor tosses the asperger diagnosis at them. Instead of dealing with their social anxiety....the same thing happens.

Now I'll climb down off my soapbox. lol This one can really get me going. Because I think all this dxing of the day sort of thing short changes all the patients with the actual dxes because information and treatment plans are often based on what works. So if you have a kid with social anxiety diagnosed with aspergers, and that kid learns to overcome that anxiety......their aspergers was treated and "cured". bah! Mucks up the waters, so to speak.

Ok. Done now. Got to get to school. lol

Interesting discussion Heather.

Hugs

 

[Fran]

I agree with Susiestar. My difficult child being 24yrs old was always just a few years in front of the trends. So when he was diagnosed with adhd, AS,bipolar in all those different years, no one knew what it was. Then everyone had a problem with the same titles. Of course, some were true and some were not and some were "sort of". My difficult child has evolved over the years. He isn't bipolar but he had mood issues which seem to have evened out as he got older. His AS isn't as apparent although executive function issues have been his biggest stumbling block at present.
I did in the past and still do believe that all those labels are part of disorder that hasn't been named.

Maybe the symptoms are so subjective to make it difficult to make a clear diagnosis. There is no CT scan, blood work, x ray to confirm the diagnosis so it is a matter of skill and experience on the part of the professional. It leaves a lot to interpretation.

Everyone has mood fluctuations. It's not bipolar until it interferes with your life. If you lose a job or can't hold a job, spend all your money on a whim, self medicate with alcohol or illegal drugs then it becomes a diagnosis. Obviously, there is more criteria to meet before there is a diagnosis but you get my drift.

Like the other "new" trends bipolar will play out and settle down.
I wish there was no reason for medications for kids ever but the truth is that you can not teach if a child can not attend. Your kid can't learn if the one in front of him is distracting him constantly. What can schools and parents do so that kids can learn, parents are pleased, schools meet their standards? I'm sure there is a better way but no one has proposed a better way so medications seem to be the biggest asset for some.

 

[DaisyFace]

These dxes of the day worry me. Docs tend to plop them onto kids as casually as a new pair of socks, doleing out medications like they're candy. If one combo doesn't work, let's try another. And many times those kids haven't even had a decent evaluation to know that the diagnosis is accurate.

I TOTALLY agree!

And so many of these medications are so new....the long term effects haven't even been seen yet....and yet they are giving them to children left and right.

It is my own contention that many of the ADHD medications stunt a child's growth. I have seen it in my own daughter. She comes from a family full of very tall people--was at the top of the pediatric growth charts all through her early development--and as soon as she was given Ritalin, her growth flat-lined. NO CHANGE at all during the time she was taking it. I didn't even have to buy her new clothes one year because she didn't grow out of a thing!

Today, at age 13....she is significantly shorter than her parents, her cousins, and is soon going to be surpassed in height by her little brother. Is is possible that she was going to be the short person in a family of tall people anyway? Maybe. But I can't help but feel that Ritalin was responsible for the year or so that she lost of child-hood development before I finally had the good sense to remove her from this drug.

--DaisyF

 

[Star*]

I third what Susie* said - in spades......

I just had this almost same conversation with someone else about Dude. We were going over all the mis-diagnoses he's received over the years. I've kept all his files and doctors reports for years thinking maybe someday he'd go off the deep end and someone would say it was our fault. Or to write a book that maybe would help someone else get through what we went through. THinking back? Absurd covers it quite nicely.

Right now AUtism seems to be getting diagnosis quite more often than I think it should be diagnosis BUT the first thing you hear out of someones mouth if a kid misbehaves now isn't ADHD it's "Could he be autistic." I'm delighted that it's being brought into the light and could get some serious funding for research - but does it bother ANYONE else - that all of a sudden we're a nation of BiPolar (BP), ADHD and Autistic people - and NO ONE knows why there is such a HUGE SPIKE in disorders?

I think there is more to it = call me a conspiracy theorist or whatever but SOMETHING has to be in the food, water, innoculations or SOMETHING for this to get to these proportions wouldn't you think?

 

[Shari]

As the allergist who sees wee difficult child said, "If that's classic ADHD, there's 3 million kids out there walking around on Ritalin who are diagnosed with the wrong thing..."
***
Labels come too fast, in a profession where answers are rarely clear. I think of all the people, me included, who feel wee difficult child is on the spectrum, and the MD's who don't. I look at all the kids I know who are much like wee difficult child and his behaviors, who are on the spectrum. Is wee difficult child mis-diagnosed? Or are those other kids? Mu gut feeling is that the spectrum explains difficult child better, but even then, there are exceptions. I don't know if difficult child fits any lable that exists now.
***

I think there is more to it = call me a conspiracy theorist or whatever but SOMETHING has to be in the food, water, innoculations or SOMETHING for this to get to these proportions wouldn't you think?

I think that's exactly it, Star. At least the epic proportions part of it, anyway. There will always be the classic autists, the classic BiPolar (BP)'s, and maybe even classic ADHD's. But how long, really, have society's diets contained all the genetically modified ingredients, all the preservatives, the chemical agents that enhance flavors, shelf life, etc? If you look at it, really, we are absolutely bombarding ourselves with chemicals that we really don't know what the long term effects of will be. Oh yeah, they've been tested and deemed safe, blah blah blah, but we've been down that path before...asbestos and Deet were safe once, too. And our airwaves? When, ever, in the history of the earth, have our airwaves been so full of traffic? We have radio signals and cell phone signals, and sattelite signals, and... Again...is that truly harmless?
***
I think some day we will find the links. We will find differences in our bodies - what may be toxic to one is not to another.
***
And don't get me wrong, I am not a health-food junky. I like my caffeine and jelly beans, and lately, potato chips... I just think there is a price we pay for every thing we eat and do, whether we truly ever know it or not.
***
ANd the mis-diagnosing/over-diagnosing...I agree, it hurts everyone. It hurts the child mis-diagnosed, and it hurts the child who truly has the disorder. The teacher in the classroom with 8 kids diagnosis'ed ADHD thinks she's an ADHD expert because she manages those 8 kids without so much as a bobble. Then along comes kid number 9, who truly has ADHD, and throws everyone into a tailspin because this teacher who manages ADHD kids so well suddenly can't manage. Instead of questioning the 8 easy ADHD's, they ostracize the 9th...the one who truly has it...the one who needs the most help, but they don't know what his problem might be, so they pass him on to someone else...Yup. Burns my hiney.

 

[DammitJanet]

My kids are on the older end of this conversation and I am obviously MUCH older...lol. I truly believe after reading The Bipolar Child that I have been bipolar since I can remember, probably as early as a toddler. Of course, back then there was no such thing as mental illness in kids especially preschoolers.

My middle son was classic ADHD without behavior problems. He never had any ODD type behaviors. He was super hyperactive and had real problems with attention. He still has problems with attention and some hyperactivity but he has learned to manage these deficits. He is contantly moving some part of his body such as jiggling his arms or legs and talks constantly. Its exhausting...lol. And trying to have a conversation with him is like trying to talk to a wall...he gets lost. But he can pull it together to take classes for work.

Now Cory was not normal for any diagnosis while growing up. He confused the doctors. We really still arent sure about anything with him. Maybe he is just an idiot. He was incredibly hyper and had trouble focusing when young but he was also defiant. medications really didnt help much. They did help his handwriting. Who knows...maybe he just needed to be contained until he reached maturity.

 

[gcvmom]

All I know is that there are crazy people on both sides of my kids' family tree, and I feel like now we have a name for what was wrong with those people back in the day... AND it explains some of the bizarro stuff that's gone on in my own little family.

That said, I have no doubt there are lots of people out there with the wrong diagnosis. Very often doctors will find whatever they are looking for in a person. And then they prescribe accordingly.

Our best defense against a misdiagnosis, as consumers, is to not blindly follow what the first "expert" proclaims as the truth, but to seek out multiple opinions from a variety of specialists. Do your homework, do the research, ask questions. And if it doesn't make sense to you or if it leaves too many things unanswered, keep searching until you find an explanation that fits.

Even then, things can change in people. Disorders go into remission. Sometimes for years. Maybe some resolve completely. Maybe other issues break through and cloud what was more apparent before.

Yes, our environment is different today. More toxins. More stressors. More opportunities for genetic mutations to be turned "on" that maybe would have lain dormant without those triggers that are more prevalent today.

For example, the human genome project has helped scientists discover 42 different genes for Crohn's disease (which my son has), but you don't need all 42 to have the disease. You only need between 3 and 6 of them. And even then, you have to be in the right set of circumstances, experience the right kinds of triggers in order for the disease to activate. No triggers, and the genes keep quiet and you don't get the disease.

It's a complicated world. So much we don't understand despite having discovered so much in the last 50 years.

Again, I believe our best insurance for getting proper diagnoses and treatments is education... and persistence.