to half hope bipolar goes the same way as homosexuality?

[Mitchy1nge]

when homosexuality came out of the DSM

What angers me most is that I currently have patients waiting 3 months plus to start essential therapeutic work - in which other field of medicine would a 3 month wait for treatment be acceptable?

And the reason it is acceptable is because mental health is simply not taken seriously.

I have bipolar disorder I, was diagnosed almost a decade ago and am being treated for and I feel pretty fucking unwell when I am. I don't regard it as a gift, it has largely been a blight on my life and is the reason that I'm enjoying my pregnancy with the perinatal mental health team watching my every move. I missed most of my GCSE year due to depression (did alright but only got 7), I was kicked out of college during my A-levels as I had a manic episode and was acting so bizarrely and eventually psychotically they demanded I get help and put my education to one side. This was as a gifted student who was supposed to be going places. And I never did thanks to this illness.

Bipolar disorder is on a spectrum and affects people differently. I have the classic type where I can be fine for ages and then a tsunami devastates my life. But in between I still struggle a lot, especially with the medication I take (which has made me 6 stone fatter) to keep the tsunamis at bay. No, I couldn't ignore this stuff as a character trait or a gift. I am a danger to myself when I'm not well. I would be dead by now.

You don't have to be an artist to have bipolar disorder. A lot of bricklayers, barstaff and housewives also have bipolar disorder.

The thing is though, there is lots of evidence linking various mental illnesses to genetic factors and imbalances of various neurotransmitters. I believe there is evidence that both can come to play in bipolar- hence drug based treatment often working for people.

Often, for all sorts of mental illness, stress can be a trigger, or trigger the illness to get worse, however, I think it is wrong to say environmental factors necessarily cause mental illness, although they may influence the behaviour of an individual.

One example of this might be anorexia, and other eating disorders- there are obvious cultural and social factors that influence sufferers. However, there is also high co-morbidity between anorexia and other mental illnesses, such as anxiety and depression, which suggests there is more going on than just the social factors.

There is also a link between socio-economic status and mental illness, or rather there is a correlation between low socio-economic status and some kinds of mental illness such as bipolar and schizophrenia. Some people have suggested that this link could be due to the increased stress people of low socio-economic class face. Others suggest that these illnesses make it harder to have a successful career in many industries, so it is the illness causing the low socio-economic class. There could also be other, more complex explanations. Of course, these theories are very hard to accurately test.

I do agree that sometimes normal human emotions can be over-medicalised. However, I think that in most cases, people do benefit from help and treatment, if they can access it, and in many cases having a "label" helps people access appropriate services. I also think the social model of mental illness is ultimately flawed in many ways- I think society may influence how people's problems express themselves, but the majority of the time, there is some kind of cause at a chemical/genetic level as well.

I just wanted to say this is a really thought-provoking thread.

When you can show me where homosexuality drains your bank account, causes suicidal episodes, or sends you into psychosis, I will agree with you.

Until that time, bipolar IS a mental illness with devastating effects if left untreated. Leaving homosexuality untreated isn't going to cause a devastating effect on your life.

Yes, mental illnesses need to be de-stigmatized. But making them "not an illness" isn't the way to do it.

but homesexuality is not a mental illness and does not cause any symptoms such as reckless and self damage for example.

If we include all mental illnesses, then quite a large percentage of the population will have been/will be affected at some point in their lifetime. It's only fair to try and educate ourselves about it and for people to lose their fear and negative responses to sufferers. This applies of course to all 'differences' between us. Once everyone is understanding, enlightened and accepting, society will have advanced a great deal.
I have to say, my niece's workplace were absolutely brilliant in supporting her at work, with extra breaks in the fresh air (her medication made her terribly sleepy) and a mentor to turn to if needed. They did everything they could to reduce her workload and see that all her colleagues understood the situation. She felt very encouraged by this, and so did her mum and I.

Bipolar disorder affects people differently. Not everyone gets psychosis during a manic episode or needs lithium. There are so many generalisations made about it, even within the health profession, and it pisses me off.

I'm bipolar type 2, rapid cycling and drug free. Its incredibly hard at times, but drugs didn't make me any better. Made me worse, if anything - and I had a long trial of various different combinations of meds under various psychiatrists, so I wasnt anti drugs at all.

Lack of funding to the NHS is a huge factor in the quality of treatment, as previous posters have said. My PCT has two teams for patients with serious mental health issues. The complex care team, which offers therapeutic interventions of various different types (long waiting lists + big emphasis on six sessions of nice, outcome-focussed CBT if they can get away with it and eventually moving you on to 'self management'), but you cant be referred to this team with a bipolar diagnosis.

Bipolar is COMPLETELY medicalised by my PCT. There is NO real 'shades of grey' approach. The psychiatric long term care team and crisis team deal with bipolar patients and the service on offer is psychiatric appointments focussed around medication review. A psychologist and other therapists will work with patients when they under the HTT (e.g. In times of crisis) but other than that, there is no long term therapeutic approach whatsoever. I really started to make a breakthrough with weekly appointments with a psychologist after a crisis, but once I was released from home treatment, the service was withdrawn.

I have to pay 55 quid a week for psychotherapy myself now (currently unemployed due to my MH difficulties and in debt after reckless spending during two hideous manic episodes, so not ideal).

Sorry to derail slightly - but bipolar disorder is poorly understood by many in my experience and treatment options are woeful on the NHS (not a criticism of some of the great practitioners who work for our NHS, btw!)

It can be tricky. I have a diagnosis of OCD and it led to a period of illness and disorder that urgently required treatment. However, when 'well' I am conscious that my mind is still quite obsessive relative to other people's. I am very aware of my thinking and of memories and thoughts others have but maybe just dismiss. I'm no longer entrapped by OCD in terms of behaviour (overtly or mentally) but I do think if there's an OC spectrum I'm on it.

I only had one period of 'illness' yet I would say I have always thought as I do now, and I have learned I definitely have some differences in how I process information to people who have never had a diagnosis. The way I think almost definitely has contributed to academic success (I have two first class honours degrees and got 80% on a dissertation at MSc I wrote up in two weeks).

I think like Aspergers, if a person is not enslaved by thinking differently in terms of behaviour, OCD can be less disordered than people imagine.

I get what you're saying about stigma, I really do.

However, homosexuality isn't an illness. Bipolar disorder can be traumatic for the person suffering and for their loved ones. (Talking from experience...my ex is bipolar.)

Also, if BP disorder were no longer considered an illness, workplaces could very easily discriminate against sufferers who need to take time off due to manic or depressive episodes. Because it would be seen as 'the way that person is' rather than something that can be medically explained and managed.

Unlike being gay, most people with bipolar 1 require medication to require stability. Therefore it is a mental illness. It is the attitude towards ALL mental illnesses that need to change. My sister is a practicing GP and once told me to fuck off and kill myself when I had depression. If that is what some doctors are like, us sufferers of bipolar are stuffed.

There was recently a piece in the Guardian slagging off Russell Brand, a sufferer of bipolar. Nothing wrong with criticising his comedy or dress sense-everyone has the right to have an opinion. However Hadley Freeman's article contained this quote:

"he displayed the kind of ecstatic hypomania you’d expect of a celebrity who long ago exceeded the outer limits of his knowledge on this particular subject and is now coasting on the adrenaline of his own messiah complex"

I was appalled that Hadley was taking a dig at his bipolar, using terms such as hypomania and adrenaline (brain adrenaline levels are raised in bipolar patients during manic and hypomanic phases).

I have met people with bipolar whose attitude towards disability is very different from mine. I see it as a challenge. If someone says I cannot do something because of the bipolar I see it as them laying down the gauntlet and I have to prove them wrong. When I first started my business my pdoc advised me it may be too stressful and it would be better to accept my Dx. Stuff that, he was wrong, I was right, and I even got him to admit he was wrong when I turned a profit. Problem is some people with bipolar internalise it and think it limits them in some way. My ex said he could not work and he could not even wash dirty dishes as he had bipolar. Perhaps if attitudes towards bipolar change, and more celebrities "coming out" as bipolar will help this, it will be less stigmatising.

However I think it needs to stay in the DSM.

I dont really understand this question properly so sorry if my reply is wrong but homosexuality isnt a mental ilness

I agree with you, op. All the way. Fuck them all

I've read this thread with interest. My now-adult DD was diagnosed with ADHD when she was 10 and spent several years on meds. At the time of her diagnosis I found it a relief to be told there was a 'chemical imbalance' - something real and physical going on, not just me being a bad mother, and it was treatable. Fast forward more than a decade, and some of the less positive aspects are having a long-lasting effect. Due to the stigma that people on this thread have talked about, my DD spent her formative teenage years thinking she was defective in some way, and that's stayed with her into her 20s. She no longer has the 'symptoms' to the extent that they would be noticeable or stop her doing anything she wants to do, but she's left with a whole lot of baggage about being damaged goods.

The experience has left me feeling I wish there was a way to diagnose mental health conditions (and for that matter all health- and disability-related issues) without conferring the 'not good enough' label. That's where it all seems to go wrong. So I'd want bipolar kept on the register as a mental health condition so that it can be appropriately treated and adjustments made by schools, workplaces and so on. But for us as a society to be able to do that without all sorts of extra unwanted consequences, we have to change the way we think about differences of all kinds.

It seems impossible from where we are now. But then I realise that within my lifetime, views on homosexuality (in this country at least) have shifted very substantially - when I was born, same-sex acts between men were still illegal, whereas now anybody arguing for the return of that legislation would be seen as a nutter. So things can change and I hope they do. Not sure that taking bipolar and other mental health conditions off the diagnostic manual would bring about the shift in attitudes we need, but maybe talking about it is as good a starting point as any.

From my experience of working in mental health services bi-polar disorder is a debilitating condition which can flare up into a devastating illness. It is terrible that this can be stigmatised-but pretending that it isn't an illness isn't the answer. Mind do have an anti-stigma campaign. This illness is not comparable to homosexuality imo.

If you took it out the DSM there'd be no illness to treat and people would suffer as a result.

I'd be dead without treatment.

Just saying.

(thanks polter :))

I might be dead without treatment too - which could be a good argument against diagnosis and treatment but anyway, bipolar and homosexuality might not be all that comparable but the introduction of the transexualisms as mental illnesses made it easier to get rid of homosexuality as an illness, that still doesn't look like a great stride forward in our quest for a tolerant and equitable society to me

hello

nice to see such a lively discussion on my blog although it appears things have veered off somewhat from my points. I was using the example of how homosexuality ceased to be seen as a mental disorder to explore the social nature of diagnoses and how what counts as a mental illness and how its causes are seen are more the result of sociopolitical forces than scientific advancement. I did not make any reference to bipolar disorder but described how diagnoses of mental illnesses have social consequences - the confer identities and this is often negative.

I am a psychiatrist and have a special interest in treating patients with treatment-refractory mood disorders. In my experience, many patients with serious mental illness feel damaged, stigmatised and see themselves more negatively as a result of internalising the label imparted by diagnosis. Those who seem to particularly identify with a diagnosis and have a more fatalistic "it's genetic/caused by chemical imbalances" appear to do much worse than those who develop a richer understandings of themselves and understand their mental health problems in the context of their lives.

There seem to be a number of myths propagated on this thread. While there is evidence showing a large number of genes may be implicated in bipolar disorder (each with very small effects), there is no evidence whatsoever that mood disorders are caused by "chemical imbalances" as has been claimed here.

There is good evidence to show that conservative/republican governments prefer a more biomedical model of mental illness as they would prefer to ignore the social/economic forces that affect mental health. These factors are widely underplayed and seen as playing second fiddle to genetics, but they are actually much more important, as with the right environment supportive of good mental health, many people wouldn't develop mental health problems at all.

Taking bipolar disorder as en example, in the UK there are widespread differences in the incidence of the illness between different cities (South East London seems to be particularly bad), and also black and other ethnic minorities have more than twice the chance of developing bipolar mania. Early adversity and traumatic experiences further increase the risk of developing bipolar illness.

I view my bipolar a bit like epilepsy. Epilepsy is defined as an enduring predisposition to epileptic seizures. Sufferers of epilepsy are not ill most of the time, just when they have a fit. I do not view myself as unwell at all. I have the predisposition to a manic/depressive episode, but all the time I am not having one of those episodes I am perfectly well.
There are lots of highly successful people with bipolar, Russell Brand is one example, Richard Branson is widely rumoured to have it (just as Bill Gates probably has Asperger's).
I genuinely do not think I am the slightest bit ill. I could get ill in the future, but no point worrying about it.

Getting a diagnosis for what I was experiencing was the best thing ever. I felt liberated. I know some people don't feel this way, but for me it was a relief.

For me bipolar is a condition I have. When it becomes unmanageable, then to me it's my illness. That's my view of it, not anyone elses mind.

That said, canard mentioned the biomedical approach to mental illness, and that's the one I prefer to buy into as it makes more sense to my personally situation. But as we all know, everyone is different and this is a spectrum.

it was a horrible horrible shock, I really thought they had accidentally hospitalised the wrong person in a case of mistaken identity

then I assumed there must be something physically wrong with me, a kidney disorder or something

it really took a long time to sink in that they actually thought there was something mentally wrong with me, am not sure it has yet and it's been years and years and years

am still waiting to be vindicated

canard there is no evidence that bipolar is CAUSED by chemical imbalances, but there is evidence of changes in excitatory neurotransmitter levels eg glutamate in bipolar.

canardtheduck

There seems to be a very complex interplay of biological, psychological and sociological factors. I agree that it can suit right wing governments to downplay the sociological aspects.
However I think it is also dangerous to downplay the biological factors and saying this isn't an illness won't help.
Ideally people suffering from mental ill-health need assessing for medication, psychological care to help them cope and social interventions to help prevent relapse and improve quality of life.
Expensive isn't it? but its what is ideally necessary.