Not enough bipolar disorder in low income nations spin doctors complain

The USA, at 4.4 %, has the highest ratio of lifetime bipolar disorder in the world. This factoid was exposed recently by a study of 11 nations published in the Archives of General Psychiatry. Unfortunately, rather than seeing the obvious, this study has been slanted into a shrewd maneuver to expand prescription drug markets. At the same time, you can be sure that if drug companies expand those markets into the developing world, the bipolar rate in low income countries is going to go up correspondingly. Why else would an article on this study, missing the statistic from the USA, bear such a misleading headline as Bipolar disorder vastly undertreated?

The eleven countries included in the study were:

Her team conducted surveys of adults in the United States, Mexico, Brazil, Colombia, Bulgaria, Romania, China, India, Japan, Lebanon and New Zealand.

This is the same study that gives India a bipolar disorder rate of .1 %.

There are many reasons for the high rate of bipolar disorder diagnoses in the USA. Let’s cover a few of those reasons. There is anti-stigma campaigning, mental health screening, direct to consumer advertising, psychiatric drugs that trigger mania, etc. Direct to consumer advertising is legal only in the USA and New Zealand. When it comes to direct to consumer advertising, you can’t sell a drug without also selling a “disease”. Mental health screening tests are often designed to discover depression. Mental health screening tests have incredibly high false positive rates. Psychiatric drugs used to treat depression trigger mania. What is so often taken to be bipolar disorder misdiagnosed major depressive disorder is more often than not actually a toxic reaction to certain psychiatric drugs.

Not that long ago, in the 1990s, a Harvard psychiatrist with financial ties to the drug companies developed a theory that much ADHD in this country was actually early onset bipolar disorder. Shortly thereafter it was found that as a result of this change in perspective the childhood bipolar disorder rate in this country had shot up 40-fold. Those psychiatrists in charge of editing the future edition of the DSM, the DSM V, in what looks like a strange case of damage control, have come up with an entirely separate juvenile mental disorder to cover some of the young people who might be so labeled in the future.

Back to the spin put on the study.

They found that less than half of those with bipolar disorder — also known as manic-depressive illness — received mental health treatment during their lifetimes. In low-income countries, only 25.2 percent of bipolar patients said they had any contact with the mental health system.

This begs the issue of what the bipolar rates are in poor countries as opposed to in the developed world. If, as in India, you’re talking 1 in 1000 people, investing in mental health treatment might also prove a way of investing in “mental illness”. Let me be the first to point out that an investment in psychiatric disability, and an investment that would certainly mean more psychiatric disability, is probably not the best kind of investment to make.

Three-quarters of those with bipolar disorder also met the diagnostic criteria for at least one other disorder, with anxiety disorders being the most common shared illness, the team found.

More than ½ said symptoms started in adolescence.

Co-morbidity (multiple diagnoses for a single patient), in the mental health treatment world, is invariably a result of over-diagnosis. The diagnosis of co-occurring disorders we see here serves merely as an excuse for polypharmacy, or the prescribing of multiple psychiatric drugs. It should come as no surprise to anyone that drug companies profit from polypharmacy. It may though come as a surprise to some people that the practice of polypharmacy is notorious for its lack of good outcomes.

Skip this therapeutic version of over kill, spare the patient, spare the country, and spare the world. The gig is up! We know that the treatment pushers of the psychiatric state are desperate for more treatment junkies. The real, and underplayed, story here is still that bipolar disorder rates are so high in the good ole’ US of A.