One of things Good Mood Bad Mood examines  is the epidemic increase in the diagnosis of bipolar disorder in our country. I said in the book that the increase did not represent an increase in real disease, but a change in the way we make the diagnosis. In an article published this past November in the Canadian Journal of Psychiatry, there are
psychiatrists who agree with me. 

Dr Phillip B Mitchel who is the head of the department of Psychiatry at the University of South Wales in Sidney Australia voiced his concern about the changes in the criteria. In his article he says, “The increasing rates of diagnosis have largely related to BD II (Bipolar Disorder 2[1]), for which there has been a dramatic broadening of the criteria.”[2]

 Dr Mitchel goes on to say that this change really matters because it will result in over-treatment with medications that have significant side effects. He also believed that the process of making the diagnosis would be oversimplified and“de-skilled” with a loss of credibility for psychiatry. And, finally, Mitchel feared that “etiologic research” for bipolar
disorder would suffer. In the field of medicine, when we find what we think is the cause of a “disease,” the result will be a decrease in research in that area. This is devastating if the discovered “cause” is not correct because it stops research. 

I believe that Mitchel is correct on all the points he makes. We are over-diagnosing bipolar disorder in the Bipolar 2
category because the criteria have been reduced to the point that it is easier to qualify. This same process has affected the way we make the diagnosis of depression. In 1980, the criteria for making the diagnosis of depression were changed removing cause as a one of the important markers of the disorder. Until then, an individual was considered to have a disease called depression only if there was no obvious cause. If the struggler could identify a loss in their life that made them sad or sorrowful, then they would be considered normally sad. Depression was disordered sadness that had no cause. 
 
The treatment of people labeled as depressed who had simple normal sadness led to another unintended consequence. People struggling with normal sadness were then treated with medication that had side effects. Those side effects could be interpreted as hypomania which is a necessary criterion for the diagnosis of bipolar disorder 2. 
 
The combination of the changes in criteria for depression, and the relaxation of the criteria for bipolar disorder is the
source for the explosion of the diagnosis of bipolar disorder. In Good Mood Bad Mood, I have said that the best way to help reduce this epidemic is to help people deal with sadness over loss before they get to a disease diagnosis. 
 
Paul spoke of the role of normal sadness in our lives and noted that it was a good thing. “For the sorrow that is according to the will of God produces a repentance without regret, leading to salvation, but the sorrow of the world produces death.” (2Co 7:10 NASB) You can find more information on how sadness relates to the current diagnosis of
depression and how the Bible can help in the book “Good Mood Bad Mood.” 

As I always say when I write about medical subjects, no one should change the medication they are taking or change the dosage without first consulting their physician.


 
  


 
 

 
 
 
[1]The parenthesis is my addition to explain author’s BDII




[2]Can J Psychiatry, 2012 Nov, 57(11):659-65 


3/23/2013 08:26:49 am

I have read and heard many statistics regarding the rise of depression, but until hearing you speak at the IBCB seminar, I had never heard the common-sense reason for this over-diagnose--a change in criteria for the diagnose. What a help to those who want to give biblical hope to sufferers! Thank you.

Reply
3/23/2013 09:23:10 am

Thank you for the comment! If you widen the criteria, you diagnose the problem more often.

Reply
Kathy Pollard
4/5/2013 08:51:34 am

Thank you for your book and blog. In 1989 I became depressed, probably because of issues over several things. One thing that I wonder is if about 9 months back from third world missions terms can be a sensitive time, as I have known others who had problems about 9 months back. I was also working rotating shifts, which I think can be very difficult for the psyche. And, of course, sin issues. Anyway, I could be the (middle-aged) poster child for your book. God was merciful to give us financial problems which made me try to taper off the antipsychotic drug, and the physical withdrawal symptoms led me to researching my bipolar condition and drugs in a new way. I have experienced many bizarre sensitivities and symptoms which seem to be the result of stopping and starting drugs that influence neurotransmitter levels. I have a ways to go in drug withdrawal, but I am very grateful for the theological and philosophical foundation you laid in your book. And grateful that God has preserved my family and me through the past 14 years especially.

Reply
4/5/2013 09:24:43 am

Hello Kathy, Thank you for your comments. Did you discuss stopping the medicine with the doctor who prescribed? It is always very important to do this.
You can email me at charles.hodges@goodmoodbadmood.com if you wish to discuss this further.

Reply
Linda Cha
6/7/2013 03:34:20 pm

I think my mother been overdiagnosed. It started a couple years back where she was having anxiety attacks. Next thing we know, she was on meds. The last couple weeks she has been under a lot of stress and has been having anxiety due to everything going on in life. I went to see her and looked at all the meds she has been taking for her anxiety. I noticed 2 were psychotic meds (which she thought were actually anxiety meds). I have not been able to find the affects of psychotic meds if used on over diagnosed patients. As soon as she learned what types of drugs she has been taking these last few years, she was shocked because she is not schizophrenic nor bipolar. I do believe that there may have been a language barrier as well with her doctors. Now she wants to get off of them, but how do you tell your doctor they have been prescribing you the wrong meds? And if you get a second opinion , how would you know if this next doctor is just going to do the same thing?

Reply
Kathy Pollard
6/7/2013 09:50:53 pm

I have been working for several months at getting "uncocktailed." I am quite sensitive to these drugs, so it is going to take a long time. I would recommend two sources, neither comes from a Christian world view. Theicarusproject.net has a document under resources about Harm Reduction. The web forum www.survivingantidepressants.com has tons of info and support about getting off all sorts of psychoactive drugs. In my experience, mainstream psychiatry knows very little of this information. I think the order of withdrawing meds is also important...it is best to take the activating drugs away before the sedating drugs. That said, my mother-in-law was over medicated, and her new doctor reduced meds over about a six month period without any withdrawal problems (although she is still on two antidepressants).

Reply
Charles Hodges
6/24/2013 01:49:55 am

Hello LInda, Have you been able to find help for your mother since you left your comment. You can email me at charles.hodges@goodmoodbadmood.com if you still need some suggestions.

Reply
6/3/2014 09:21:55 pm

Bipolar disorder is also called as the most affective disorder affects the emotions that are not in accordance with the real situation and do not represent the expected response to any situation in life.

Reply



Leave a Reply.