is diagnosing bipolar social engineering?
just to preface, i am not denying the existence of bipolar disorder. the real question i am asking is a bit long for a blog post title: what proportion of bipolar diagnoses are cases of social engineering?
in other words, how many people are diagnosed as having bipolar disorder because their behavior deviates outside the norm of social acceptability? is the diagnosis of a mental illness and subsequent prescription of medicine a way of controlling unruly people?
i’m going to stick with bipolar 2, since that is what i am most familiar with, and i will really just be evaluating the hypomanic end of the spectrum. finally, i am NOT a medical doctor nor a clinically trained psychologist. so, with that in mind let’s commence.
first, some facts.
what are the criteria for bipolar 2?
- The presence or history of at least one hypomanic episode and depressive episode
- No history of a manic episode
- Significant stress or impairment in social, occupational, or other areas of functioning
Note: This is not a codeable disorder.
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day (or any duration if hospitalization is necessary).
B. During the period of mood disturbance and increased energy and activity, three (or more) of the following symptoms have persisted (four if the mood is only irritable), represent a noticeable change from usual behavior, and have been present to a significant degree:
1. Inflated self-esteem or grandiosity
2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
3. More talkative than usual or pressure to keep talking
4. Flight of ideas or subjective experience that thoughts are racing
5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed
6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
7. Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic.
D. The disturbance in mood and the change in functioning are observable by others.
E. The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic.
F. The episode is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment).
Note: A full Hypomanic Episode emerging during antidepressant treatment (medication, electroconvulsive therapy, etc.) and persisting beyond the physiological effect of that treatment is sufficient evidence for a Hypomanic Episode diagnosis. However, caution is indicated so that one or two symptoms (particularly increased irritability, edginess or agitation following antidepressant use) are not taken as sufficient for diagnosis of a Hypomanic Episode, nor necessarily indicative of a bipolar diathesis.
Specify with Mixed Features.
so when i told my new therapist about my behaviors last summer, the period i perhaps presciently called my manic period, which included profuse drinking, recreational drug use, inability to hold a part-time job, copious sex with a 21 year old italian deviant playboy, and spending every last cent i had, she said indeed that does sound like a hypomanic episode.
to me, that just sounds like a hell of a good time.
is it really a reflection of mental illness? or is the Man just shifting form and finding a new way to tell me how to live my life?