Why is bipolar disorder so popular?

One person in a Facebook group asked why is it popular to have bipolar disorder and other mental disorders among the young 111213091304-celeb-health-catherine-3-story-toptoday? One possible answer is that bipolar disorder has been associated with an unusual amount of creativity,intelligence and wealth. Kay Jamison is partly responsible for this romantic notion. Other studies on the topic seem to support the theory regarding creativity and upward mobility but not so much intelligence. I think most people would rather be diagnosed with a disorder that is associated with excess productivity,creativity and wealth than depression or schizophrenia which hasn’t been associated with any of these attributes. Here is an excerpt from one article regarding the topic:

We examined clinical features in 877 in- and outpatients affected by depression who were enrolled in psychopharmacological trials, subdivided according to Hollingshead’s method into five social classes. The results showed that social class correlated significantly with the subtypes of mood disorders, with bipolar disorder being more frequent amongst the upper than the lower social classes. Furthermore, as already reported in other countries, social class appeared to influence the psychopathological pattern of depressive symptoms: somatization and anxiety were more frequent amongst the lower social classes, while psychic and cognitive symptoms were more common amongst the upper classes.

Another answer might be that the bipolar disorder which many are diagnosed with today isn’t Bipolar I but Bipolar II. Bipolar II is less likely to be associated with psychosis which could make it more acceptable. In the past Bipolar disorder or Manic Depression was associated with a severe emotional disturbances, psychosis and a lack of treatment. No one wants a disease with no treatment.

A third possibility is that a small number of celebrities have been diagnosed with bipolar disorder and this could increase the popularity of the disorder. Catherine Zeta- Jones is one such celebrity who has been diagnosed with Bipolar II. She is obviously beautiful, popular and wealthy. Who wouldn’t want to be associated with all that? Moncrief  who is a psychiatrist doesn’t think Bipolar II patients need drugs and even questions the diagnostic category. Here is an excerpt from an article she wrote:

Bipolar disorder has become the ‘fashionable’ mental health diagnosis – helped, no doubt, by the fact that many celebrities, including Catherine Zeta-Jones and Stephen Fry, have said they, too, are sufferers.

A fourth possiblity is that artists such as Silvia Plath have been diagnosed with bipolar II. Artists share the angst that is more popular among younger people and popular artists are associated with increased social status/wealth.

A fifth possiblity is that bipolar disorder is more unusual than other mental illnesses with a percentage of around 2% of the population. It is also respected as more severe than say depression which is known as the “common cold” among doctors. This combined could make the person feel more unique and respected.

A sixth possibility and the most likely explanation is that Bipolar disorder is now seen as existing on a spectrum by a few bipolar experts. Additionally the concept of a spectrum gave pharmaceutical companies a new market for many of their highest priced medications which they market to psychiatrists and directly to the public.

In conclusion, I think it is popular to be slightly mentally ill but not so much that it is associated with loss of productivity and poverty. Poverty and isolation are what we all are trying to avoid.


Four day rule of hypomania questioned

Published by the American Psychiatric Associat...
Published by the American Psychiatric Association, the DSM-IV-TR provides a common language and standard criteria for the classification of mental disorders. (Photo credit: Wikipedia)

A group of researchers are questioning the validity of the four day hypomanic threshold needed for a diagnosis of bipolar II. The four day rule could potentially exclude a considerable number of individuals with bipolar II.

They found that 186 bipolar II disorder patients who met the 4-day criteria did not differ significantly from 315 patients whose manic episode lasted less than 4 days on a number of illness correlates on the Mood Swings Questionnaire (MSQ).

“Our study findings are strongly consistent with previous studies arguing that the clinical phenotype of [bipolar] II disorder (and its existence) is not dependent on a minimum duration of four days as imposed by DSM-IV and DSM-5, but further advanced by validation against a number of clinical correlates and not simply by examining phenomenological expression,” the researchers Gordon Parker (Prince of Wales Hospital, Sydney, Australia) and colleagues comment.

The only difference was that patients with brief manic episodes were more likely to rate manic symptoms as being less severe than those whose episodes lasted for 4 days. The average total MSQ scores were 49.6 and 57.0, respectively.

I personally have experienced a significant mood change for less than four days. It often occurred  over a a period of three days and the mood switches within a day were almost like clock work. Given the arbitrariness of the rule I’m not surprised by this study’s finding.