False Epidemic of Bipolar Disease in America
In 1994 DSM-IV was published with new criteria added to the Bipolar Disorder (BD) diagnosis. Put another way, there were more scenarios in which a doctor would be lead by DSM to diagnose someone with BD.
Indeed, that is exactly what happened next. Sadly, it happened mostly to children.
Sep 2007: (NY Times) The number of American children and adolescents treated for bipolar disorder increased 40-fold from 1994 to 2003.
This meant that there were now more patients diagnosed with BD-NOS than BD 1 and BD 2 combined. In 2009, Professor Emeritus Allen Frances, MD, of Duke University (the chair of the DSM-IV Task Force) himself directly acknowledged this issue in the hopes of warding off similar outcomes from DSM-V when it is published:
For instance, a seemingly small change can sometimes result in a different definition of caseness that may have a dramatic and totally unexpected impact on the reported rates of a disorder. Thus are false “epidemics” created. For example, although many other factors were certainly involved, the sudden increase in the diagnosis of autistic, attention-deficit/hyperactivity, and bipolar disorders may in part reflect changes made in the DSM-IV definitions.
In 2011, Dr Stuart L. Kaplan posted this about the false epidemic:
I have been a child psychiatrist for nearly five decades and have seen diagnostic fads come and go. But I have never witnessed anything like the tidal wave of unwarranted enthusiasm for the diagnosis of bipolar disorder in children that now engulfs the public and the profession. …
I believe, to the contrary, that there is no scientific evidence to support the belief that bipolar disorder surfaces in childhood. In fact, the opposite seems to be the case: the evidence against the existence of pediatric bipolar disorder is so strong that it’s difficult to imagine how it has gained the endorsement of anyone in the scientific community. And the effect of this trendy thinking can have devastating consequences. Such children are regularly prescribed medications that are not effective in kids and have unwelcome side effects.
In Jan. 2012 Jill Littrell, Ph.D, Associate Professor at the Georgia State University in the School of Social Work wrote about the impacts:
Of course, the consequences of being wrong in diagnosing a person as Bipolar are steep. The drugs for Bipolar have serious side effects. Lithium has been estimated to destroy kidneys in about 12% over a 20 year period (Presne et al., 2003). Atypical antipsychotics will shrink the cortex taken over a two year period (Ho et al., 2011). Anticonvulsants can cause damage to the liver and pancreas and induce depression (PDR). Then there is the issue of potential withdrawal symptoms when you discontinue the medications. These dangers are not trivial. The practice of diagnosing Bipolar is now epidemic. The label will probably shorten the lives of many people who would otherwise be resilient in the face of adversity.
Bottom line: There is no question a lot of patients out there need a different diagnosis and treatment.
Doctor Ankenman’s website and book may be the only source of information today for what many of them have and how to treat it.