The Rise of Bipolar Disorder Symptoms and Treatment

If you’ve been around as long as I have, you may remember a time when the diagnostic label “Bipolar Disorder” was relatively unknown.  Although that term has been around since the 1950s, it came into common usage only in 1980 when the APA released its third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III); before then, mental health professionals discussed and wrote about Melancholia or Manic-Depressive Illness. It was considered quite rare.   As you may know, that revision to the prior version of the DSM sought to eliminate its psychoanalytic/psychodynamic bias and replace it with a supposedly more “scientific” approach, thereby embedding psychiatry within the medical model of treatment.

According to the 1969 book, Manic Depressive Illness by George Winokur of Washington University, Bipolar Disorder used to be fairly rare.  In 1955, only one person in every 13,000 was hospitalized for it.  Today, by contrast, according to the National Institute of Mental Health, Bipolar Disorder symptoms affect an astounding one in every forty adults in our country!!!  It’s also worth noting that, before psychiatric medications were introduced, the long-term outcome for those patients was fairly good.  Only 50% of the people hospitalized for a first attack of mania ever suffered a second one.  Studies have found that, in the pre-drug period, 75-80% of hospitalized patients recovered within a year and only half of them had even one more attack within the next 20 years.  Today, Bipolar Disorder is a chronic illness, with patients spending years and years on psychiatric medications.  In other words, Bipolar Disorder was comparatively rare before 1980 and the prognosis for hospitalized patients was fairly good; today it’s 325 times more common than it used to be and has become a lifelong illness.

How are we to account for this change, from a rare and acute illness to one that is pervasive and chronic?

Four possible explanations occur to me.  (1) Manic-Depressive Illness was actually more common than believed at the time and clinicians unfamiliar with its features failed to recognize it.  (2) Bipolar Disorder is currently “in vogue” and therefore over-diagnosed.  (3)  The threshold for diagnosis has been lowered and our conception of the illness has been expanded.  (4) Something social or environmental has occurred that has actually increased the incidence of Bipolar Disorder symptoms.  I believe that all four explanations are true to varying degrees.  Let’s begin with No. 3

Over the years of my practice, I’ve noticed a steady increase in the use of the term Bipolar Disorder.  With the introduction of additional diagnoses such as Cyclothymic Disorder, the division of Bipolar Disorder into Types I and II, as well as a juvenile form of Bipolar Disorder, a reduction in the severity of symptoms needed to meet the diagnosis, plus the identification of a new rapid-cycling form of Bipolar Disorder, this category of mental illness has expanded its reach to cover an ever-larger population.  At the same time, I’ve seen exponential growth in the use of psychiatric medications as the primary form of treatment.

As for No. 1, I’m sure that years ago when mental illness was more of a taboo subject, many cases of Bipolar Disorder went undiagnosed.  Regarding No. 2, I believe it’s quite true that many people who receive the diagnosis today don’t merit that label, especially when under-informed general practitioners rather than psychiatrists assign the DSM-IV code and write a prescription for psychiatric medication.  None of these factors can fully explain the astronomical increase in the incidence of Bipolar Disorder or its transformation from an acute into a chronic illness.

Robert Whitaker, whose book The Anatomy of an Epidemic I covered in several recent posts, has a disturbing explanation.  He begins with a study from researchers at Mt. Sinai Medical School, who found that “nearly two-thirds of the bipolar patients hospitalized at Silver Hill Hospital in Connecticut in 2005 and 2006 experienced their first bout of ‘mood instability’ after they had abused illicit drugs.[footnote omitted]  Stimulants, cocaine, marijuana, and hallucinogens were common culprits.”  Another study from the Netherlands found that marijuana use increased the risk of first-time diagnosis of bipolar disorder five times, and that one-third of that country’s new bipolar cases resulted from such drug use.  In other words, these illicit drugs kick some people into a manic or depressive episode they might not otherwise have experienced.  Illicit drug use has been on the rise since the 1960s, which might partly account for the increase in the incidence of affective disorders such as bipolar illness.

Whitaker likens the stimulant effect of anti-depressants to those of elicit drugs; he goes on to offer the unsettling results of various studies:  one from Switzerland which found “that the percentage [of patients] with manic symptoms jumped dramatically following the introduction of anti-depressants.”  They also reported more frequent manic episodes.  Another study from the Yale University of Medicine reviewed the hospital records of 87,290 patients who had been diagnosed with depression or anxiety during the period from 1997-2001.  They “determined that those treated with antidepressants converted to bipolar at the rate of 7.7 percent per year, which was three times greater than for those not exposed” to those medications.  As Whitaker explains, “This is data that tells of a process that routinely manufactures bipolar patients.”

To make matters worse, the conversion to bipolar disorder is often permanent, even after medication is withdrawn.  As Fred Goodwin, in a 2005 interview with the journal Primary Psychiatry, explains, “that patient is likely to have recurrences of bipolar illness even if the offending antidepressant is discontinued.  The evidence shows that once a patient has had a manic episode, he or she is more likely to have another, even without the antidepressant stimulation.”  Giovanni Fava, a prominent Italian researcher, believes that “antidepressant-induced mania … may trigger complex biochemical mechanisms of illness deterioration.”

Now we have a better understanding of the factors that have brought about this change in the frequency and severity of Bipolar Disorder:   Better diagnosis by mental health professionals, an enlargement of our notion of what constitutes the illness, the rise of illicit drug use, and finally, the creation of a whole new class of bipolar patients whose biochemistry has been altered by the use of antidepressants.

Finding Your Own Way:

Many people one might consider “moody” have ups and downs that wouldn’t meet the criteria for a diagnosis of Cyclothymic Disorder much less Bipolar Disorder.  Many people cycle occasionally from undue optimism to feeling gloomy.  Is it possible that Bipolar Disorder is the extreme of an emotional condition we might consider “normal” in less pronounced forms — that we are talking about a spectrum rather than discrete categories?  I believe many people given the diagnostic label and prescribed drugs might once have been considered “moody” instead.

Do you consider yourself “bipolar” and why?  Read the actual diagnostic criteria here and see if you meet them.  How do you feel about this diagnostic label?  If you’re taking psychiatric medication and have actually had a full-blown manic episode that meets the DSM-IV criteria, did it happen before or after you started the meds?

Do you know other people who consider themselves to be or have been diagnosed as bipolar?  Do you think they actually suffer from Manic-Depressive Illness, or is it something similar to it and less severe?  Do you know whether they’re taking psychiatric medication and whether it might have had a role in the onset of their manic symptoms?

I don’t know about you, but I find this all deeply disturbing.  To me, the worst part is the medicalization of this emotional difficulty, to the point where hardly anyone considers the psychotherapy of Bipolar Disorder at all viable.  The psychodynamic interpretation of Manic-Depressive Illness has fallen completely out of favor, and now, people who might once have  discovered the meaning behind their cycles of exuberance  and despair now routinely receive medication that makes them worse and perpetuates their illness.

By Joseph Burgo

Joe is the author and the owner of, one of the leading online mental health resources on the internet. Be sure to connect with him on Google+ and Linkedin.


  1. I knew a couple of whom one was quite manic-depressive. He would go off for a number of weeks barely sleeping and doing all sorts of risky things.

    It seemed to his partner that it started in his shoulders. If he got a shoulder massage to loosen up it could nip the incident in the bud. They got it down from weeks being manic to hours.

    I don’t know of anyone else who has recounted this type of experience. But it is very intriguing and suggestive I think.

  2. I had my first depressive episode as a second grader. Needless to say, I was not medicated as back then it was not done. I continued to have depressive episodes during my teens and later adulthood after the death of my 16 year old daughter. I also had hypomanic episodes but wasn’t aware that they were anything other than more “productive” (both in thinking and doing) and expensive times as I spent money as if it were a need rather than a want. Not until I was diagnosed as having bipolar when I was about 48 were these episodes explained. I had many of these episodes prior to using antidepressants. I wasn’t using illegal drugs.

    One thing I think may have been missed or ignored in studies in the use of psychiatric medications, specifically antidepressants, is that even if individuals did better when they were not medicated, perhaps those who were medicated had more severe or multiple depressive episodes prior to being medicated.

    1. Carole, I didn’t mean in any way to suggest that the use of illicit drugs and SSRIs are the *sole* causes of Bipolar Disorder. Manic-Depressive Illness has been around since the Greeks. My point was to address the explosive growth in its incidence and to try to understand why. You may be right about the studies, but as I understand them, SSRIs are associated with an *increase* in the number of episodes and a shortening of the space of time between them.

  3. My mother was hospitalized when I was ten and remained depressed for six years despite antidepressants and therapy until Lithium came on the scene in the late 1960’s. She went off lithium only once in the 1980’s, with her therapist’s encouragement, and became manic within weeks. Once back on lithium, she went on to live a fulfilled, though somewhat constrained, life until her death in 1999.

    That said, when I suffered post-partum depression, I resisted the use of medication because I wanted to breastfeed, and with therapy, I worked through many of the issues underlying my depression. I went on to graduate school, became a licensed psychologist, and spent the last twenty years working with parents of young children.

    I agree with you over-diagnosis is a problem and the medicalization of emotional difficulty often leads people to seek a quick fix. I have seen a two-year old misdiagnosed with autism without actually being seen by the diagnosing clinician, solely on the basis of the developmental history of prematurity and dyspraxia. I have had preschool teachers ask me whether a three-year old is hyperactive and might benefit from Ritalin. My own clinical work is rooted in the graduate research I did on temperament, which helps to explain the variability of emotional experience and expression. I always recommend therapy first, and if the patient is a child, intensive work with the parents to help them understand their child’s temperament and to learn parenting strategies. But I also know for some people, medication might be the last, best resort.

    1. There’s no question that some people are helped by these medications, and that they may be the “last, best resort,” as you put it. Your cautious approach seems both right and rare. Too often meds are the first rather than the last approach, and the potential side-effects are not adequately disclosed to patients and especially to parents contemplating medication for young children.

  4. I think it’s possible that back in the old days of College(late 60’s-70’s) and even High School ,there was that p0rtion of students who seemed to drink and party a little harder than some of the rest. Some of the same people were also involved in a great deal more disruptive behavior than most. Back then we called it the wild and reckless days of youth. I’m not so sure that that was all it was. Especially when we become aware where those people are now and the status of their lives. There’s a lot of things that we don’t get a grip on one way or another until someone defines what that something is and the label becomes well accepted across the dividing lines of our society A necessary evil some say has gone too far in some cases. I’m aware of teenagers and adults who have been diagnosed Bipolar and are on medications to control the ups and downs. A lot of them say the control is about as disconcerting as the roller coaster ride. The issue then becomes a matter of having some degree of normalcy in everyday life and of course functionality.

  5. I think it is overdiagnosed in both children and adults; careful diagnosis usually reveals other disorders. I believe that pharmaceutical companies have influenced researchers to the point where the researchers believe their own crappy research (funded by, guess who, the pharma companies) really validates the Bipolar diagnosis. It’s true that mood stabilizers and other medications may help some of these patients symptomatically, but that doesn’t mean they have Bipolar disorder.

  6. Hi Dr. Burgo, Very informative blog, After Psychotherapy. Nice work, sir. This one really hits home for me, and you’re right, the conclusions you come to are disturbing, and well backed-up. I’m 38 now, was diagnosed in 2000 with schizo-affective disorder bipolar type ii. My psychiatrist and I kept working at it and now, for the past five years I have been relatively stable on 15 mg Abilify, 150 mg Zoloft, and 30 mg Propranonol, per day. I will finally get my BA this summer! In an attempt to answer the questions you pose at the end of the blog, I look back and think I have always been bipolar, and the psychosis aspect came in in my mid 20’s. My paternal grandfather was hospitalized for years for psychiatric reasons I am told, so I would wager that whatever it is I have is at least partially hereditary. As far as the meds, I was thinking I should be grateful they’re out there, but now I’m not so sure. . .Ever read Michel Foucault’s “Madness and Civilization?” Thanks again for a great blog. Look forward to the next one!

    1. Scott, I want to write something soon about the difference between behavior/psychology that is “heritable” vs. something that is in our genes. They’re not the same thing, although people often confuse them and believe that genetic connections have been scientifically proven. As for Foucault, I’ve tried him before and he makes me want to scream. That particular style of deliberate obfuscation in the French school (like Lacan) drives me absolutely crazy. I know there’s something worthwhile and important in what he has to say, but I can’t seem to make myself wade through his prose to decipher it.

    2. Foucault was a bit of a pompous ass, if not a dierct plagerist of Freud and other neo-Freudians. Just from the repetative writting persective–he is sometimes embarassing to read. Gee: “I thing I’ll write a book entitled, ‘the Order of Things,” –not too manic. Luckily,for him, he missed a nice vaca on the “Ship of Fools.”

  7. No one heard about autism 20 years ago, and now we are in what appears to be an epidemic. Is this a similar correlation?
    I have been fascinated with the schizophrenic for years. Is bipolar the transitional phase before schizophrenia? Are they all related to sleep?

    1. I do think diagnoses go through “vogues” where they become much more common, as with autism, as you point out. From my point of view, what has occurred is that autism symptoms in other types of emotional disorders have been increasingly recognized by mental health and medical professionals; sometimes people with those features aren’t fully autistic but receive the diagnosis anyway.

    2. >No one heard about autism 20 years ago, and now we are in what appears to
      >be an epidemic.

      They had heard of “mental retardation”, though, hadn’t they?

      I’m currently enjoying the book We’ve Got Issues. The author started out intending to write another “evil parents, evil doctors, over-diagnosed, over-medicated” book, but once she actually started looking at the data and the people, a very different book emerged.

  8. I had my first depression when I was 18 in 1968. I was hospitalized because I answered the question “Do you ever think about suicide?” with a “yes”. Within 6 months I had my first manic episode and from then on it was manic, hospitalization, depression and short time of being okay until another manic episode came which resulted in hosipalization and then deep depression. In 1971 I found myself hospitalized in the state hospital in Milledgeville where I was given shock treatments. Most of the time I would be given thorizine or stellazine and I was dianosed with every thing from schizphrenia to manic depressive. Finally in about 1977 I was given lithium. It worked. I have had episodes since then but only when I stop taking the lithium. I had my last hospitalization in 2000 and that was the first time that I went into a manic state while still taking lithium; what set me off was an antidepressive my doctor gave me. I am now lucky enough to have a husband who can see the warning signs if I do begin to show signs of becoming manic, and I make sure I stay on my medication. I am very lucky that lithium works for me. Ofcourse there are days when I wonder if I might ever be able to get away without taking it.

    Interesting article, thank you.

    1. I’m glad you have found something that helps. I do think psychiatric drugs have there place, and can really be life-savers for some people. If you don’t mind my asking, what was the year when you were first given Thorazine or whatever drug they prescribed for you?

      1. I was first given thorizine (an orange pill) and stellazine (a little blue pill if I remember correctly) in 1968 during my first hospitalization for depression. I was given thorizine during various hospitalizations for depression as well as for mania. I seem to remember another drug they gave me called mellarell (not sure of the spelling). But none of these drugs ever did any good. The depression and the manic states were only help by time. The only thing that has helped is the lithium. My question to you. Do you think it is possible for a bipolar person to stay “level” without any drugs and if so how? Thanks for your time.

        1. Yes, I do think it’s possible. I’ve worked with people who have suffered from manic-depressive illness and, over time, helped them to stabilize without drugs. It has to do with learning how to bear psychic pain and it takes years. As I discussed in my earlier posts — one about feelings of hopelessness and another on the psychotherapy issues involved in bipolar disorder, the central problem in bipolar disorder is an overwhelming feeling that the internal damage is so great that the only solution is a magical (manic) one. Learning how to bear with the pain of that damage takes time; learning how to take smaller steps to find alternative ways of coping with and repairing it takes longer.

  9. Hi Dr. Burgo, I really enjoyed your article. In my case, it is my husband who is affected with a mental illness – but just exactly what is wrong with him still remains a bit of a mystery.
    My husband was severely abused as a child by his mother – who also had some kind of mental illness. All her sisters were also affected (similar conditions) with 2 dying in state hospitals. Recent x-rays of my husband’s torso found more than 4 “healed” broken ribs. And we know that he did sustain head tramas during some of the abuse.
    Could children who have survived brain injuries suffer from mental illness brought on by those injuries?
    I am sure that the genetic components have an impact. My husband does have several cousins who also suffer silently. Also, as a teen, my husband did take illegal drugs including marijuana.
    While I am proud of the obsticles he has had to overcome, there were/are so many hurtful events in our life. He has zero emotional intelligence. And he struggles to make his share of our living. Expensive choices he makes, he cannot afford. On the upside, he rarely has anxiety attacks anymore. He appears happier, more now than ever.
    He takes lexapro (OCD), welbutrin (depression, max dose) & topamax (for migrains). A mix that has worked for 5 years.
    I am thankful to all the Psyc docs who have worked with my husband. And I would like to ask them to find a way to reach out to the spouse of a patient – to educate them and help them understand the nature of the condition. I need help dealing with my husband and sometimes even just coping on a daily basis.
    And lastly, I preach to my two daughters the seriousness of taking illegal drugs. As you have observed, the increase in bipolar conditions, and other illnesses may well be due to a mix of genetics, home enviroment & drugs/alcohol.

    1. Terry, I’m not sure where you live but in many places there are support groups for the family members of people who suffer from various conditions, like Al-Anon but for other problems as well. Do you have a trusted physician you could ask, or possibly your husband’s medicating psychiatrist?

  10. I responded to a March post today before reading this which supports what I said in my earlier post. While it is clear to me that since early adolescence I’ve had biopolar systems (supported by consistent diaries, journals, and poems) I never had a manic episode or a night of psychosis until wrongly given an SSRI. Nothing nearing that extreme, though lack of sleep probably added to it. When given other medicine, Prozac, I felt another bout coming on because of racing thoughts and reading into things in a rapid-fire way. I stopped the medicine immediately and the racing thoughts stopped. Then they diagnosed Bipolar leaning more to the depressive side than manic. I never had thoughts about harming myself or others, or thinking I could fly or was the Queen of England, but it was very uncomfortable what I was going through.

    An insurance company told me that they don’t cover bipolar illness because too many people land in the hospital which gets expensive for them. My counselor thought I was having a manic episode recently because I was talking so fast…I told her I had had lots of coffee that morning, which was true. My thoughts were clear and articulate, just fast talking. Unfortuately it’s things like this that make me wary of psychiatrists and psychologists these days, though I have to say one cognitive therapist could have been helpful in that he dealt with the motto: “It’s easier/faster to act your way into a new way of thinking, than think your way into a new way of acting.” In other words, get out and exercise, get involved, etc. He didn’t go into early childhood, family issues, but dealt with the now.

    A recent news item was that Catherine Zeta-Jones was admitted to Silver Hill Hospital in CT due to stress-induced bipolarism. Huh? I don’t agree with that all. It has been clear that there is such a thing as sleep psychosis; I remember a case where some guy in England tried to go days without sleep and by the third day he thought he was some famous basketball player. Sleep took care of that problem. I felt it was irresponsible to report her admittance due to the above. You’ve addressed a significant topic, thank you, and one I’ve been trying to navigate since it applies to myself. It’s very disconcerting that I never experienced that degree of wackiness until the SSRI’s and then have come close to that a couple of times thereafter. The kind of manic-ness I experienced was just being suddenly in an up-mood after a depressive mood for superficial reasons, maybe a new date or falling in love, not tackling the depressive thoughts.

    1. Very distressing. It must be painful to think you might never had to go through what you went through had it not been for the SSRIs. I thought the whole Catherine Zeta-Jones thing was indicative of the problem we have in medicalizing everything, turning every mental health issue into a disorder requiring hospitalization and pills. Maybe she needed a nice long vacation and a good therapist instead.

  11. My own experience spans years of depression and hypo-manic states from childhood to being ‘diagnosed and medicated’ in my late 20’s to a decade later of more actively finding a lifestyle of balance that matches my personality and mood/energy fluctuations better in such a way that I have actually almost entirely eliminated medication. I would have to agree that unfortunately the psychotherapuetic approach to treating the experience of mental disorder or imbalance is taking a back seat to the pharmacuetical approach. Diagnosing mental disorder as chronic is fatalistic, perpetuating imbalance within the body through adding a foriegn substance, ie: medication long term does not account for the body’s incredible ability to regenerate, heal change and adapt.

    1. I totally agree.
      I`ve been diagnosed and medicated for a year now , and it has been a heaven sent break from confusion and pain , but nevertheless – I hope to find a way of living with as little medicin as possible.
      But until then , my meds are my lifesaver.

      1. Maybe you’ll be able to taper off gradually without going back to all that “confusion and pain.” I hope you’re getting some good psychotherapy, too.

  12. Thank you for writing this. I went to social work school in the late 60’s and interned at MacClean Hospital. Since that time, the rise of both bipolar and autistic diagnoses have so sharply increased that I have been concerned about lazy and careless diagnosticians.

    While in social work school, I worked with autistic children. These were definitely autistic children, but now children with slight degrees are diagnosed, labeled , and their families don’t understand the subtle nuances. At MacClean, the bipolar young adults we saw (my age at the time) were indeed using drugs, and your suggestion about the effect of drugs and their connection to manic-depressive disorder is validated by my experience. (Of course, there are authentic right on diagnoses of autism and bipolar disorder.) With the autistic children, we did a great deal of non-drug therapy, including music, gentle touch, gentle talk, and active listening. We saw improvements.

    I am concerned about our children now. I see the mothers on blackberries and cell phones with the toddler sitting there just hoping for some human contact. Sometimes in this culture, I feel the easiest thing might be to tune out and distrust, too. I have not done research, as you have. But from my observations, our high use of medications, our faddish way of identifying mental illness, and our lack of empathic psycho-therapy is extremely concerning.

    1. Yes, diagnosis has become very sloppy and over-inclusive, which isn’t to say that true autistics don’t exist or that bipolar disorder is imaginary, as you pointed out. I share your concern about younger parents today. It’s sad to think of those toddlers just craving eye contact. At some point, as you say, they may smply check out.

  13. Very interesting. I read a post where a psychologist diagnosed Charlie Sheen with Bipolar Disorder. It seems to me that “(2) Bipolar Disorder is currently “in vogue” and therefore over-diagnosed. ”
    Addiction is a consequence of trauma. I often think that people who are diagnosed with bipolar disorder could just as easily be diagnosed with PTSD. These are the statistics for child sexual abuse- many people have symptoms of PTSD:

  14. I think as with most things in life its unlikely that the massive increase in bi polar diagnosis/incidence is due to any one reason, but more a combination of contributing factors…
    its possible misdiagnosis accounts for a huge part in this.

    Simple time constraints on over worked Dr that just does not give them the time required for an in depth exploration of the nuances in their patients behavior/conditions.
    Sloppy/lazy diagnosis with bipolar merely being the quick easy option…
    or caring sympathetic but overly cautious Dr diagnosing bipolar “to be on the safe side” erring on the side of caution due to the possibly huge ramification should they be wrong
    and i hate to say it but, in some cases, greed its far more profitable to diagnose bipolar than to tell some one they are moody

    And of course with the symptoms of bipolar being so widely know now there is that fraction of society that will lie or exaggerate their “symptoms” merely to procure an excuse for miss behavior
    or in the case of children parents who will do like wise simply so they have an out… a reason to say their childs behavior is not because they as a parent failed

    Another thing to take into consideration is the “seek and you will find” factor… you see what your looking for

    Life styles/society/the environment even diet is ever changing it is highly plausible that this or an aspect of this may also explain an increase

    The illicit drugs factor is difficult as there is always that chicken or the egg factor… is the incidence of higher use merely an attempt at self medication?
    I feel i have to mention that i have had bipolar all my life although of course i was not diagnosed until early teens, medications were fairly ineffective, leaving me foggy, unable to concentrate or create. As i entered mid to late teens i like many others “experimented” with hashish, smoking it socially fairly regularly for around a year or so, iv got to say that although this would be considered the “wildness of youth” it was possibly the least “wild” time of my life… the incidences of both the deep depressions and (rather perversely) the highs mellowed with a greater space of time between them

    In incidences where it is said that there was no bipolar before drug use, one thing i have noticed with my bipolar is that with or with out drugs every 4-7 years it “morphs” .. it could merely be a case that for some the symptoms were milder and over looked prior to drug use, and diagnoses after drug use merely a result of a normal progression (morph) of the disorder

    All good things must come to an end though and as i started thinking of having a family i stopped using hashish and the bipolar returned as strong as ever and i struggled with it for years, various medications that left me ill foggy or just simply did nothing.
    Lithium did once work when i took it well over a decade ago… but… and i know this is silly, the effect scared me, keep in mind i had grown up with bipolar and knew nothing different other than when i was on hashish… so to me waking up in the morning smiling meant, to my mind, that i must be high or manic, no one had explained to me that this could be considered “normal”. Happiness with no cause/reason was something i had only ever experienced whilst in a manic state or whilst using hashish… both of which in societies eyes are bad/wrong/evil a sign of mental instability and something to be avoided, and so i ceased using it … when questioned years later on why on hearing my explanation a Dr suggested we try it again, this one patiently explaining that happy for no reason was ok but unfortunately the lithium no longer had the same effect

    If i may digress from the subject of the article for a moment, something you may find interesting, a number of years ago i developed a few mass’s. (one on the thyroid, one on the adrenal gland) since then the bipolar (curiously) has been minimal, perhaps even milder than when i was using hashish, or when the lithium worked.
    I’ve went from….
    ….. rather regular periods of mood swinging, from the seven pits in the depths of hell going through suicidal tendency out the other side to feelings that even death wouldn’t help or ease pain (or that i deserved this pain and did not deserve the escape), and its flip side of weeks with little sleep and extreme activity (were talking decorating,revamping,remodeling the entire house in the nude in three days kinda thing whilst dashing off 4 canvases and wanting to copulate with anything in trousers)….

    ….now days … i get a little blue sometimes and have occasional bursts of inspiration, got to say with such a drastic change i find it hard to believe the occurrence of the mass’s and decrease in bipolar are unconnected (although i do doubt it will become a popular cure lol)

    apologies for the length it seems i have a lot to say on bipolar

    1. The link between the masses and your bipolar is fascinating. I wouldn’t be surprised if there were a connection, though a highly complex one that could be reduced to insufficient or excessive amounts of one particular neurotransmitter. And I agree that the increase in frequency of bipolar disorder as a diagnosis is due to many factors.

  15. I was put on an anti-depressant in 1996; within 6 mos. I was manic & as a result, I have been on too many medications to list (or remember). My personality has changed so much I’m not who I used to be & for years, I was literally lost. Unfortunately, my kids are the ones that suffered the most as their mom was MIA. Thankfully, they are very forgiving & our relationship is still in the healing process, it always will be.
    I was diagnosed with bipolar disorder & have been on SSDI since 2002. I’ve got a really good therapist & we both believe I’m not bipolar, but suffer from depression & Borderline Personality Disorder. In the past 10 years I’ve been hospitalized numerous times for attempted suicide & depression.
    I can remember being depressed ALL of my life, and I’ve also had the symptoms of Borderline Personality Disorder as far back as I can remember. I did use illegal drugs from the time I was 13 until I was 27; when I was an adult, the drug use was to feel “normal,” how I thought other people felt & just to fit in. I wasn’t partying, but was working F/T, raising 2 kids & just happened to be a heroin addict.
    I quit taking anti-depressants in August 2010, and currently just take 900 mg. neurontin for mood stabilization – a great part of why I take it is the fear of withdrawal & affect it will have on my body. I also take klonopin when needed, but I try not to take it.
    I hope I don’t sound like a mess because I’ve made so much progress. I really have my therapist to thank, and even though his office is 90 miles away, it’s worth the drive.
    I think bipolar disorder has become the “catch-all” for mental illnesses now. I have a lot of friends diagnosed with it & all have been on crazy psychiatric cocktails, in my opinion, those can be as dangerous as any illegal drugs.

  16. I recently dated someone who claimed to be bipolar. After three months in the relationship, I came to the conclusion that she wasn’t bipolar, she was just nuts (in the non-clinical crazy-b*tch sort of way, if you get my meaning).

    I personally have a concern that a great many issues which are being medicated these days are not nearly as serious as they claim to be; [please don your tinfoil hat now] I honestly think that the drug companies are trying very hard to convince people that they NEED medication for this or that, in order to make a profit. Otherwise, why is it that in the last five or so years, there has been a sudden explosion of television adverts for medications which MAY treat conditions that are easily self-diagnosable?

    Do understand – I’m not in any way saying that there aren’t people out there who DO have these conditions and who DO need help/medication/et cetera. I myself was diagnosed three years ago as ADHD (combination type). But I spoke to multiple doctors and was assessed by a psychologist before I began medication. I think a lot of people just drop by a pill-pushing GP for a quick pharmacological remedy to their bad day or their situation-related sadness.

    1. As you can imagine, I’m very much of your point of view. What concerns me most is your last point — the indiscriminate writing of prescriptions by GPs who do not undertake a thorough psychiatric evaluation of their clients beforehand, and then don’t follow up on results.

  17. I am one of those Bipolar people that have been effected by marijuana. It’s deadly effective at “waking” those inner emotions and making the internal into something external. I believe it’s not only the marijuana that caused this, as BPD is genetic as well, but it certainly fueled the fire. Manic Depression is a powerful perspective on life that happens when the brain is set to interpret reality permanently differently.

    The system that western society has in place to treat these destabilizations of the brain certainly deals with it the best they can, but many things are lost in a system that tries to treat an almost purely emotional distressed patient with cold hard psychiatry and book logic. Bipolar Disorder is not that simple, and requires trusted individuals that won’t disregard delusions as signs of another pill, or episode, but people that want to know why these symbolic decisions and connections have been made. The main thing that I’ve noticed is Bipolar individuals not having the language to articulate their ideas, and doctors taking that as a sign that the illness is acting up. I’m lucky, as I am highly educated in the basics, and am now able to express ideas. Many of the Bipolar patients I’ve talked to have an intuitive understanding of high physics concepts that if they talked to an advanced scientist, the scientist would be able to decipher a patient’s ideas and give them a language to use. Or, they could talk to an artist about the symbolism that they experience. Or a religious leader for the religious experiences. These are misguided and misplaced souls in the journey through life that are being shown by their own brains their pathway through it, and should not be marked as insane, but mentally destabilized and shown a way to survive in our overstimulating environment.

    I find medication a reset button on the mental realization scale. That is, for now, in this age, medication is needed to suppress the ideas and actions that the Bipolar people might take in desperation at being so different until we can find a way to safely regulate our minds and be at peace in our environment.

    1. I think a background in medical science is one of the very least useful you can have as a psychotherapist. It helps you to rule out organic causes, but does nothing to guide you in understanding the emotions and ideas of your patients. I entirely agree with your remarks to that effect. I also agree that medication can work as a “reset” button — nice way of describing it — which can help severely depressed people stabilize. As long as we understand it’s not a permanent solution and that long-term usage has drastic side effects.

  18. Call me a conspiracy theorist if you will however, I believe that this is just another way to medicate America against rising up, to fight for what is being done against them on a very broad scale. One of the things I noticed in my research on anti-depressants alone, they all have one common side-effect … apathy. I believe for people at this time in history, it’s very “normal” to feel depressed, normal to feel elated when something finally goes as expected. I keep hearing reports of people who go seeking relief, never get to see a therapist, only to have the doctor prescribe something that’s addictive (even though the bottle and the doctor say it’s not) and possibly causing permanent brain damage. That Monsanto, Abbott Industries, Forrest Pharmaceuticals ad infinitum, are all in cahoots with the FDA. I’m not buying into any of the propaganda. I think it’s all a ploy to keep us from standing up and being counted.

    1. In his book PROZAC BACKLASH, Joseph Glenmullen has a lot to say about the revolving door between Big Pharma and the FDA. Whether or not they’re “in cahoots,” as you say, there are huge conflicts of interest that do the public a great disservice.

  19. I could drop links to several websites listing the “cahooting” and documentation however, I would also rather you found your own sources for this information. Here’s a hint though –> start with Stop the Thyroid Madness, then look around.

    I have to point out the many commercials I’m now seeing about birth defects being associated with several (mostly psychotropic) drugs, that have been on the open market for several years now. The backlash is huge.

    The drug companies spend a lot of their subscriber’s money on promotion of certain drugs all over every type of media that a person might run across.

    Last but certainly not least, is Monsanto’s push and the FDA’s endorsement of removing any and all labeling, that might indicate that a food source might be GMO. I’m sure you’re aware that after the Haitian natural disaster, Monsanto offered them seed product “free of charge”. The Haitian’s objection to this was so strong, they burned all Monsanto related products.

    The information is there, to prove Corporations are conspiring against the consuming public, to gain profit even at the cost of human life. There’s even proof of it at the Library of Congress website and

    The thing that irks me the most though is this; I once had to explain to a doctor that pain is the body’s way of telling someone that something is wrong. With the way things are in our nation, wouldn’t NOW, be the appropriate time to be depressed or angry at the way things are going?

  20. The almost hallucinatory level of psychosis experienced in a manic breakdown, goes beyond qualification as a “mood.” Mine were experienced before use of drugs. In your Bipolar video, comparing the character in the movie as “feeling like a pice of shit, or that life had passed him by” was not accurate for me. I felt a victim of circumstances, that found my life at that point. Unfortunately the other helpful pill in the film has yet to be manufactured. It’s my manic side that qualifies to me as the real illness. The was in denial about the depression, but learned it was there as well.

    1. Feeling like a “victim of circumstances” — I wonder what that means. Sometimes I have found (and I’m not saying this is true for you) that people resort to a kind of self-pity/sense of victimization as a defense against feelings of shame.

  21. I recently saw an interview with Sinead O’connor, who was diagnosed as “bi-polar.” In the interview, the interviewer asks her, “isn’t bi-polar when you have extreme highs and extreme lows?” Sinead explains that she never had any highs, just terrible lows.

    So then they was she diagnosed with “bi-polar” instead of uni-polar or simply clinical depression?

    1. This is what happens when a diagnosis becomes “popular”; all of a sudden, the incidence of the illness turns out to be much more common, because doctors are sensitized to the label and using it more frequently, and often incorrectly. Sounds like she was depressed and needed help, no diagnostic label necessary.

  22. This post validated me.
    I am sure that wasn’t your intention, but it did it all the same.

    I come from a family riddled with mental illness the way some families pass on noses. At 18 I had my first manic episode, flew across country, left my husband and child, school and job to prove my God given genius.
    I was given lithium and it stabilized me.
    Later, at 20, I was hospitalized three times, in three months, for self harm, a suicide attempt, and prescription drug abuse respectively.
    I was given risperadone, geodon, haldol, klonopin, anafranil and a higher dose of lithium and a new shiny diagnosis of borderline personality disorder to go along with my bipolar 1.
    Needless to say, my “bad” behavior ceased. Pretty hard to be irritable if you can’t even stay awake.
    I was introduced to therapy. That, I believe, is the first thing that should have happened.
    Now, I am off of all medication. I have learned to sit with my moods/emotions/feelings/thoughts/ and not act. I still get my highs, but now I spend my time intentionally, deliberately, and rationally.

    I still have Bipolar Disorder, but I can control myself.
    Most days I wake up OK and I go to sleep OK. Some days I am fantastic and others I am volatile, but I don’t do stupid things anymore. (Little known fact: You can choose how you behave.)

    So, many thanks.
    I enjoy the blog.


    1. Thanks, Kendra. I, too, believe in the power of choice. One of my many objections to the current medication craze is that it instills this notion that you are powerless because of your “chemical imbalance” — that is, you have no ability to choose. Sometimes it takes a while in therapy before you understand yourself and your feelings well enough to be able to see what the choice actually is, but it’s definitely possible with hard work.

  23. I find your comments about ssri’s and the fact that they can induce bipolar-like symptoms interesting, as that happened to me a few years ago. I never had bi polar disorder, but did have a bout of depression- I was on Zoloft for a number of years and was afraid to go off of it because I was afraid the depression would come back. When I went off of the Zoloft, I did great for awhile, but about a year later, some stressful life circumstances began to take a toll on me, and I began to experience anxiety and depression again. I tried to go back on the Zoloft, but when a doctor gave it to me, it made me have panic attacks, HORRIBLE nervous system problems, and I will NEVER touch the stuff again! It took my body more than a year to recover! I take the smallest dose of Seroquel at night to make me sleep, as sleeplessness has always been a problem for me, and it seems to keep me from getting depressed as well- I have felt great since starting it and will never ever touch ssri’s again!

    1. What most people don’t understand is that psychiatric medications do not correct chemical imbalances; they create them, and when they do, all sorts of bad things can happen. I’m glad you found your way out of that trap.

  24. Me han diagnosticado bipolaridad hace unos diez años. Ahora tengo 47. Estoy convencida que todo viene de mi infancia. Siempre me he sentido incomprendida y marginada por mi familia. Esto hizo que en la adolescencia empezara a beber y a fumar porros. Busqué psiquiatras y psicólogs desde los 21 años y hasta los 32 no encontré una buena psicóloga (terapia dinámica) y estuve con ella 13 años. Lo que pasa que ella trabajaba con una psiquiatra y me recetó antidepresivos y ansiolíticos. Entonces al cabo de 8 años tuve un “transtorno bipolar” y me encerraron en un psiquiátrico. Y allí me dieron litio, antipsicóticos, etc. Luego me dieron antipilépticos. Y al cabo de 7 años he vuelto a tener un brote. Ahora estoy con un terapeuta fantástico (análisis bioenergético o terapia psicocorporal). El está convencido que no soy bipolar. Que me he sentido toda mi vida incomprendida y abandonada por mis padres. Ahora empiezo a sentirme más viva y quiero dejar la mediación (poco a poco)

    1. Peter Breggin escribio un libro (Your Drug May Be Your Problem) que explique como dejar la medicacion poco a poco. Despues de tomarla muchos anos, es dificile pero no imposible. Es buena suerte que finalement Vd. encontro un terpeuta que puede ayudarte!

  25. I hadn’t experienced a manic episode prior to being prescribed the anti-depressant amatryptaline. For 12 years my life resembled a typical ride for a person with Bipolar: suicide attempts, addiction, hospitalizations, manic episodes and then finally the diagnosis and treatment with Lithium.

    After 10 years on Lithium, I began a new journey that eventually led me to be medication free and experiencing zero symptoms. I’d like to add that weening off of Lithium was done with the support of both my Pdoc and Therapist.

    For me the process was threefold: Stabilization, Recovery and then Healing. Stabilization came through Lithium. Recovery came through implementing meditation, supplements, exercise, a very healthy diet, no caffeine, no alcohol, no pot, lots of water, quitting smoking (I call all of this “Brain Health” and I made up the acronym M.E.D.S = meditation, exercise, diet, supplements…to focus myself). The Healing was interspersed throughout twelve years. The further I recovered my brain health, the more access I had to my root issues that caused the imbalance. I call this aspect “Mental Health”.

    Shame was a huge player in my dysfunction. It resides in my early child identity. My teenage/adolescent identity was damaged through a break in belonging – belonging so important in this time of development. My adult identity gained terrific strength through me understanding these distinctions and hearing when shame is present especially. When the child (shame) or the teenager (hurt) are in control, I (the adult) is not.

    So, I literally focused on healing my brain. For that I had to have a paradigm shift because I’d been initiated into the paradigm that I had a chronic mental illness caused by genetics and that the best I could do is passively comply with medication treatment. This perpetuated my shame, created more imbalance in my brain, and disempowered my Adult identity that really needed to be the main resource for actualizing my own healing.

    The brain can change. I have power. I can heal.

    But to think I didn’t have the help of a damn fine therapist would be naive. Of course I did.

    Warmly, and thank you,


    1. That’s an inspirational story, Diedrich. It’s so good to hear that people can recover from the damage done by these medications. Of course it takes strength of character, self-discipline and good professional help but it’s possible.

  26. Goodness–this has me written all over it. I converted–from chronic depression treated w/SSRIs (mostly Prozac until it stopped working, then Wellbutrin and several others) while in weekly therapy for a few years. About 6 years later I crossed over into bi-polar II w/psychosis (treated with the wonderful neuroleptics–Geodon for a decade AND wellbutrin, lexapro AND prozac). And I was abusing Adderal and methylphenidate (had been prescribed it for ADD-inattentive) the entire time (even though I was in recovery for decades–mostly for heavy pot and stimulants–in an incredible case of denial).
    None of these worked, that is, stopped the depression. I find it curious how prescribers focus so much on the mania when the depression is what is generally most crippling. But I kept taking them.Why? Because I wasn’t ready to do anything else, to make choices; it is easier to take the pills (and to keep the stimulants coming, of coure).
    And then–a new prescriber decided litium was what I needed, only he didn’t “clean me out,” and I was hospitalized for several days with serotonin syndrome. I didn’t know at the time how serious and deadly that was.
    After that the real fun began–I was taken off of all the meds (though I still kept my stash of Ritalin) and began the hell-ride that is rapid cycling bipolar illness. Before, my mania happened once, twice a year for a couple of days, and was felt like a very positive experience. With the rapid cycling, I became an angry, rageful, irritable and aggressive person; I would keep myself at home because I was afraid I’d strike out at strangers. Sounds became louder, more grating. I felt this pressure, as if my skin was going to split.
    And that’s when I got Seroquel. Seroquel (and Geodon, too) thickens the mind–it is as if someone removes a precious jewel from you and you didn’t even know it was yours–or its value–until too late. I staggered, I slept, my mind was muffled. And then I received Abilify–and started word searching, misspelling common and everyday words.
    And that’s what made me change. I am a writer and editor, and I was afraid; I was losing words. So I told the prescriber I had to get off of Abilify, that I was being made dumb by this drug, that the others had raised my weight and my blood sugar (w/a family history of diabetes, which he knew), but I couldn’t risk this. And he told me, “You’d better get over it; you’re gonna have to be on these drugs for the rest of your life.”
    I researched how to titrate down from *all* of the drugs, and I did. I have been free of them for 2+ years; my mental health is better than its been in a very long time, and I’ve changed what I eat, I exercise regularly, meditate, don’t work like a maniac, and made other changes. I also take numerous supplements, which change over time.
    The biggest piece is being willing to own my responsibility for my health, and also to let go of my long-standing belief that prescribers knew and know best.
    Yes, I do have some depression, and ocassional mania but no rapid cycling, thank goodness. In fact, I think I’m just a normal person with some challenges.
    As you see, my story does fit the profile that Whitaker and you have described–anti-depressants, drug use, and depression = bipolar illness. I’d be interested in the number of people who did an Uncle Ben (converted) while only taking anti-depressants, and whether the length of use is a factor.

    1. I have so much respect for the decision you made. We live in a culture that holds the prescribing physician knows best; as you found out, it’s far from true. I get especially riled up by the ones who say “you have to be on these drugs for life.” Good for you!

  27. Thank you for your article, and your openness.

    I think much of the change in statistics you cite have to do with the fact that social structure is so much more flexible these days. When people didn’t move around so much, they knew people, and had a built in support structure of people who would drag them out to do things when they weren’t being sociable, which is incredibly important. Now you could hide out in your house or dorm-rooom, and be undisturbed. And the idea that Bipolar is or isn’t a life long illness depends on your model of the illness. If you class mania as a one-time nervous breakdown in your early twenties, and your resulting, low-grade depression as “working out your life”—then yes, it is not life long. Unless, of course, you have another episode. But still, these are isolated episodes. If you instead see it as a cyclical pattern with the potential for an episode, your model changes. I think that second model describes things better, provided someone diagnosed recognizes that they will have to make changes (and I don’t mean lowering your aspirations).

    I’ve been diagnosed with bipolar, and at this point, the meds are working for me. I’m also a very firm believer in lifestyle changes–going to bed at a regular time, getting up, having habits, things to do and places to be. In some ways I’ve become over vigilant—daily mood tracking, recording who I talk to, how much exercise I get, and how much sleep. I’m hoping that any problems that show up, will show up in my mood calendar, and at least I’ll have something to refer back to after a crisis and have a tool to have an intelligent discussion with my psychiatrist. So far, so good.

    I think a lot of what I’ve read in the comments has to do with people’s perceptions that being diagnosed with bipolar is somehow worse than being diagnosed with major depression. Either can be life threatening without treatment: whether therapy, medication, etc.

    I think part of the problem with being bipolar these days is you actually could be up all night and have something to do. There are very old studies (very small scale) of controlled darkness alone curbing mania. That’s not the method used these days as we have antipsychotics and lithium etc….but there’s something to be said for turning out the lights. If you can’t do anything, you can’t get more worked up, and perhaps you’ll sleep. And sleep really is the key. We now have the internet, and computers, and smart phones and facebook, TV, and blogs, and if you have poor impulse control, and don’t know when to stop, these things can become a problem.

    And I’m not sure if all suffering has a point. I am incredibly grateful for how full and interesting my life is now, but I don’t think I need to go through another period of blankness and disconnection to be grateful. I don’t think sadness and depression are the same thing. If you’re sad, you’re unhappy, but you can still connect with other people. Depression, not so much.

    I think the kind of therapy I’ve seen described in your practice sounds very useful for someone who is well, or someone who is depressed, but still well regulated. I can’t see it helping someone whose life is completely out of whack. For someone with an erratic life, scheduling, figuring out activities, helping to set reminders, helping to negotiate relationships, teaching mindfulness techniques, and advocating for a full and meaningful life would be much more useful. And then, perhaps once that is under control, all the problems that were overwhelmed by the mood-swings would come to the fore, and the sort of fine grain analysis that you do would be useful.

    1. In regard to your last paragraph, I have spent my entire career working with the very people you believe wouldn’t be helped by the kind of therapy I practice — people diagnosed with “bipolar disorder” and “borderline personality disorder”.

  28. I was diagnosed with bipolar after being on an SSRI. I was told repeatedly that the SSRI had alleviated my depression, and that’s why my bipolar showed up. I was prescribed an anti-psychotic in addition to the SSRI, I was told by 2 seperate Dr.s that my new onset of Bipolar was permanent not related to the SSRI and would never go away. I didn’t take the new prescription, I quit the SSRI cold turkey, most unpleasant experience I’ve ever been through. Immediately my symptoms got a lot worse then slowly began to fade and 9 months later I recovered fully from the SSRI, and my bipolar symptoms went away, permanently. I’ve done some research and I have noticed a huge correlation in statistical data that points to an extreme increase in bipolar diagnosis numbers shortly after SSRI’s came on the market. The correlation is so obvious, why is modern medicine ignoring the facts? SSRI’s are causing bipolar.

    1. Because the pharmaceutical industry has spent millions of dollars promoting the illusory benefits of these drugs, because the APA has bought into the disease model of mental illness for financial reasons, because doctors are over-worked and don’t know what else to do, because people desperately want to believe you can cure emotional pain with a pill …

    2. Hi Mitch,
      Is there any way that I can get in touch with you through email? I found one of your posts on another web-site and would like to talk to you further about your current situation. I am in agreement with you regarding the correlation between SSRI’s and bi-polar diagnoses. I believe the two are linked as I have had similar experiences myself.

  29. my ex boyfriend is bipolar and like so many I’ve read about (I “attend” an online support group) he has been smoking pot since the age of 12, daily. He would quit at times only to return to it. I am not sure when he was diagnosed as bipolar but I always felt uncomfortable about his relationship with pot, especially as a 45 year old man. He told me many lies to cover up his usage and I now know its the most important thing in his life. He is currently deluding himself into believe he is not a pot smoker by sticking to the chemically created and “legal” alternative, spice.

    In talking with oter significant others of bipolar sufferers, it seems the addiction portion is always significant (at least in those of us who are suffering due to our partner not being stable).

    I find it so sad how many think the pot is helping them when it could just be part of their continued deterioration.

    This is part of what has made me decide he is not a viable life partner. It’s not the bipolar as much as seeing that he will probably continue to deteriorate without much of a fight.

    He is also taking prozac. I’ve voiced many times I think it has been in part a reason his anger and rage has been hard for him to control.

    He’s refused to listen or read about the topic, I believe partly because he’s terrified of being depressed or having negative feelings.

    1. Now that I’ve read several of your comments, I see that you are very focused on this ex-boyfriend, probably in that hyper-empathic rescuing mode we’ve talked about. It seems to me that you need to work hard to move on and focus more on yourself than on him. You can’t save him, as much as I can see you’d like to.

  30. do you think there are dangers with ‘natural’ anti depressents like SAM-e or fish oil? Just curious.

    I was taking SAM-e for awhile (I still am but reduced the dose greatly compared to what I read was used for depression).

    It did seem to ‘push’ me in the other direction after a certain amount of use and I found it quite scary since I’ve never been that way. For instance I found myself in Vegas gambling. I do like to take off to Vegas but I’d never been much into actually gambling. I could easily tie it to life events and even influence from others or just me having a different type of fun than usual and of course hoping to win. It still seemed a little odd to me the way it seemed to consume me.

    1. Honestly, I don’t know much about SAM-e. I think the jury is out on the benefits of fish oil, but Omega-3 fatty acids do seem to play a large part in healthy brain function.

  31. My psychiatrist recently told me that virtually any other diagnostician would have concluded that I am bipolar. I’ve read over the diagnostic criteria and, yeah, I fit it to a T. But I agree with my psychiatrist, I’m not bipolar. I’m just someone who is running away, as you would say, from my shame and becoming then “manic” in my work. When running away doesn’t work, I fall into myself into a depression because I turned out to be a failure no matter what I tried to do.

    Whenever he has prescribed or altered my medication, my psychiatrist has discussed in length the side effects, and one of the ones he mentioned was, paraphrasing, “If I’m wrong and it turns out you are actually bipolar then this will trigger a manic episode and you will need to notify me immediately.” This has led me to believe that mis-prescribing medication does not create bipolar disorder but rather to expose it.

    If it is true that the incorrect medication can cause those with bipolar to become worse, then it shows that prescribers need to be extremely careful. And I think its clear that prescribers are not being careful when it comes to dispensing anti-depressants. My psychiatrist is also a psychotherapist and he did not prescribe me any medication until after we had been working together for a month, I imagine because he wanted to ensure he prescribed the correct medication. Prescribers need to be thoughtful like that.

  32. Dr.s and drug manufacturers have done countless numbers of studies and preach constantly about how people with bipolar tend to self medicate with alcohol or marijuana, leading them to believe that these substances are responsible for creating bipolar in people. However if there was any causal effect to individuals developing bipolar becuase of drug abuse we would see an increase in the numbers of cases in areas of the world that allow marijuana or rampant alcohol abuse. This isn’t the case. However if you look at the numbers there is a direct correlation with a more than 100% increase in bipolar diagnosis and cases that correlates with the use of SSRI medications. Unfortunately for the victims it’s almost always a permanent condition.

  33. I had my first manic episode only after taking Zoloft (SSRI) around age 20. Prior to that I was only very anxious and depressed (since around age 10). I was put on mood stabilizers after the first manic episode and was told by psychiatrists that the SSRI triggered the manic episode. Four years later I took Lexapro for 3 months (I had still not been “diagnosed” Bipolar yet) and experienced a very severe manic episode that lasted about 3-4 months. I was then diagnosed bipolar but since then have not experienced any manic episodes. That was back in 2008 and now it’s 2016. I am just wondering if I even need the mood stabilizers I am taking now, since they tend to make my depression worse. So far this article and most of the comments seem to be making sense and are consistent with what I have experienced.

  34. Thank you for this! I’m just reading it here in 2016 because I still struggle with whether I
    a) am bipolar or not and b) accepting either case.
    So, I’m back on the hunt for balanced views. Grateful you have one!
    I experienced my first major manic episode at age 32, shortly after stopping alcohol.
    I stopped for a few days or weeks, started again, stopped again over and over for 3 years)
    (I’m in AA for that now for over 8 years this time around)
    I remember having several episodes, drunk and not, where I felt “mild” elation for no good reason deep emptiness (not a feeling) also for no discernable reason.
    In between, I responded to ups and downs of emotional reactors as any other person might.
    My mania state changed overnight (literally) into what I might only TRY to describe as a psychotic depression. Again, not a feeling… a state. In that state, I attempted suicide-seriously slashing my wrists to the point of floating tissue in the tub. (sorry… might be tmi)
    I awoke to my parents and a psychiatrist trying to comfort me with the jointly surmised and agreed upon diagnosis of bipolar 1 disorder.
    (My parents were a much much better source of manic evidence…we don’t tell about that.
    We just enjoy it)
    In short,
    Lithium. Got lethargic and fat after 2 years of success)
    Depakote made me crazy. Discontinued AMA.
    No episode for 2 years.
    Then disruptive but not as extreme mania. 2nd serious psychotic suicide attempt.
    New doctor rx’d Lamictal and Prozac.
    Dropped the Prozac 1 year later when insurance stopped covering.
    Now on 300 mg Lamictal for 16 years.
    Perfect except for mild “breakthrough” episodes but tolerable and managable with
    therapy and careful watch of diet, excercise and sleep.
    STILL want to stop meds! (common amongst us, although true bipolars are rare in my
    experience and opinion too.)
    So, back in therapy with a WOMAN this time.
    So many more details over all those years, jobs, marriages, men, money etc…but I’ll stop.
    Just thought I’d drop in a case you specifically asked (:
    Sad but stable

  35. PS
    I wholeheartedly agree that it’s overdiagnosed (especially self diagnosed from pharm ads SELLING it and pushing drugs!), overtreated, too often a ticket for disability and more.
    sad but stable

  36. Bipolar Does not run in our family,
    My son used marijuana in college at age 19 along with lot of stress and trauma with some network marketing job and had a depressive psychotic episode.

    He was not on medication for two years.
    He acted strange and got a lot into spirituality and recently had a manic episode and is on depakatone 750mg.

    Doing great after two months of medication. He was never moody even prior to treatment, but acted strange like he could not see the world clearly.

    He was always a great happy kid and never depressed. We strongly feel it was the drugs that made him bipolar.
    As he is never depressed and always a positive person,
    Can he successfully come off meds ??

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