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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.

4 Responses

  1. As a consumer of mental health services, and a state certified peer specialist, I would like to protest the following term found in your article: “bipolar patients”. It is very important to recognize all who suffer from a mental illness as “people first”. We are people, not our diagnosis. In my opinion the correct terminology should be “patients suffering from, (or diagnosed with), bipolar disorder”.

    Thank You,
    Terry Findley

    • As a survivor of mental health services, and a human rights advocate, I can see your point, Terry. I personally don’t believe the “bipolar” germ to have much of a tangible existence at all, but some folks are bound to disagree with me. Finding the right language to use has always put me, and others, at a serious disadvantage on these matters, and I am one who has, in fact, been lumped into the catch-all “schizo-affective” labeled bag in the past.

      The only “bipolar patients” that I see, you will notice, is contained by blockquotes, and so I’m actually quoting from an article I am referring to in my post. This was the article from Reuters new service that bears the heading, Bipolar disorder vastly undertreated: study, and it was reported by one Julie Steenhuysen. Her editor is listed as Cynthia Austerman. They are the people behind this expression, and not me. I was quoting. If you want to criticize this usage, please, address your arguments to the person who is using the expression, and not to the person who is merely quoting. Thank you.

    • Yo Terry.

      I think that it can be perfectly acceptable to describe a person as a fucking loony. If a doctor or a cop or a magistrate asks me why I have described a person this way I can tell them.

      But it is NOT OK to say that a person has schizophrenia or bipolar disorder.

      If a neighbor has a smelly house, owns a hundred cats and dances naked in the backyard at midnight on a full moon, I can say, “That woman is crazy.” But it can never ever be in any way useful or of any real benefit to anyone to say that she suffers from schizophrenia or OCD or any other psychiatric diagnosis. Even to say that she might have a personality disorder would be to say absolutely nothing. If you want to say anything about such a person say, “She’s crazy.” If someone asks, “What do you mean?”, then you can tell them what she does. There is no way that I can say anything about her brain and how her brain state can be the cause of her behavior, and neither can ANYBODY else.

      Workers in the field often lie somewhere between two camps. Some believe that the person has a medical condition and that drugs can be used to treat a chemical imbalance. Many don’t believe that there is any medical illness but advocate drug treatment for the sake of political expediency, ie drug a person for no other intention than to make them more manageable. Most workers oscillate between these beliefs yet generally refuse to discuss or even privately consider the conflict and the absurdity of their own thinking.

      The psychtroopers have a horror of political incorrectness but see no problem in dismissing, drugging, assaulting and humiliating people.

  2. When PC interferes with “calling a spade a spade”, as the expression goes, then I say fuck PC.

    I see schizophrenia and bipolar disorder as insults or names applied to people by psychiatry. I’ve never seen a person said to be schizophrenic or a bipolar disorder sufferer who wasn’t a human being. I think people often use the terms schizophrenic and bipolar disorder on people expressly in order to downplay the fact of their humanity. I’ve never in my life seen a schizophrenia or a bipolar disorder. I’ve only seen people who it was claimed were beset by this or that “disorder”.

    Madness and craziness are words that were used before the introduction of the term “mental illness”. “Mental illness” was used because it was thought that by treating madness as an “illness”, people would achieve better treatment thereby than they had previously received in history. Apparently this trend has run full circle as now people are attributing to the “mental illness” label a “stigma”. This “stigma” is supposedly preventing more people with “mental illness” from coming forward, admitting they are “ill”, and receiving treatment.


    The USA is the epicenter of a worldwide epidemic of “mental illness”. The USA is the biggest manufacturer of “mental illness” in the world. There are more people labeled “seriously mentally ill” in the USA than in any other place on earth. We, in other words, are a leader in “mental illness”. Why is this so? You have drug companies selling drugs here, and to sell drugs they need people with conditions for which the drugs could be used. You can’t sell pharmaceutical products without also selling “disease”. You also have these groups focused on campaigning to “de-stigmatise” the “mental illness” label. When it becomes alright to have a “mental illness”, the number of people claiming to be “mentally ill” goes up. When having a “mental illness” becomes trendy, you are going to see more people claiming to have one (or, more) “mental illnesses”. One thing feeds another, and the rate of people with psychiatric labels, living off disability payments, goes up accordingly.

    This so called “mental illness” is all about dependency. You get people out of the mental health service system, leading productive lives, and there is no “mental illness”. This person or that person is “mentally ill” only so long as the insurance company is paying his or her bills. He or she who can pay his or her own bills isn’t “mentally ill” because he or she no longer needs the “mental illness” excuse. We have a word for those folks who have gotten out of the mental health system, and that word is recovered. A person who has passed beyond the reaches of the mental health system is said to have had his or her mental health restored or recovered. So much for “mental illness”. I think that there is a whole lot to be said for getting over it.

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