Is Everybody Bi-Polar?

In the old days in American psychiatry nearly everybody was thought to be a little bit schizophrenic. Under the influence of such writers as Harry Stack Sullivan the shades of possibilities for schizophrenia were all-inclusive.
While this is a serious psychiatric disorder that involves incongruous thoughts and emotions that are often very pecu-liar, even the slightest symptoms of distress were considered to be schizophrenic in nature. The current craze is to think that everybody is a little bit bipolar.
Many people have sud-den changes in mood from being somewhat or very depressed to being happy or giddy and euphoric. In other cases people are quiet and calm and suddenly blow up, supposedly for no reason. When somebody acted in a way that we didn’t understand or couldn’t tolerate, it was very easy to label them as abnor-mal. Nowadays we, the public, go further —we label them “Bipolar.”
With all the television programs that we, the public, see almost every day on FX, Lifetime, Oprah, Dr. Phil and other stations, we’ve all be-come pseudo-experts in psychiatry. Not only do we have the problems of celebrities and historical figures put forward for our analysis, but we’re also asked to diagnose ourselves.
Who among us hasn’t seen the ads for Cym-balta, Zoloft and Abilify? The drug companies ex-pect us to see ourselves in their ads and to go to the family doctor and ask for the medicine in ques-tion. This way, too of-ten, people are put on medicines that may or may not be appropriate for their condition.
Some good can come from the current prac-tices. At some point in their lives, 15 to 25 per-cent of Americans suffer from a major depressive episode (commonly known as clinical depres-sion). It has probably improved many lives for people to go down to their family physician and ask to be put on Prozac, Celexa, Lexapro or Zoloft. These medicines are very safe: the risk of severe side effects or any major difficulties is small. They are effective for mild, moderate, and even major depression.
They probably also im-prove minor symptoms of dysphoria and stress. Thus it is very comfort-able for doctors to pre-scribe them without do-ing a thorough psychiat-ric evaluation. In many cases the patients get better in some way and the doctor is confirmed in his or her expertise. However, for some bipo-lar patients, antidepres-sants may actually add to their problems by trigger-ing a manic episode.
The challenge for psy-chiatrists is to discrimi-nate between those who have a mood disorder that will respond to treatment and those who have personality traits that are enduring and unchangeable.
While other mental health professionals, in-cluding psychologists, social workers, marriage and family counselors and pastoral counselors all have opinions of medica-tions and when they are necessary, the psychia-trist may be in the best position to assess the underlying psychiatric disorder and determine the appropriate treatment.
Many problems can be addressed by talking ther-apy, which the practice of Dr. William Hankin, provides to every patient. Some patients will come for advice when medica-tions are causing side effects and want to know what their other options are. Hankin’s working philosophy is that every-one should receive the maximum benefit with the fewest possible side effects. If any medication is causing side effects, there are many other op-tions among which a best choice may be made.
Dr. William Hankin, is Board Certified in general psychiatry and is a Fellow of the American Psychiat-ric Association. For more information about this or other issues, con-tact Hankin at his Atlan-tic County office in Lin-wood 609-653-1400 or his Cape May County office in Court House at 609-465-4424. Or visit www.WHHMD.com.