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bipolar disorder?

10597 Views 71 Replies 12 Participants Last post by  Anne
How many of you have been diagnosed with bipolar? because I'm really starting to think I'm bipolar, no for reals.
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The strategy has enabled the pharmaceutical industry to squeeze millions in additional revenue from the blockbuster drugs known as selective serotonin reuptake inhibitors (SSRIs), a family of pharmaceuticals that includes Paxil, Prozac, Zoloft, Celexa, and Luvox. Originally approved solely as antidepressants, the SSRIs are now prescribed for a wide array of previously obscure afflictions - Gad, social anxiety disorder, premenstrual dysphoric disorder, and so on. The proliferation of diagnoses has contributed to a dramatic rise in anti-depressant sales, which increased eightfold between 1990 and 2000.

For pharmaceutical companies, marketing existing drugs for new uses makes perfect sense: a new indication can be obtained in less than 18 months, compared to the eight years it takes to bring a drug from the lab to the pharmacy. Managed-care companies have also been encouraging the use of medication, rather than more costly psychotherapy, to treat problems such as anxiety and depression.

But while most health experts agree that SSRIs have revolutionised the treatment of mental illness, a growing number of critics are disturbed by the degree to which corporate-sponsored campaigns have come to define what qualifies as a mental disorder and who needs to be medicated.

When Paxil hit the market in 1993, the drug's manufacturer, then known as Smith-Kline Beecham, lagged far behind its competitors. Eli Lilly's Prozac, the first FDA-approved SSRI, had already been around for five years, and Pfizer had beaten Smith-Kline to the punch with Zoloft's debut in 1992. With only a finite number of depression patients to target, Paxil's sales prospects seemed limited. But SmithKline found a way to set its drug apart from the other SSRIs: it positioned Paxil as an anti-anxiety drug - a latter-day Valium - rather than as a depression treatment.

SmithKline was especially interested in a series of minor entries in the diagnostic and statistical manual of mental disorders (DSM), the psychiatric bible. Published by the American psychiatric association since the 1950s, the DSM is designed to give doctors and scientists a common set of criteria to describe mental conditions. Entries are often inuenced by cultural norms (until 1973, homosexuality was listed as a mental disorder) and political compromise: it is written by committees of mental-health professionals who debate, sometimes heatedly, whether to include specific disorders. The entry for GAD, says David Healy, a scholar at the college of medicine at the University of Wales and author of the 1998 book The Antidepressant Era, was created almost by default: "Floundering somewhat, members of the anxiety disorders subcommittee stumbled on the notion of generalised anxiety disorder," he writes, "and consigned the greater part of the rest of the anxiety disorders to this category."

Critics note that the DSM process has no formal safeguards to prevent researchers with drug-company ties from participating in decisions of interest to their sponsors. The committee that recommended the Gad entry in 1980, for example, was headed by Robert L Spitzer of the New York state psychiatric institute, which has been a leading recipient of industry grants to research drug treatments for anxiety disorders.

SmithKline's first forays into the anxiety market involved two fairly well-known illnesses - panic disorder and obsessive-compulsive disorder. Then, in 1998, the company applied for FDA approval to market Paxil for something called social phobia or "social anxiety disorder" (SAD), a debilitating form of shyness the DSM characterised as "extremely rare".

Obtaining such a new approval is a relatively simple affair. The FDA considers a DSM notation sufficient proof that a disease actually exists and, unlike new drugs, existing pharmaceuticals don't require an exhaustive round of clinical studies. To show that a drug works in treating a new disease, the FDA often accepts in-house corporate studies.

With FDA approval for Paxil's new use virtually guaranteed, SmithKline turned to the task of promoting the disease itself. To "position social anxiety disorder as a severe condition", as the trade journal PR News put it, the company retained the New York-based public-relations firm Cohn & Wolfe. (Representatives of GlaxoSmithKline and Cohn & Wolfe did not return my phone calls.)

By early 1999 the firm had created a slogan, "Imagine Being Allergic to People", and wallpapered bus shelters nationwide with pictures of a dejected-looking man vacantly playing with a teacup. "You blush, sweat, shake-even find it hard to breathe," read the copy. "That's what social anxiety disorder feels like." The posters made no reference to Paxil or SmithKline; instead, they bore the insignia of a group called the social anxiety disorder coalition and its three non-profit members, the American psychiatric association, the anxiety disorders association of America, and freedom from fear.

But the coalition was not a grassroots alliance of patients in search of a cure. It had been cobbled together by SmithKline Beecham and Cohn & Wolfe handled all media inquiries on behalf of the group.

The FDA's advertising regulations also helped the Cohn & Wolfe strategy. "If you are carrying out a disease-awareness campaign, legally the company doesn't have to list the product risks, notes Barbara Mintzes, an epidemologist at the University of British Columbia's centre for health services and policy research. Because the "Imagine Being Allergic to People" posters did not name a product, they did not have to mention Paxil's side effects, which can include nausea, decreased appetite, decreased libido, and tremors.

Cohn & Wolfe's strategy did not end with posters. The firm also created a video news release, a radio news release, and gave journalists a press statement stating that SAD "affects up to 13.3% of the population," - one in eight Americans -and is "the third most common psychiatric disorder in the United States, after depression and alcoholism." By contrast, the diagnostic and statistical manual cites studies showing that between 3-13% of people may suffer the disease at some point in their lives, but that only 2% "experience enough impairment or distress to warrant a diagnosis of social phobia".

Cohn & Wolfe also supplied journalists with eloquent patients, helping to "put a face on the disorder", as account executive Holly White told PR News. Among the patients most frequently quoted in stories about social anxiety disorder was a woman named Grace Dailey, who had also appeared in a promotional video produced by Cohn & Wolfe.

Also on that video was Jack Gorman, the Columbia University professor who would later make the rounds on Paxil's behalf during the GAD media campaign, appearing on numerous television shows, including ABC's Good Morning America.

Gorman was not a disinterested party in Paxil's promotion. He has served as a paid consultant to at least 13 pharmaceutical firms, including SmithKline Beecham, Eli Lilly, and Pfizer. Another frequent talking head in the SAD campaign, Dr Murray Stein of the University of California at San Diego, has also served as a Smith-Kline consultant, and the company funded many of his clinical trials on SAD.

Cohn & Wolfe's campaign on SAD paid immediate dividends. In the two years preceding Paxil's approval, fewer than 50 stories on social anxiety disorder had appeared in the popular press. In May 1999, the month when the FDA handed down its decision, hundreds of stories about the illness appeared in US publications and television news programmes, including the New York Times, Vogue, and Good Morning America. A few months later, Smith-Kline launched a series of ads touting Paxil's efficacy in helping SAD sufferers brave dinner parties and public speaking. By the end of last year, Paxil had supplanted Zoloft as the nation's number-two SSRI, and its sales were virtually on par with those of Eli Lilly's Prozac. (Neither Prozac nor Zoloft has anapproval for SAD.)

The success of the Cohn & Wolfe campaign didn't escape notice in the industry: trade journals applauded GlaxoSmithKline for creating "a strong anti-anxiety position" and assuring a bright future for Paxil. Increasing public awareness of SAD and other disorders, the consulting firm Decision Resources predicted last year, would expand the "anxiety market" to at least $3bn by 2009.

* This is an edited excerpt from an article in Mother Jones magazine.

See also: Pharmaceutical companies have come up with a new strategy to market their drugs: First go out and find a new mental illness, then push the pills to cure it.
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All of us are quite informed on the effects of medication and ultimately the choice is ours. I've taken my fair shair of pills but i've also turned down many attempts to put me on an anti-psychotic or an ADHD med.
Interesting stuff, will print out and read it. I kind of glanced over it just now - what's iatrogenic?

I agree with you in the sense that 'diagnoses' ie giving a name to something and then prescribing a particular med to treat it may be a way to make money because quite often its never that clear cut. In fact I doubt it ever is. However, my panic attacks weren't caused by any drug (thats why i asked about iatrogenic), i was quite young. And drugs have helped me. But will read your stuff because I'm a bit of a conspiracy theorist and love to doubt the government and drug companies... :lol:
what is the mother jones magazine?
Iatrongenic means that you are creating the illness (or the signs of the syndrome) because you're looking for it.

Common example in the psych literature is the burst of Multiple Personality Disorder cases that sprung up in the 1980's/90's in the Boston area here in US. There were some prominent doctors who had a huge grant to study MPD, and they set up a clinic and inpatient hospital, etc... nearly any Borderline or dissociative patient who ambled in there ended up being seen as a "multiple"

Those patients weren't faking it, but they were sort of "encouraged" to view the different aspects of themselves as "different personalities" - so because the docs were LOOKING for MPD, they ended up creating the disorder in patients who had major problems, but whose problems might not ever have included MPD had they not walked into those doors.
As far as I know iatrogenic means "doctor induced", that is if a pathological symptom is caused by a doctor, it is iatrogenic.

Is the definition of the word iatrogenic that you, janine, referred to more common in the medical field?
No, I think we're talking about the same thing. I just think saying only "doctor induced" sounds like the doctor actually MADE you get an illness. What happens in these situations, is that the Diagnosis is iatrogenic. The patient doens't have anything he wouldn't have had otherwise, but they're calling it X Disorder because they were looking for something so hard they either found it, or brought out clues in patients to lead them to that conclusion.
This topic is disturbing.
Pronunciation: I`atru'jenik

WordNet Dictionary

Definition: [adj] (medicine) induced by a physician's words or therapy (used especially of a complication resulting from treatment)

I here this term used over and over when discussing benzodiazepene addiction.
kenc127 said:
This topic is disturbing.
Indeed it is to me for personal reasons as my cousin has severe bipolar and schizoaffective disorder which initially had him hospitalized for a month so that he might get the right combo of meds.

When he had his first psychotic break at 20ish, he was preaching the Gospel on a concrete trash can in the freezing cold at 3am or so. No coat. Some 100 miles from home. Forgot who and where he was. Lost his car. Kindly, decent police officers had to calm him down and get him to a hospital. He was laughing and crying simultaneously, etc., etc., etc.

Bipolar EXISTS. It is a serious illness, and hasn't been invented by anyone. Many doctors, not just psychiatrists, can recognize it -- usually in emergency rooms after the individual has a psychotic break. Bipolar individuals also self-medicate (4 times the average population) with alcohol.

***I will agree, there are often "fads" in diagnosis, no doubt about it. OVERdiagnosis, but I don't know the details of that. I agree with Janine in the overdiagnosis and literal CREATION of false memory syndrome and "multiple personalities" -- that term is out of date now as a result.***

I believe iatrogenic can be applied to psychiatry but per a number of sources I found the following definition, which seems to apply to MEDICAL treatment more than psychiatric, but psychiatrists can and do make medical errors -- they are medical doctors:

"An iatrogenic complication is an unfavorable response to medical treatment that is induced by the therapeutic effort itself. Although some are minor, others are life-threatening. Serious or fatal iatrogenic complications occur in 4 to 9 percent of hospitalized patients. One retrospective series found that 14 percent of cardiac arrests could be traced to an iatrogenic event."

Clinical errors contribute to about half of all iatrogenic events. No matter how you analyze clinical errors the fact remains that they represent a level of medical practice that is below the accepted standard of care. In the law such errors are called medical malpractice or professional negligence.

This occurs with misdiagnosis in the elderly frequently, and in hospital settings.

Also, the history of lithium (from which was commonly the first treatment of choice for bipolar disorder (formerly manic depressive disorder.

"Lithium, discovered in 1817, was noticed to have mood stabilizing properties in the late 1800s when doctors were using it to treat gout. (At least one doctor, in fact, concluded from this that gout was the cause of mood disorders.) It was Australian psychiatrist John Cade who, in 1949, published the first paper on the use of lithium in the treatment of acute mania. The U.S. Food and Drug Administration did not approve lithium for use until 1970.
Research has never indicated that that bipolar disorder might be caused by a lithium deficiency. Rather, it happens that this naturally occurring substance has the fortunate effect of acting as a mood stabilizer.

First answers in 1998
For almost 50 years, manic-depressive people were treated with lithium even though medical science did not know why or how it worked. Then in 1998, University of Wisconsin researchers unlocked the mystery. It has to do with nerve cells in the brain, and the receptors for the neurotransmitter glutamate.........etc."


Please remember we are not doctors here. Mental illnesses exist, and they are terribly disabling. My cousin is on disability and is terribly unhappy at being ill. He is at great risk for suicide as he feels his life is over.

If you want to really understand bipolar you MUST read medical journals. Self-diagnosis is not possible, or shouldn't be the way one decides whether or not one has a psychiatric disorder. If you don't trust your diagnosis, and are able to afford it, get a second and third and fourth opinion.

I am not saying psychiatrists are saints. They piss me off. My mother was one and she was a vicious person. But psychiatry is a legitimate medical profession... and psychiatrists are imperfect. But psychiatry is changing as we speak, and seems to be moving towards NEUROPSYCHIATRY.... integrating with neurology. It also involves cogitive study as well.

Believe me, bipolar is real, disabling, horrendous. And yes, there are many variations of it on a huge spectrum.

Read the work of Kay Redfield Jamison who is a Professor of Psychiatry who herself has bipolar.

Also go to or the Merck Manual in the LINKS section to find out more about bipolar.

It exists. I have seen it. It is a living Hell for sufferer and caretaker.

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Yes, Dakota Joe is correct, as is Janine... I just have no specific recollection and I should.

Psychiatrists are most notorious for CREATING in patents "multiple personalities" and "false memory syndrome."

MISDIAGNOSIS, or OVERDIAGNOSIS is different however, and equally as dangerous.......

There is a difference -- and hence a slight semantic difference regarding other physical disorders.

I do consider mental illness a MEDICAL/PHYSICAL/NEUROLOGICAL disorder. My POV.

Also, whoever said that GAD was created doesn't know me. I have it, but didn't receive that specific diagnosis until about 1997. For the rest of my life I was "Depression, Depersonalization Disorder".... I am 46 years old and have been ill since a child.

The NAME of a syndrome (a collection of symptoms) evolves over time, as did the diagnosis and naming of AIDS which was originally GRID.

This doesn't mean defining it is "making it up" -- that would be like saying defining diabetes means someone made it up.

I agree there is tremendous difficulty in trying to communicate about this, but we don't know everything, I DON'T know everything... have to look up the same info 50 times........
First off Id just like to say that the following is all just my OPINION!! Wether bi-polar really exists or not, the drug companies are going to keep selling pills to treat it cause they are making alot of fucking money. I think the current situation with our mental health "experts" drugging kids(for being kids) with drugs that are chemical cousins to meth or cocaine is a good example of how ridiculous things are getting.

Im with narcotic on this one. As many know here, I think psychiatry is just a bunch of bullshit. Its so far away from a science that its not even funny. When I used to see a shrink, I would sit in his waiting room and think what an illusion the environment was. Everything looked professional. Initially I felt as tho I was in a real doctors office yet I quickly found out how unprofessional these people really are. Im simply amazed that health insurance companies will even cover this crap. They could just as well be covering voodoo therapy. I dont even want to think of how much money was robbed from my insurance just to turn me into a klonopin junkie.

In my opinion its just complete wrecklessness, that these quacks can prescribe powerful, potentially dangerous drugs with no known mechanism to treat "illnesses" that are alot of times conjured up just to make a profit. On top of it, there is nobody held responsible when they make a mess of your physical or mental health. The whole thing stinks.

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Just to clarify my own position here (and again, as Joe says, this is only MY opinion on the subject)

I was offering the definition to my buddy g-funk who asked what Iatrogenic MEANT, I was not in any way saying I think Bi-Polar Disorder is an inatrogenically created condition. (the MPD "epidemic" in the Kris Group was my example)

If anyone has ever SEEN a person under the sway of bi-polar episodes (either the mania or the depression) they would know it certainly exists. The real mccoy is like NOTHING anyone else could imagine. It's not "mood swings" or "feeling like running away with oneself" etc. It's potent and it's highly highly frightening to behold.

There is a really good movie (and it is NOT to be taken as anything but a Hollywood flick, but the performances are spot on) called "Mr. Jones" with Richard Gere and Lena Olin. She's a psychiatrist who meets a bi-polar patient (in emergency, he is not her patient), and in time they form a personal relationship (NOT good, lol...but hey, it makes for a sexy little movie). His performance of Bi-Polar is excellent. THAT is mania, and those are the delusions (psychotic delusions) of mania. And his depressive state is so deadened that he looks catatonic. That's the real mccoy.

In my humble opinion, Bi-Polar is often diagnosed when it's not what some of us woudl consider the actual disorder, but only a "slight" variance of it. To me, that's not Bi-Polar, but to some people, it's close enough to warrant the label.

Let me guarantee you, though....MY dp existed. My obsessive anxiety and chronic mental leaps into delusional and obsessive thought was REAL. This was not med induced (happened before I'd ever taken anything but aspirin). And it was not doctor induced. I actually suffered from it for years before even admitting the worst of it to any doctor.

If we've "got" something, we know it. And we don't need anyone to agree.

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Interesting post Janine..

Your and Dreamer's personal accounts and descriptions of bi-polar sound very real and frightening. I have never seen anybody on a manic high or whatever you'd call it, and I don't want to, for it would very likely be a terrifying and discomforting experience...

On the other hand, watching it through a movie isn't nearly as tough a thing to do... I saw Mr. Jones way back when, must have been 10-11, and I don't remember a thing. But I'd really like to see it again (after your description), and have added it to my Netflix queue.
IF there is such a thing as a devil, then he is surely present in the field of psychiatry.

Think about it..You know for a fact that so many people get sick from these pills. Patients take the pill only to get symptoms that they have never encountered before. Over time, the number of symptoms keeps rising and the patient becoems more and more debilitated. When the patient goes for help, then they are diagnosed as a nutcase and are thrown more and more drugs which make them MORE sick. It doesn't matter if the patient was prescribed the pills for sleep or muscle spasms and had never experienced anxiety before. The minute you step into a doctors office or accept a pill then you have a label for the rest of your life.

Another thing is that alot of people committ suicide on these drugs. But that doesn't matter. It will always be blamed on the illness and not the drugs. Even if the patient showed NO signs of suicidal behavior before taking the drug. It's ALWAYS the ilness. The scary thing is that 90 percent of the population is brainwashed into believing that psychiatry is harmless and that it WAS the illness. I bet you look at this message and think it's bogus already. Scary scary stuff.

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Dreamer wrote:

This doesn't mean defining it is "making it up"
This is my stance as well, and although I do know that a lot psychiatrists are quick diagnosing anything that is not accurate, the definitions of disorders do describe observable symptoms. That is, I do think that the disorders are based on observable data and they mostly (not in any case) are not only made up without any basement. Although I also know that the data presented to back up the diagnosis is sometimes biased and far fetched.

However, the fact remains that psychiatry and psychology as a whole is so far from being an objective approach and therefore as unscientific as miracle healers that it should be abandoned. Furthermore it is so damaging in too many cases that it should be considered a crime and therefore forbidden.

Although I think that some of the most common disorders do have some validity it is doubtful if diagnosis is a useful tool.

Pathological symptoms persist no matter what terms there are applied to them.

All in all I really do wonder why there are still people that honestly take psychology and psychiatry seriously.
Besides the very obvious flaws that must pop into one's eye only scratching the surface of the subject of psychiatry or psychology, it must dawn on anybody reading a bit more on the matter that the whole psychiatric industry is far too idiotic to be even worth the time reading about it and unfortunately too damaging to discount it as a bad joke.

Psychiatry and psychology are so stupid and damaging that they should be deprived of the right to exist.
It not only damages the ones that have the misfortune of directly receiving psychiatric ?care?, but the influence of psychiatry and psychology tears down the society as a whole.
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neal quit ruining my post with your stupid pill bashing bullshit

Only if you stop criticizing people for smoking pot :p
I was diagnosed with bipolar disorder about six years ago. I was on lithium for awhile, which seemed to be the only medication to help me. It evened me out; I have not been on lithium for about four years, but my moods still seem a lot even and easier to deal with back then.
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