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 peculiar, 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 sudden 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. Previously, when somebody acted in a way that we didn’t understand or couldn’t tolerate, it was very easy to label them as abnormal. Nowadays we, the public, go further—we label them “Bipolar.”
With all the television programs that we, the public, see almost every day on networks such as FX or Lifetime and shows such as “Dr. Phil”, we’ve all become 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 Cymbalta, Zoloft and Abilify? The drug companies expect us to see ourselves in their ads and to go to the family doctor and ask for the medicine in question. This way, too often, people are put on medicines that may or may not be appropriate for their condition.
Some good can come from the current practices. At some point in their lives, 15 to 25% of Americans suffer from a major depressive episode (commonly known as clinical depression). It has probably improved many lives for people to go 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 improve minor symptoms of dysphoria and stress. Thus it is very comfortable for doctors to prescribe them without doing a thorough psychiatric evaluation. In many cases, the patients get better in some way and the doctor is confirmed in his or her expertise. However, for some bipolar patients, antidepressants may actually add to their problems by triggering a manic episode.
The challenge for psychiatrists is to discriminate 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, including psychologists, social workers, marriage and family counselors and pastoral counselors all have opinions on medications and when they are necessary, the psychiatrist may be in the best position to assess the underlying psychiatric disorder and determine the appropriate treatment.
Many problems can be addressed by talking therapy, which is a practice Dr. William Hankin, MD provides to every patient. Some patients will come for advice when medications are causing side effects and want to know what their other options are. Dr. Hankin’s working philosophy is that everyone should receive the maximum benefit with the fewest possible side effects. If any medication is causing side effects, there are many other options among which a best choice may be made.
Dr. William Hankin, MD is Board Certified in general psychiatry and is a Fellow of the American Psychiatric Association. For more information about this or other issues, contact Dr. Hankin at his Atlantic County office in Linwood 609-653-1400 or his Cape May County office in Cape May Court House at 609-465-4424. Or visit www.WHHMD.com.