Talk:Bipolar disorder/Archive 2

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Archive 2
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Elitest Norms

I know most doctors have gone through 8 years of conditioning to get to whgere they are today, so they'd never admit this medicine, but why exactcly is it that no one mentions the most obvious cure for manic depression, THC? A perfectly naturally, controllable, effect measue for treat this.

The answer is that the pharmaceutical industry is one of the most corrupt in the United States. I'm not sure where to find statistics, but it's my understanding that they have one of the highest profit margins of any industry. They have no problem with getting tens of millions of American kids hooked on Ritalin, so it's understandable that they don't have scruples promoting the War on Non-Corporate Drug Users even if the result is prisons overflowing with mostly non-violent drug 'criminals'.

It's not hard to understand why they fear legalization of marijuana. It works much quicker than prescription anti-depressants, doesn't turn people into zombies, and feels good to boot. From their perspective, it's a non-patentable plant which can be grown anywhere by anybody--they stand to lose billions in revenue from lost sales of Zoloft, Paxil, etc. etc.

On the other hand, marijuana increases the risk of schizophrenia as well *increased* depression if overused. However, it is *probably* safer than many pharmaceutical drugs and definitely safer than taking nothing at all, as 20% of bipolar people commit suicide.

Psychotropics as a treatment are largely only the most basic tool for those in a state of post traumatic stress , deep rooted depression and other extreme cases. As a general treatment in BPD I certainly wouldn't advise it. Everybody knows why the drug companies don't want legalisation, not everybody realises why smoking marijuana isn't healthy (bio-psycho-socially.) My contribution to the discussion. Mcbean 02:27, 13 December 2006 (UTC)

Presently, manic depression (like most mental illnesses) is consider to be incurable. Like diabetes, mental illnesses can only be controlled.

Drug use is generally bad for mood disorders although, of all the illegal drugs, those that contain THC are likely the most benign. Cocaine, in particular, is hell on people who are in the manic phase. Successful treatment of bipolar disorder has more to do with REMOVING harmful things, rather than ADDING them. There's been some interesting recent research on aspartame (Nutrasweet) in this regard. -- EFS

--I don't consider marijuana to be a 'harmful thing'. The brain contains at least two types of cannabinoid receptors and THC itself has a resemblance to a natural neurotransmitter anandamide.--

  • Indeed, this is true. At best, THC can mask the effects of some mood disorders by burying them beneath its own effects, and it hardly makes the user functional. Stimulants - including cocaine - have been documented to trigger full-blown bipolar disorder in individuals who are already predisposed to it. - 129.49.145.65 16:38, 29 August 2005 (UTC)

--'Hardly makes the user functional'? I've functioned well for years on THC. On the other hand, it's the crap like lithium or Paxil which has disrupted my sleep patterns to the point where I suffered from delirium due to sleep deprivation and couldn't function at all.--

  • "Self-medication" is an important issue that needs to be discussed in the main article, considering that it takes the average mentally ill person 7 years to get an accurate diagnosis, and even then other co-existing mental illnesses are usually not diagnosed. Once proper treatment begins it can take several years to find an efficient medication regime. Considering these facts, and the deleterious effects that untreated mental illness can have, it is not surprising that the mentally ill resort to "self-medication" (even if they are unaware that that is what they are doing).
  • Although any mind-altering substance can be dangerous for the mentally ill (including some prescription medications), some can be of some use in the temporary relief of symptoms. Alcohol, as a natural depressant, is often used to "self-medicate" a manic episode (nonetheless, alcohol can be dangerous for those who are prone to addiction!). THC can be effective for immediate symptom relief (unlike prescription medications) and has few and rather mild side-effects (dry mouth, drowsiness, etc.). It should be noted that, unlike cancer sufferers, mentally ill THC users tend to use very small amounts of THC, often if doses so small that they do dot feel "high". Since THC is natural, and hence not patentable, there is no incentive for pharmaceutical corporations to invest in research; additionally, due to anti-drug propaganda, government's rarely fund THC research.

--Good points about THC. I'd like to also add that, in my personal experience, alcohol and bipolar are a very dangerous combination. Sometimes, alcohol can mitigate a manic cycle, but in my case, it usually made me more obnoxious and anti-social by removing my natural inhibitions against 'acting out' in public.


  • Actually, there are many pharmaceutical preparations of THC/THC-receptor activators, such as nabilone (a Cannabinoid)!!! Perhaps there is good reason why these drug companies haven't tried to cash in on treating bipolar depression?

--I'd like to add that they've also produced Marinol (a THC pill) and, in Canada, they have something called Sativex which is medical-grade marijuana in plant form. I think the existence of these drugs indicates that the pharmaceutical industry considers THC to be safe and effective enough to develop and cash in on the anti-depressant market (not to mention its anti-emetic and anti-spasmodic properties). However, I'd guess the main reason the pharm industry didn't go far with these cannabinoid medicines is that manic-depressives and other users might decide that it's cheaper to simply grow some marijuana plants than pay something like $10 per Marinol tablet.

How the hell is weed going to cure it? Hah, not likely. misanthrope 17:51, 23 December 2005 (UTC)

--I don't know if any anti-depressant actually 'cures' bipolar disorder--Standard Operating Procedure is that patients are given a prescription of Paxil, Zoloft, etc. for life--so THC is no better or worse than prescription anti-depressants in that regard.

First of all BP is incurable, secondly why should cannabinoids be any less effective than say Neurontin? Anarchist42 17:58, 23 December 2005 (UTC)

--It's probably just as effective. However, the pharmaceutical industry can't sell Marinol tablets for $10 each when people can easily grow their own marijuana, so the pharmaceutical lobby has decreed that cannabinoids are less effective.

Actually, Neurontin was given to multitudes of BPs despite the fact that there was NO research to suggest that it did anything (the manufacturer admitted in court that the whole thing was a scam). Now that Sativex is on the market (at least in Canada, with limited availablility in the UK and Spain), researchers now have a legitimate pharmaceutical to use in their research - numerous studies are now underway, including treatment for various mental illnesses. Anarchist42

Instead of ongoing rhetoric, could some of the posters here supply supporting references for your assertions? This page would be significantly shorter if opinions and "conventional wisdom" were replaced with emperical argument. Here are some I just Googled which represent differing points of view (in no particular order):

(In the interest of candor, I am a BPII sufferer who has used cannabis with beneficial effect in conjunction with Rx meds; no signs of schizophrenia...yet ;) Limbo socrates 16:28, 2 March 2006 (UTC)

Bipolar and Mental Health

1. Biploar Disorder 2. Bipolar Affective Disorder, also known as "manic depression" is a disorder of the brain resulting in unusually extreme highs and lows of an individual's mood over time. 3. Bipolar disorder is a condition that causes extreme shifts in mood, energy, and functioning. In most populations it affects around 1 percent of the population. Men and women are equally likely to develop this often-disabling illness. The disorder typically emerges in adolescence or early adulthood, but in some cases appears in childhood. 4. There are no definite known causes. Scientists believe that Bipolar Disorder may be caused by a combination of biological and psychological factors. Most commonly this disorder can be linked to stressful life events. More than two-thirds of people with bipolar disorder have at least one close relative with the disorder or with unipolar major depression, indicating that the disease has a heritable component. Studies seeking to identify the genetic basis of bipolar disorder indicate that susceptibility stems from multiple genes. 5. Mania is often characterized by insomnia, elation, euphoria, hyperactivity, productivity, hyper imagination, a "flight of ideas," over-talkativeness, etc. Depression or Clinical depression, is often characterized by slowness to conceive ideas and move, anxiety or sadness, even suicidal thoughts or actions. It should be noted that this disorder does not consist of mere "ups and downs". Ups and downs are experienced by virtually everyone and do not constitute a disorder. The mood swings of bipolar disorder are far more extreme than those experienced by most people. 6. There is no cure for Bipolar, how ever there are medications that can be used to prevent a person from going out of control.Medications, called "mood stabilizers" can sometimes be used to prevent or mitigate manic or depressive episodes. Periods of depression can also be treated with antidepressants. In extreme cases where the mania or the depression is severe enough to cause psychosis, antipsychotic drugs may also be used. Some common medications are Lithium salts, Anticonvulsant mood stabilizers,and Atypical antipsychotic drugs. Also Psychotherapy and Electroconvulsive therapy have been shown to be effective.

7. Even though Bipolar Affective Disorder can be extremely difficult at times, individuals (and to some degree their families) who have it, tend to be intelligent, creative and successful. Some also believe that the manic state is a type of universal connection which provides creativity and intelligence but comes with the price of the depressive low.

· Support groups · National Alliance for the Mentally Ill(US) (http://www.nami.org/) · Depression and Bipolar Support Alliance (US) (http://www.dbsalliance.org/) · Manic Depression Fellowship (UK) (http://www.mdf.org.uk/) · Child & Adolescent Bipolar Foundation (US) (http://www.bpkids.org/) · Psych Forums: Bipolar Forum (http://www.psychforums.com/forums/viewforum.php?f=135) · Health Diaries: Bipolar Disorder (http://www.healthdiaries.com/bipolar-disorder.htm) 8. BPrayer: Support for Those With Bipolar Loved Ones (http://bprayer0.tripod.com/)


The above are not support groups. They are pro-psychiatry groups. Don't keep calling bipolar disorder or any other mental illness a "disease of the brain" until you can provide the objective test for the disease. Until then, bipolar disorder remains, like schizophrenia, a social construct. -- Francesca Allan of MindFreedomBC
Agreed, too many support groups and websites pretty much tow the psychiatric industry line. For example, just TRY to find any mention of the Neurontin scandal (heck, some websites STILL promote Neurontin as a psychiatric drug!). Additionally, there is rarely any mention that most psychiatrists regularly mis-diagnosis and/or under-diagnose their patients. Anarchist42
NAMI, for instance, is heavily subsidized by pharmaceutical companies. NAMI's website is not much more than a drug advertisement. Their website is also riddled with comical statements such as the shocking news that bipolar people experience a divorce rate of 60%. (Last time I checked, the general divorce rate in North America was 57%.) -- Francesca Allan of MindFreedomBC

Bipolar disorder, talent and famous people Many famous people are believed to have been affected by bipolar disorder, based on evidence in their own writings and contemporaneous accounts by those who knew them. See list of people believed to have been affected by bipolar disorder. There is no definitive scientific basis for classifying dead people as having had bipolar disorder, though they may very well have suffered from severe and even recurrent bouts of disordered mood. Until very recently there were no diagnostic systems with any degree of reliability. Even with the development of tools such as DSM-IV, there is a great deal of diagnostic uncertainty with living patients who have been intensively studied for decades, and there is no reason to think that it is any easier to diagnose individuals in their graves. For these reasons, some doctors regard psycho-history of this sort as a dubious endeavour. There appears to be an association between bipolar disorder and artistic talent in many cases - this is documented in Jamison's book "Touched With Fire: Manic-Depressive Illness and the Artistic Temperament".



24.58.228.xxx makes the assertion that

Psychohistory is a highly unreliable and dubious enterprise generally promoted by less than reputable psychologists and psychiatrists, patients who wish to be in good company, and organizations that stand to benefit from contributions made by those whose sympathies would be aroused by such "diagnoses at a distance".

The leading author of books on mental illness in history, Kay Redfield Jamison, is a Professor of Psychiatry, at The Johns Hopkins University School of Medicine. She is a MacArthur Fellow. She has been published extensively in peer-reviewed journals. Her book on the subject, 'Touched with Fire', has been favourably reviewed by Herbert Pardes, Dean of the Faculty of Medicine at Columbia University, and James. D. Watson, the Nobel Prize winning discoveror of DNA. Hardly 'less than reputable'.

24.58.228.xxx, your contributions on this subject seem to be remarkably forceful, as if you are speaking with authoritative professional expertise on a subject of which previous authors have little knowledge.

Can you tell us what your qualifications as a medical doctor are?

-- The Anome (who is not a medical doctor)

Reply to Anome: I have entered this reply twice and once in another location for Talk, but for some reason it is not taking. Hence I repeat my reply here, again: For some reason the person who made the original entries on bipolar disorder and depression (you, I take it) deleted my corrections of these and snidely challenged my credentials (assuming that like himself, I was unqualified), while acknowledging that he was not an MD. Somehow my reply to his comment was deleted. The fact is, I am an MD, a neuropsychiatrist and an officer of a society on the history of psychiatry. As I explained, it would not seem appropriate for him to go in and on his own authority delete everything that I have written because he assumes that I am no more qualified than he. I assume that there is a reconciliation to be done between the (rather obvious) misinformation he has been providing and the detailed and accurate information I have provided. Where appropriate I have given chapter and verse for my explanations. Despite the fact that his work was riddled with errors and misleading information, I did not take it upon myself to delete any of his work, and I should appreciate his giving me the same courtesy. (SE)

I have therefore replaced the last version of the bipolar and depression entries with the last version which included what I have written. If you wish to correct anything that you have written, or suggest anything incorrect in what I have written, I welcom you to re-enter these as separate comments. I trust that you will not delete or in any way alter what I have written without informed authorization from the owner/editor of the Wikipedia site.

For some reason, my restoration has not taken in the bipolar and depression entries, so I will replace them again. I trust that you are not purposely erasing my work a second time.

I will attempt to inform the owner/editor of the problem

Thanks, SE

---

Kay Redfield Jamison receives flak because she conducts mesearch and diagnoses the dead. I myself like her work but regard it as somewhere between amusing and tacky.

Kay Redfield Jamison is a beautiful writer and very intelligent woman who found that lithium was an effective treatment for HER. She somehow extrapolated that to recommend such treatment for the rest of us bipolars which was way over-stepping. As I said, she's a fabulous writer but she is merely one pro-psychiatry writer. She is certainly not THE writer on the subject, but rather a minor player. Much more important works were contributed by, among others, Thomas Szasz, Peter Breggin and (most recently) Robert Whitaker (author of "Mad in America", which I highly recommend to everybody, regardless of their personal viewpoint on psychiatry). -- Francesca Allan of MindFreedomBC

Hey, SE! Please don't just revert my changes - I am trying to merge in your point of view. Please don't just write CORRECTION all over the place: it breaks up the article, and forces others to edit the article back into readable shape. Please either:

  • boldly edit the article to what you think it should be (but be aware you may be boldly edited in turn) or
  • (better) where there are differing points of view, mention it: 'some say this, others say that' or 'medical opinion now generally considers x to be true; some disagree and say y'

This is particularly true of the several different meanings assigned to 'Manic Depression' over time. Remember, your view is not the only view - and even if you consider yourself to be correct, others may not - so cite evidence for your opinions.

You will find that I have 'authorization from the owner/editor of the Wikipedia site'. As do you. Please see Welcome, newcomers and Most_common_Wikipedia_faux_pas

I am glad to hear that you are an MD. We could use your informed point of view. But please don't assume that non-experts in a given field have nothing to contribute - we are after all the intended audience for Wikipedia, and are generally competent at editing text.

I am sorry that you are upset by my request to state your qualifications - I am more likely to take your point of view seriously as an expert in the field, rather than as another non-expert.

But you do need to _work with_ other authors.

-- The Anome (who is a recognised expert in a number of non-medical fields)

SE, please see my edits to Depression, with matching commentary, in talk:Depression. See how Wikipedia works: the striving for consensus and NPOV? It's not my text, or yours: it belongs to Wikipedia, and via the GFDL, the world. -- The Anome

Right, now watch the same process applied to Bipolar disorder, in a number of logically defensible stages. -- The Anome

  • The first edit: I entirely remove the paragraph you complain about, and replace it with your corrected text. I change the formatting slightly to make it prettier, and remove the start of the first sentence as it no longer needs to state that it is a correction. -- The Anome
  • The second edit: now I change an assertion that Bipolar II is milder, to the assertion that 'some consider it to be milder'. Now, this is a statement of the opinions of others, that I am willing to give cites for. -- The Anome
  • The third edit: now I cite your opinion, in your own words, as the opinion of 'other doctors', representing your opinion as that of an MD, rather than that of 'some people'. (You change from 'a doctor' to 'other doctors', as I assume that you are not the only MD that has this opinion.)


  • The fourth edit: I qualify 'manic people losing insight' with the word 'some' as per your correction.
  • The fifth edit: I remove the sentences requesting the correction above, as they are now redundant. I leave in the rest of the correction paragraph.
  • The sixth edit: I take the rest of your qualification to the statement in the para above, and I insert it in-line into the text. I remove your sentence regarding what it is correcting, as it now follows it as an extensive qualification in-line. Note that the qualified statement has always stated that the drugs 'can' prevent episodes, not 'can always'.
  • The seventh edit: I weaken the qualified statement to 'can sometimes'
  • The eighth edit: I remove the rest of your correction, as the above I believe incorporates its sense into the text
  • The ninth edit: I consider G+J to be a classic; you consider the Kraepelin text to be a classic - let's make a list!
  • The tenth edit: not only do I consider G+J to be a classic, so do all these others: (see http://www.oup-usa.org/isbn/0195039343.html ). I will just let two stand here:
    • "The best treatise on the subject since Kraepelin."--Journal of Clinical Psychiatry
    • "A classic work--a textbook in scope, but literate, readable, and compassionate. Sets a new standard in scientific medical writing."--Myrna M. Weissman, Columbia University College of Physicians & Surgeons

Oh look, these people are Medical Doctors too. In my opinion, four named MDs, and a number of writers in peer-reviewed medical journals beats the opinion of one anonymous MD, using the well-known techniques of 'meta-review'. So I will delete your comment deriding the G+J book.

  • the eleventh edit: I downgrade the assertion re historical figures and bipolar disorder to an opinion, and cite that others are skeptical
  • the 12th edit: I move your sentences qualifying this statement in-line
  • the 13th edit: I remove your comment deriding those who attempt to consider whether historical figures were bipolar, as there is evidence (see the top of /Talk above) that (at least some) highly regarded medical authorities have taken part in this activity, and the comment appears ad hominem.
  • the 14th edit: s/Unlike/Compared to/; s/have/are more likely to have/; moved comment re schiz. patients inline; removed CORRECTION notice, as its sense (and some text) is now incorporated into the text
  • the 15th edit is a pure copyedit, removing dividing lines that are now redundant, and restoring the bullet-list structure of the external link list
  • the 16th edit: Moved external link to end of article, put comment pointing to end of article in its place
  • the 17th edit: mentioned your opinion that psycho-historical stuff is dubious

Now I'm done - for now. I hope that I have fairly incorporated all your opinions into the article. If you disagree, please feel free to edit - and please justify your changes here!

-- The Anome


"Many famous people are believed to have been affected by bipolar disorder, including Spike Milligan...There is no definitive scientific basis for classifying any of the above deceased persons ..." Does Spike Milligan know he's dead? The internet doesn't seem to think so. Verloren

Ah yes, but Milligan's not a medical doctor - he and I only think he's alive. An MD's opinion overrides that of a layman, therefore, as non-qualified people, we should accept Milligan's death as a fact. The alternative of thinking that an MD might be wrong about anything is too appalling to contemplate. If I was to believe that, next thing I'd be believing that MDs might actually disagree with one another! And at that point, we'd have to use our tiny brains to work out which doctor was right. I guess that might involve 'cites', or 'literature research', or somefin' -- The Anome

Fixed up the wording cited above as a kindness to SE (s/any of the above deceased persons/dead people/) -- The Anome

I haved moved an earlier version the text before the SE/Anome edit wars to An older, deprecated, version of this page - please note that it contains text that SE, who is a doctor, claims to be inaccurate, and is only there as a temporary copy for comparison purposes, to check if there is any non-contentious material there that might be useful. I will delete it when this is done. -- The Anome

Several more edits made to recreate wiki links: see changelog for details -- The Anome

Changed some of the text to emphasis more the difference between BP in remission and schizophrenia in remission. It's often the case that someone with BP disorder who is not being medicated will appear normal between distrbances and to be fully functional and independent. It's rather uncommon for people with schizophrenia who have undergone several episodes to be fully functional and independent without medication.

Thanks for that. I've since made a couple of (I hope) non-controversial edits: see the changelog comments for details. -- The Anome

I have now added the words associated with mania]] or hypomania to the first sentence - this seems justified as the diagnoses for Bipolar I and Bipolar II (as cited by SE) appear to require an incidence of either mania or hypomania, respectively.

I'm also going to move the 'ups and downs' paragraph up the article to a more logical place, and delete its first word 'futhermore' -- The Anome

There are two essentially identical one-sentence paragraphs crediting Kraepelin with the discovery - replacing/merging the first one with the slightly more detailed second one. -- The Anome


I have now added subheadings, hopefully applying some structure to what is now becoming a reasonable length article -- The Anome

Added note re incorrect, but common, usage of term 'manic depression':


Note: Bipolar Disorder is also commonly (and wrongly) called manic depression by laymen (and by some psyciatrists in the twentieth century) although this usage is now unpopular with psychiatrists, who have now standardised on Kraepelin's usage of the term to describe the whole bipolar spectrum.

Please, SE, note that I am recording usage here, and noting that it is incorrect. -- The Anome

Many famous people are believed to have been affected by bipolar disorder, including Spike Milligan, Lord Byron and Winston Churchill, based on evidence in their own writings and contemporaneous accounts by those who knew them.

I think that Spike Milligan was actually diagnosed with bipolar disorder - in any case, I remember something in one of his books about him being diagnosed "manic depressive" (this wasn't the war books, it was, I think, the intro to a books of his letters, probably published around the 70s). I think he talked about it elsewhere as well - anybody know for sure?

There's a book written by him and Anthony Clare, based on his appearance on Clare's BBC Radio 4 programme. That's where I read about it. -- Tarquin


Dysphoric mania is not the same thing as manic depression / bipolar disorder: it's one of the possible phases of bipolar disorder. Recent thinking is that depression and mania are two different axes, thus creating four possible extremes:

  • euthymia (ie normal): not manic, not depressed
  • depression: not manic, depressed
  • mania: manic, not depressed
  • mixed state / dysphoric mania: manic and depressed

-- The Anome 07:08 24 Jun 2003 (UTC)

So, I guess it's all covered. Every single mood level is now worthy of psychiatric diagnosis and, by extension, medication. What a pile of shit psychiatry is! -- Francesca Allan of MindFreedomBC
Actually, it's about time that the myth that mania and depression are opposites on the same axis ended, considering that the very existance of mixed states belies that assertion. Anarchist42
Perhaps it's time to retire the myth that biomedical psychiatry is a legitimate branch of medicine. If bipolar disorder were a brain disease (like Alzheimer's or Parkinson's), we would consult neurobiologists not psychiatrists. -- Francesca Allan of MindFreedomBC

WikiProject Psychopathology started, please feel free to join.

I have restored Kurt Cobain to the list of famous bipolar people. In various interviews his cousin Bev Cobain has confirmed that he was diagnosed as bipolar. See http://www.ahealthyme.com/topic/cobainqa for a cite.


The list of alleged, presumed or diagnosed bipolar people probably needs to be spun off into its own article, with just a select few cited here -- large numbers of famous people have been associated with BP, and if we put them all in, the list will overwhelm the article. -- The Anome 21:32, 13 Sep 2003 (UTC)

Sounds good to me. Go for it! Noel 01:19, 14 Sep 2003 (UTC)

What view does alternative medicine hold of the causes/treatments of bipolar disorder? Crusadeonilliteracy 14:55, 25 Nov 2003 (UTC)

A bit of Googling will find a few hits: it's all somewhat bitty. -- The Anome 00:50, 26 Nov 2003 (UTC)

I was just about to do something about that list, some anon keeps adding names to it in no particular order and without wikifying: though shouldent it be put in alphabetical order G-Man 00:57, 26 Nov 2003 (UTC)

Much of it seems already to be alphabetical by surname: I've formatted it as a list item for each letter of the alphabet, to cut down on space. -- The Anome

Depakote is also widely used for the treatment of Bipolar. Is this simply a brand name for one of the listed drugs, or does it belong in the article?

Yes, Depakote is a brand name for one form of semisodium valproate. -- The Anome 10:30, 23 Jun 2004 (UTC)