Talk:Bipolar disorder/Archive 5

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Additional information request

In addition to the rates of mortality (0.4%) could you also mention the rates of homicide and multiple homicide in relation to the general population? Jrundlexx (talk) 17:40, 23 August 2011 (UTC)

Edit request from Villegas.john, 6 May 2010

{{editsemiprotected}} Please change

Studies show that tobacco smoking induces a calming effect on most bipolar people, and a very high percentage suffering from the prolonged use.[118]

to

Studies show that tobacco smoking induces a calming effect on most bipolar people.[118]

because the first version is redundant, confusing, and poorly worded. The same thing can be said with the second version.

Villegas.john (talk) 04:22, 6 May 2010 (UTC)

Done Doc James (talk · contribs · email) 05:17, 6 May 2010 (UTC)

Occupational Therapy Interventions

Occupational therapists can assist individuals with bipolar disorder by helping them improve their ability to function and perform their meaningful daily activities. Occupational therapy interventions focus on client's strengths, using them as a platform to identify goals that are achievable, functional and most importantly, meaningful. Occupational therapy services can be carried out in both individual and group settings. Common occupational therapy interventions for bipolar disorder treatment include educating clients, changing or adapting the environment, compensating to make things easier, and developing resources and skills.

References

— Preceding unsigned comment added by Mortonj (talk • contribs) 19:00, 8 May 2010‎ (UTC)

Education

When working with clients living with bipolar disorder and various other mood disorders, occupational therapists play a big role in providing education to clients, their families, other health care professionals, and the general public. By providing more knowledge about the disorder and the side effects, occupational therapists can help clients stay in treatment and on medication. Education also helps clients recognize symptoms that appear in early stages of episodes. Occupational therapists help clients develop management skills for their bipolar disorder including: controlling stress and coping skills, identifying things that cause episodes, and creating a relapse plan. Research shows that many available relapse plans tend to focus on four main areas. These include illness awareness, continuing treatment, noticing early when symptoms re-occur, and regular activity scheduling.

Educating family members about bipolar disorder improves overall well-being. Families are taught to decrease disagreements by learning communication and problem solving skills. Often, family education also includes discussing the importance of creating and improving social support networks for individuals living with bipolar disorder. This will lead to long-term benefits including social support, involvement in meaningful leisure and productivity, and family attitudes towards bipolar disorder.

References

— Preceding unsigned comment added by Mortonj (talk • contribs) 19:00, 8 May 2010‎ (UTC)

Skill Development

A manic or depressive episode can impair the skills needed to function in everyday activities. The goal of an occupational therapist is to enable the client to function to the best of their abilities. This can be accomplished by teaching new skills or re-establishing old ones in order for the client to participate in meaningful tasks. Skills, such as social and organizational, are developed through learning or re-learning within the environment that the client wishes to participate in. In general, occupational therapy focuses on skill development within the areas of self-care, productivity, and leisure.

Common Techniques & Concepts

Grading: Grading is a key concept and widely used technique in occupational therapy. Grading involves slowly increasing the difficulty of a given task and allows the client to re-learn or acquire new skills needed to reach their goals. Some ways that grading can be applied is by increasing the difficulty of the activity, or breaking down the activity into component parts.

Chaining: Rooted in behavioural therapy, chaining is widely used in skill development training. Forward chaining is one type of chaining method where tasks are broken down into small steps, starting from the beginning of the task. Once an individual learns the first step of the task, they continue to learn each sequential step until they can complete the entire task independently. The opposite occurs in backward chaining where individuals are shown an entire task except for the last step, which they have to perform independently. Preceding steps of the task are performed by the individual until they can complete the entire sequence on their own .

Just-Right Challenge: This is a concept central to skill development in occupational therapy. This challenge refers to creating treatment activities that are neither too difficult or too easy to perform. By doing so, the individual will experience small successes in their chosen occupation, while still being challenged and improving on the necessary skills required.

Role Play: Role play is mostly used in specific skill training in occupational therapy. It focuses on areas such as assertiveness training and anxiety management to help gain a better understanding of certain problems experienced by the a client. When dealing with bipolar disorders, role play gives an individual a chance to view their situations more critically and objectively .

Cognitive Behavioural Therapy (CBT): Using a goal-orientated system, Cognitive Behavioural Therapy (CBT) techniques are often used by occupational therapists to address the dysfunctional relationship between a client's thoughts, emotions, and resulting behaviours . Some approaches used when working with individuals with bipolar disorder include coping skills for manic and depressive episodes, and teaching self-monitoring and regulation techniques, such as journalling.

References

— Preceding unsigned comment added by Mortonj (talk • contribs) 19:00, 8 May 2010‎ (UTC)

Environment Adaptation and Resource Development

After experiencing a period of depression or mania, a person may feel they no longer have the skills or resources to suit the environments where they complete daily activities. An individual may choose to use a resource or adapt their environment to take on a meaningful role without learning new skills. An occupational therapist connects clients to people, places or things that will help them in their communities. This could include help with applying for government financial assistance, or providing an object like a simplified bus schedule which allows an individual to move around their community independently. The therapist helps a person re-build their support network, which may have been disrupted during a severe episode. This support network then acts to help the individual monitor their mood to prevent relapse. Mentorship or peer support programs can allow the client to share their successes and struggles with someone who has learned to live with bipolar disorder.

References

— Preceding unsigned comment added by Mortonj (talk • contribs) 19:00, 8 May 2010‎ (UTC)

Occupational Intervention Strategies

Self-Care Intervention Strategies

Some common self-care goals for people living with bipolar disorder include re-establishing sleep routines, acquiring coping skills, and improving medication compliance, healthy eating and exercise habits. Some key intervention strategies used by occupational therapists for these goals include:

Activity scheduling: Occupational therapists act to help individuals create in-depth weekly logs and schedules for their daily lives.

Sleep Routines: During depressive episodes, an individual will often increase the amount of time spent sleeping. To counteract this occurrence, a strict sleeping schedule is encouraged to eliminate daytime sleeping, and control wake-up times. During manic episodes, an individual will often have little or no sleep due to increased agitation and irritability. As a result, an occupational therapist would help an individual create target times for sleeping, as well as making sure that caffeine intake and late working hours, were eliminated in the early evening.

Healthy Eating and Exercise Habits: Occupational therapists collaborate with the clients to formulate meal and exercise schedules. A common goal is to help people to commit to eating at regular periods three times a day. Increasing regularity in food intake and physical activity will be graded by the occupational therapists depending on what level the client is currently at and what their overall goals are.

Thus, when an individual is in a depressive state and suffering from inactivity and lack of motivation, the goal is to incorporate more meaningful activities in their lives. On the other hand, while an individual is in a manic episode, adjustments would be made to the schedule to reduce the amount of activity.

Education: Occupational therapists play an important role in educating clients with bipolar disorder about increasing their self-awareness and knowledge about certain signs and symptoms of the illness and how they may impact their basic activities of daily living. Occupational therapists also teach clients about compensatory strategies and environmental adaptations that may help them achieve their self-care related goals. For instance, when a client is having a difficult time falling asleep, an occupational therapist may advocate the regular use of relaxation techniques to help create a more regular sleep pattern.

Productivity Intervention Strategies

People who have recently experienced an acute episode of depression or mania are likely to experience a disruption in their activities as students, volunteers, and employees. Research has found that paid work is highly valued by people receiving mental health services. Tse and Walsh outline the most important roles for occupational therapists as: helping clients maintain hope in their ability to return to work, helping increase self awareness, providing support at the workplace, and helping the client find meaningful employment.

Workplace support: Occupational therapists may provide support to a client by: advocating for changes at the worksite, coordinating transportation for work, teaching cues for specific tasks and safety, and promoting social interactions with co-workers.

Advocating: Collaborating and advocating with employers and schools helps to ensure a safe, stigma free environment which is more likely to accommodate individual needs. Occupational therapists may also play a role in advocating for policy changes to decrease discrimination against people with bipolar disorders.

Leisure Intervention Strategies

Research shows that leisure provides a path to self-determination, skill acquisition, improved self-esteem, social connections, and overall life satisfaction. Some common leisure goals for people with bipolar disorder include: individual or group involvement in sports, arts, music, reading, computers, and socializing with friends. Regardless of what type of bipolar disorder an individual has, they will likely lack the confidence to be involved in leisure activities. Occupational therapists help their clients change their thinking to gain confidence and choose leisure activities that are meaningful and motivating to them. Occupational therapists organize and run groups to improve interpersonal skills as well as to connect clients to groups already existing in the community.

OT Run Groups: Occupational therapists organize and run a wide range of leisure groups. Some may take place within a clinical setting or in the community. Often the activity chosen for the groups are selected by the participants and might include activities such as badminton, walking, cooking, painting, pottery, music, movie nights, and outdoor outings. Groups run by the therapist may also focus on learning social, communication, and problem solving skills that the participants can then apply in leisure pursuits.

Linking to Community Groups: Many leisure groups already exist in many communities. The occupational therapist will help connect their client to these organizations and may help support them in their involvement. This may involve the occupational therapist attending the first few sessions with the client and providing less and less support over time until the client is comfortable participating on his or her own. Many communities have mentorship or peer support groups where the therapist can help link clients to a volunteer who also has bipolar disorder and can act as support within the community.

Mortonj (talk) 19:00, 8 May 2010 (UTC)

References

Hi, this is so I can see the references here. Casliber (talk · contribs) 20:48, 8 May 2010 (UTC)

Jimmy Corkhill

I notice the Cultural references section covers the Stacey Slater storyline from EastEnders, but if we can find a good source it might also be worth making mention of the Jimmy Corkhill storyline from Brookside, a much earlier storyline showing bipolar and its effects. Any thoughts on this? TheRetroGuy (talk) 13:54, 18 May 2010 (UTC)

hah, there's a name I haven't heard in ages. Love to add it but really need a secondary source discussing it. Cheers, Casliber (talk · contribs) 14:18, 18 May 2010 (UTC)

There's this from Staffordshire Health Authority in which Dean Sullivan briefly talks about playing the character when he opened an exhibition. Not sure whether we can use it. I'll see if I can find something better. TheRetroGuy (talk) 14:36, 18 May 2010 (UTC)

There's also this article which originates from the Liveerpool Echo on 14 May 2003. The link itself is probably not usable but the article could be added as a source. TheRetroGuy (talk) 14:50, 18 May 2010 (UTC)

I've added him to the Stacey Slater paragraph as there isn't enough info for a stand alone paragraph. I've used the Liverpool Echo ref, but not the link as I wasn't sure about that. Cheers TheRetroGuy (talk) 15:22, 18 May 2010 (UTC)

Incidents of the disorder amogst children go from 20000 to in 1994 to 800000 in 2007.

Is this the prime example for overdiagnosis? People who take Zypraxan brains shrink 10%. It causes liver failure and death. Exactly how easy is it for psychiatrists to diagnose this condition? It requires no input from the patient. The entire world is bi-polar. There's not even a lie detector test involved. It's the psychiatrists who are schizophrenic... they don't understand the implications of what they are doing. All they're doing is collecting a paycheck. I can literally have anyone commited to a hospital for an extended period of time with just one phone call to any mental institution - followed by severly detrimental side effects caused by the anti-psychotics with no expiry date. If an idividual has temporary insanity due to outside factors are they bi-polar? According to psychiatrists the answer is yes. Just because they're professionals doesn't mean they're smart. If temporary insanity is a legal term to describe a mental health condition in a court of law why isn't it recognized by the health community? No violence, no threats, no lie detector test = liver failure, diabetes + possible sudden death as a side effect. Those are pretty severe side effects. I now have to take anti-psycotics for the rest of my life because I had an arguement with my sister. The psychiatrists should take lie detector tests - there is even a new kind of lie detector test similar to a CT scan. It's flawless. It's going to court. —Preceding unsigned comment added by 70.50.59.233 (talk) 07:37, 24 June 2010 (UTC)

I agree... the blatant overdiagnosis of this disease (in the United States at least) is quite a disturbing phenomenon and even worse, overlooked to the point of tragic consequences. The line in the article mentioning its "underdiagnosis and misdiagnosis" is sourced solely by the same people who declared homosexuality to be a disease. This can be quite a dangerous statement as cyberchondria will make many people further justify self-diagnosis and experience the devastating costs behind the treatment of this disorder with no benefit. This trend, I hope, will end one day. From my observations of several, several people, the main causes for misdiagnosis is substance dependency (doctors are trained to detect high people, not the long-term bipolar-like effects unrelated to acute intoxication) and misunderstood giftedness. The psychiatric drugs, such as olanzapine as you mentioned, ironically have side effects like mood swings and psychosis which only appeared to confirm its apparently progressive nature. Worse yet, if one wanted to come off the medication, they'd instantly be dismissed as having a delusional episode. Thus the justification for further inappropriate, though well-intentioned, prescriptions of drugs. What with the money that promises, talk about a psychiatrist's dream! I come from a family of physicians including a mental health professional and with my experience with several medical professionals; I can attest to the fact that doctors are very human and not universally brilliant. The matter of fact is that it is overdiagnosed to a historically unprecedented degree that actually, I believe, justifies a section of its own in this article.Gaith M. (talk) 14:18, 29 March 2012 (UTC)

Definition Manic Depression

This term manic depression should include the original definition per Emil Kraepelin. I lack the knowledge of how to edit the actual page so I am hoping some one picks this up and puts it in. The term Manic depression was originally defined as the following:

"Manic-depressive insanity...includes on the one hand the whole domain of so-called periodic and circular insanity, on the other hand simple mania the greater part of morbid states turned melancholy and also not inconsiderable number cases of amentia (confusional or delirious insanity). Lastly we include here certain slight and slightest colorings of mood some of them periodic, some of them continuously morbid which on the one hand are to regarded as rudiment of more severe disorders, on the other hand pass over without sharp boundary from the domain of personal predisposition."

This is from page one of

"Manic-depressive insanity and paranoia" by Emil Kraepelin., 1921. ISBN 0405074417

• Manic Depression has not been in use in the DSM since the 1980s when the term was changed to bipolar disorder. It is not necessary to go into something that is out of date and no longer applies. It only spreads old information that no one needs. * — Preceding unsigned comment added by Bree25 (talk • contribs) 06:17, 26 March 2011 (UTC)

Link to full English version book:

http://www.scribd.com/doc/33270822/Manic-depressive-insanity-and-paranoia-1921 —Preceding unsigned comment added by TamKelly (talk • contribs) 17:36, 26 June 2010 (UTC)

Causes - Childhood Precursors subsection - Multiple issues

This is a strange little section. The presence of bipolar spectrum disorders and attentional disorders amongst children is a politically charged topic. There is a sort of mythos that has grown up around the pediatric prevalence of these disorders, helped by a great deal of hysterical attention in the popular media.

The claim (from the Childhood Precursors subsection) that "A history of stimulant use in childhood is found in high numbers of bipolar patients and has been found to cause an earlier onset of bipolar disorder..." is misleading and an outright falsehood, stating that a proven causal relationship exists where there is none. A definite causal relationship between the stimulant treatment of ADD/ADHD and the risk of later onset mood disorders is not asserted in any of the articles cited. The positions taken in this subsection are opinion. They are not supported by the articles named in the citations [43] through [45] that are given. There is a common-knowledge statistical correlation between attentional disorders and bipolar spectrum disorders. They are very frequently comorbid, and even when the attentional symptoms are not severe enough to constitute a separate diagnosis, the generalized CNS depression that occurs during depressive phases commonly interferes with attention and concentration. Ucbuffalo81 (talk) 15:43, 16 July 2010 (UTC)

Notes

Yes, that reference seems to cover the facts, so I added it. Thanks,  Chzz  ►  23:59, 19 July 2010 (UTC)

 Done

Irresponsible caption

The Van Gogh painting is fine for the lead, but the accompanying text is extremely irresponsible. It reinforces the false notion that creativity and manic depression are mutually-reinforcing, even mutually-necessary. Children are fed this shit by media and actually believe it. Adults who have survived with the disorder (I am one of them) know how dangerous this is to repeat to children.

I have 30,000 or so edits on the English Wikipedia and can log in through an admin account to change it. We already have Van Gogh on Major Depressive Disorder and don't need to burden the memory of the poor man on this page as well. Please someone else just NPOV this. A pic of a suicide victim with a caption explaining cause and outcome would satisfy NPOV.

-- Thanks.

Eh? What's that about being able to log in through an admin account? Looie496 (talk) 23:19, 30 July 2010 (UTC)

Thanks for the response. --Thanks. —Preceding unsigned comment added by 173.239.187.26 (talk) 12:58, 1 August 2010 (UTC)

I can't recall if/where/how the original painting was discussed as a infobox image. Probably should open it up again (sound of wikipages ruffling and being searched). Casliber (talk · contribs) 21:24, 29 August 2010 (UTC)

It's irresponsible to diagnose or even suggest that a deceased person has a mental illness with no medical records to back it up. All references of this kind should be purged from WP. If the encyclopedia is concerned with the truth and with verifiability, it should avoid making allegations no one can offer proof of. Relleka (talk) 06:42, 3 March 2011 (UTC)

genetics-new developments

genetics have always been disputed when in relation to mental illness however there is growing evidence that genetics plays a powerful role

http://esciencenews.com/articles/2009/07/01/study.strongly.supports.many.genetic.contributions.schizophrenia.bipolar.disorder

the current hereditary studies also support the importance of genetics. If children of bipolar parents and grand parents are also experiencing bipolar disorder (as is my case) then this strongly supports the importance of genetics in the illness

http://esciencenews.com/articles/2010/03/01/offspring.2.psychiatric.patients.have.increased.risk.developing.mental.disorders

 (78.145.29.102 (talk) 23:47, 31 July 2010 (UTC))

Yes to a point. There is also the issue that if someone has a chronic mental illness this may markedly impact on their parenting, and childhood adversity is a predictor to all forms of mental illness. There is often a heterogeneity in the conditions that relatives of a person with a mental illness has, which doesn't easily gell genetically. But still, yes there does appear to be genetic loading. Casliber (talk · contribs) 01:34, 1 August 2010 (UTC)

I guess the important question is whether the necessary information is in the article. My impression is that it's there, but a lot of it is worded too technically for a large part of our target audience to be able to handle. Med-speak rather than People-speak, that is. Looie496 (talk) 01:52, 1 August 2010 (UTC)

(belatedly) this article has been on my to-do list for a while.... :( Casliber (talk · contribs) 21:22, 29 August 2010 (UTC)

NIHH Science Update • December 15, 2010

Scientists at the Johns Hopkins University School of Medicine in Baltimore led by Mikhail Pletnikov developed the mouse model used in this study by inserting a gene with a mutation known to be associated in humans with schizophrenia, depression, and bipolar disorder. They used a technique that allows them to turn the gene on and off at desired time points during brain development. In earlier research, mice with the gene, mhDISC1 (mutant human disrupted-in-schizophrenia-1) showed effects on social behavior and mood which differed depending on the sex of the mice, and the age at which the gene was active. The study shows brain development is more complex than originally thought and the argument between nature v. nature is not an easy question. The mutated gene has more control than originally thought.

http://www.nimh.nih.gov/science-news/2010/transgenic-mouse-offers-a-window-on-gene-environment-interplay-prenatal-infection-alters-behavior-in-genetically-vulnerable.shtml

NIMH Science Update * Breaking Ground, Breaking Through: The Strategic Plan for Mood Disorders Research, 2003

pages 28 - 31

http://www.nimh.nih.gov/about/strategic-planning-reports/breaking-ground-breaking-through--the-strategic-plan-for-mood-disorders-research.pdf — Preceding unsigned comment added by Bree25 (talk • contribs) 07:03, 26 March 2011 (UTC)

Low Dose Lithium

Over the last 20 years there has been an increasing body of robust evidence that lithium is an essential trace mineral. When lithium is absent from the soil and drinking water the incidence of bi-polar disorder in the population is greater, as is the incidence of many other psychological and behavioral disorders. Lithium administered in low doses (15 - 20 mg/day) as against the clinical dose (up to 1700 mg/day) it is effective as a preventive measure, and can be used effectively to treat the disorder as adjunct to other mood stabilizers.

Here is a useful review. [http://intelegen.com/nutrients/lithium.htm review on low dose lithium]

I am not authorized to edit this page, so I cannot work the relevant parts of these findings into the text. Perhaps someone else can do this.

Ergo4sum (talk) 09:41, 30 September 2010 (UTC)

npov, genetics

Read through today, first impression -NPOV whole article does not nearly discuss "all the disputes within a topic" but is more biased towards medical model way of thinking. -Inital section claimes genetic factors are important cause as fact, but later section on genetics (under causes) describes mixed inconclusive research.

when I am able to suggest edits with sources to reference I will, later on —Preceding unsigned comment added by Jamster1981 (talk • contribs) 16:59, 30 September 2010 (UTC)

Edit request from Subharanjan, 4 October 2010

{{edit semi-protected}}

Subharanjan (talk) 09:11, 4 October 2010 (UTC)

Not done: please be more specific about what needs to be changed. Thanks, Stickee (talk) 09:32, 4 October 2010 (UTC)

Prognosis

Under the subheading Recurrence

I believe there are a lot of stated "facts" that require a [citations needed] tag.

For example, I'm quite up-to-date on current research and very familiar with past research and I've never come across a reputable journal published study of the effects of caffeine on bipolar disorder. I found one study comparing the rate of suicide between bipolar patients who did smoke and drink coffee and bipolar patients who didn't and found a statistically significant correlation, however without a control group of smokers and coffee drinkers without bipolar disorder I feel that the study was flawed. They also failed to consider the severity of the illness with the consumption of nicotine and caffeine, is it possible that patients which more severe illness are more likely to smoke and/or drink coffee than patients with less severe illness and therefore more likely to die by suicide? [1]

A second study from 1976 found some similarities between patients who consumed high amounts of caffeine and similar symptoms but did not draw the conclusion that the caffeine was the cause of these similarities. In fact, the summary concluded with this statement "Further research is suggested to determine whether high caffeine consumption among inpatients may be related to staff coffee- drinking behavior and/or treatment with anticholinergic drugs." [2]

In general I believe while the statements in this section may be true they should all have citations. Lindygrey (talk) 19:17, 5 October 2010 (UTC)

You should feel completely free to improve the article. Because it is semi-protected (due to high levels of vandalism), you would normally need to have an account that is at least four days old and has made at least 10 total edits. However, since you are obviously competent, you could also go to Wikipedia:Requests for permissions and request that your account be confirmed, which would allow you to edit the article immediately. Regards, and let me know if there is any way I can be helpful. Looie496 (talk) 20:21, 5 October 2010 (UTC)

Edit request from 68.12.164.49, 17 October 2010

{{edit semi-protected}} I think whoever edited: Recovery A naturalistic study from first admission for mania or mixed episode (representing the hospitalized and therefore most severe cases) found that 50% achieved syndromal recovery (no longer meeting criteria for the diagnosis) within six weeks and 98% within two years. 72% achieved symptomatic recovery (no symptoms at all) and 43% achieved functional recovery (regaining of prior occupational and residential status). However, 40% went on to experience a new episode of mania or depression within 2 years of syndromal recovery, and 19% switched phases without recovery.[120]

This is not the conclusion of sitation 120 (http://ajp.psychiatryonline.org/cgi/content/full/160/12/2099). One would assume from the cut and paste above that it would be adnormal not to have full recovery. But the study sited was for people admited with MANIA (not depression which is why most are admitted) and the numbers don't match the conclusion of the author:

Within 2–4 years of first lifetime hospitalization for mania, all but 2% of patients experienced syndromal recovery, but 28% remained symptomatic, only 43% achieved functional recovery, and 57% switched or had new illness episodes. Risks of new manic and depressive episodes were similar but were predicted by contrasting factors.

68.12.164.49 (talk) 18:50, 17 October 2010 (UTC)

Not done: I'm sorry but I'm having trouble understanding what exactly you want changed. The template states that:

This template may only be used when followed by a specific description of the request, that is, specify what text should be removed and a verbatim copy of the text that should replace it. "Please change X" is not acceptable and will be rejected; the request must be of the form "please change X to Y".

Please re-state your request. Thanks, Shearonink (talk) 02:24, 18 October 2010 (UTC)

main picture

The main picture is extremely irrelevant to the article, and should be changed or removed for obvious reasons. —Preceding unsigned comment added by 75.1.139.211 (talk) 20:45, 18 October 2010 (UTC)

remove disorder from the system pls

(copy of entire article deleted, please see this revision) — Preceding unsigned comment added by E1st3in (talk • contribs) 10:31, 27 October 2010‎ (UTC)

Neutrality Disputed

I see a lot of text starting from the point, "Bipolar exists" and going from there - how to treat it, the causes, the symptoms, etc. But I don't see *any* text demonstrating that the illness even exists.

How would you tell the difference between bipolar disorder and something made up? If I were to make up an illness, I would make sure it was not testable, and I would have it be vague and blurry. If I were also trying to make money, I would have it cover a broad base of descriptions.

The "evidence" listed is that people swing between happiness and sadness. So does everybody. You can say bipolar causes more dramatic swings, but apart from the fact that this claim cannot be tested, it's also irrelevant. So what? People swing back and forth wildly. That doesn't make it an illness, that makes it an observation. Immediately jumping to the conclusion that an "illness" has caused such an observation is called pseudoscience.

A similar situation can arise if I make up an illness called "Sleepiness." Symptoms include being tired, irritable, lacking concentration, and a desire to sleep. There is no cure but it can be managed with cocaine. See, all these observations are real. People *do* experience all of these "symptoms" and cocaine does manage them. It doesn't make sleepiness an illness because I haven't identified the cause - lack of sleep. I've only identified observations and made up a cause that sounds legitimate. But observations are the first step in science - not the last.

Okay, long story short, I'd either like to see evidence establishing that such an illness even exists, or a section called "criticism" highlighting the flaws in psychiatry's view of people with bipolar.

Thanks,

--Sk8teh14 (talk) 05:31, 30 October 2010 (UTC)

The only accepted approach in Wikipedia is to base articles on the consensus of reputable scholarly sources -- we don't try to figure out the truth for ourselves, because we aren't capable of it. In the realm of psychiatry, by far the most reputable sources of information are the Diagnostic and Statistical Manual (DSM; for the United States) and the International Statistical Classification of Diseases and Related Health Problems (ICD; for the World Health Organization). Both of these define bipolar disorder as a distinct condition, and list the symptoms associated with it. They don't define sleepiness as a medical or psychiatric condition; they do however define some forms of insomnia as conditions. Bottom line: we don't make these decisions, we just follow the sources. Of course the manuals may ultimately turn out to be wrong -- when the literature comes to that conclusion and the manuals change, we will follow them. Looie496 (talk) 17:25, 30 October 2010 (UTC)

As Looie496 says above, we must rely here upon the consensus of reputable medical science, as required by Wikipedia's WP:NPOV policy. For a fuller discussion of the current state of medical opinion on this, the book Goodwin, Frederick (2007). Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression, 2nd Edition. Oxford Oxfordshire: Oxford University Press. ISBN 0195135792., provides an 800+ page in-depth review of recent research into bipolar disorder. -- Theredactor (talk) 19:35, 30 October 2010 (UTC)

Additionally, "Criticism" sections should always be avoided.76.120.66.57 (talk) 04:12, 5 November 2010 (UTC)

Not necessarily.

In many cases they [criticism sections] are necessary, and in many cases they are not necessary. And I agree with the view expressed by others that often, they are a symptom of bad writing. That is, it isn't that we should not include the criticisms, but that the information should be properly incorporated throughout the article rather than having a troll magnet section of random criticisms.

— Jimbo Wales

Xcrivener (talk) 22:02, 7 November 2010 (UTC)

Sounds like someone is unhappy with their new diagnosis.Unklekrappy (talk) 12:19, 25 September 2011 (UTC)

Looie496 is right, of course, about the "consensus of reputable scholarly sources", etc., but it might be worth pointing out that common sense tells us "sleepiness" is better "managed" with sleep--natural sleep--than with cocaine. When natural sleep becomes difficult we have the problem we call insomnia, a problem Looie496 discusses briefly. (I suppose this is all by way of merely making one of the steps in Looie496's argument more explicit.) TheScotch (talk) 06:19, 24 December 2011 (UTC)

Published NPOV challenge

Last month, the London Review of Books published Mikkel Borch-Jacobsen's article "Which came first, the condition or the drug?" (http://www.lrb.co.uk/v32/n19/mikkel-borch-jacobsen/which-came-first-the-condition-or-the-drug) (http://politicalcrumbs.wordpress.com/2010/10/07/when-profit-leads-the-way-to-diagnosis-doctors-and-profit-mongers/), which includes the following:

As a British blogger noticed recently, the Wikipedia entries Bipolar Disorder and Bipolar Spectrum were edited from a computer belonging to AstraZeneca, ensuring that everyone is on the same diagnostic page as the industry.

This appears to refer to experimentalchimp's not partcularly recent "AstraZeneca and Wikipedia: More Edits Uncovered" (http://experimentalchimp.wordpress.com/2007/08/17/astrazeneca-and-wikipedia-more-edits-uncovered/). Borch-Jacobsen's Rue89 article (http://www.rue89.com/2009/04/07/l-industrie-pharmaceutique-manipule-wikipedia?page=0) expands on these concerns, citing Manhattan Research's "advice to healthcare marketers looking to establish their own Wikipedia strategy" (http://social.eyeforpharma.com/story/wikipedia-strategies-european-pharmaceutical-healthcare-marketers).

Xcrivener (talk) 21:55, 7 November 2010 (UTC)

Nearly all psychiatric disorder generate controversy. A section address these concerns would be interesting. Doc James (talk · contribs · email) 21:58, 7 November 2010 (UTC)

That would belong in Mental disorder. Here, my question would be whether this (re)published challenge justifies a POV-check. Xcrivener (talk) 22:11, 7 November 2010 (UTC)

A section addressing some of controversy as it directly relates to bipolar would however belong here. Balancing the two approaches to psychiatry ( biological and psychological ) is always difficult. All psychiatric disorders are of unknown cause / pathophysiology. BTW the discussion of movements that oppose a psychiatric disease would belong in the section under society and culture.Doc James (talk · contribs · email) 22:14, 7 November 2010 (UTC)

I don't think the opposition is to the disease itself, but rather to the way the media, including Wikipedia, have seemingly been manipulated to manufacture consensus. Xcrivener (talk) 12:55, 17 November 2010 (UTC)

Scientific articles:

• Carlson GA, Glovinsky I (2009). "The concept of bipolar disorder in children: a history of the bipolar controversy". Child Adolesc Psychiatr Clin N Am. 18 (2): 257–71, vii. doi:10.1016/j.chc.2008.11.003. PMID 19264263. {{cite journal}}: Unknown parameter |month= ignored (help)
• Carlson GA (2009). "Treating the childhood bipolar controversy: a tale of two children". Am J Psychiatry. 166 (1): 18–24. doi:10.1176/appi.ajp.2008.08091362. PMID 19122014. {{cite journal}}: Unknown parameter |month= ignored (help)

Doc James (talk · contribs · email) 22:21, 7 November 2010 (UTC)

A debate rages in the medical community on the prevalence of bipolar disorders and ADHD. According to some, the disorders are over-diagnosed and over-treated while others believe the conditions are understudied with the wrong type of medication(s) often prescribed potentially causing harm.

— http://psychcentral.com/news/2007/03/19/bipolar-controversy/693.html

Xcrivener (talk) 23:18, 7 November 2010 (UTC)

Ref needed

Have removed this content until appropriate refs are found:

In the progressive metal band Dream Theater song Six Degrees of Inner Turbulence, the lyric of the first movement, About to Crash, describes a girl with bipolar disorder.

Tom Wilkinson portrays a manic-depressive lawyer in Michael Clayton. Matt Damon portrays a manic-depressive whistleblower and FBI informant in The Informant!. In Mark Whitacre, Matt Damon displays bizarre behavior including recklessness and grandiosity.

Next to Normal, a rock musical, concerns a mother who struggles with worsening bipolar disorder and the effect her illness has on her family.

In Law & Order: Special Victims Unit, Elliot Stabler's daughter, Kathleen Stabler, has been diagnosed with bipolar disorder. It is later revealed that Elliott's mother, Bernadette, also suffered with the disorder; but Bernadette chose not to take medication for it.

In King of the Hill, it is revealed that Kahn, Hank's neighbor, suffers from bipolar disorder. He has severe mood swings when off his medication, being extremely happy and energetic one day and completely depressed to the point of losing all hope of living the next.

In the serie ER, Dr. Abby Lockhart's mother Maggie suffers from bipolar disorder.

--Doc James (talk · contribs · email) 22:08, 7 November 2010 (UTC)

Yep. There should be some 3rd party refs for some of those in decent works, but looks like there are some core issues to address first... (groan) Casliber (talk · contribs) 23:50, 7 November 2010 (UTC)

bipolar I with schizoaffective disorder mixed state will not be included in the DSM-V

Reference http://www.dsm5.org/ProposedRevisions/Pages/MoodDisorders.aspx —Preceding unsigned comment added by Totalmindeclipse (talk • contribs) 06:32, 17 November 2010 (UTC)

The DSM-V isn't even a book yet. The DSM-IV-TR remains the diagnostic standard for the fields of psychology and psychiatry. Relleka (talk) 06:45, 3 March 2011 (UTC)

Situational versus Clinical Depression

Misinterpretation of causes of depression, nature verses nurture, etc leading to overzealous knee-jerk diagnoses.

Totalmindeclipse (talk) 06:39, 17 November 2010 (UTC)

Controversy Surrounding the Bipolar Diagnosis

There should be a section called "Controversy Surrounding Bipolar Disorder" that details the difference between mania and psychosis, as the terms are often conflated. Iatrogenic processes during evaluation need to be addressed. Mental hospital staff biases, the prevalence of staff that advocate religiosity as a cure in mental hospitals, the prevalence of bibles in mental hospitals, and social systems that force a conflict of interest, violating patient rights; all subjects must be discussed. Contemporary academia compares bipolar disorder to multiple personality disorder, which psychologists blamed on satanic ritual abuse. The majority of SRA cases were never proven and most likely the result of iatrogenic forces. A subsequent investigation aired on PBS's Frontline in 1996 was banned by the FCC. The issue of doctor's incentives offered by pharmaceutical companies to sell more medications. As a new wikipedia member, and previous member of academia, it astonishes me that there is no section on the controversies surrounding bipolar disorder. —Preceding unsigned comment added by Totalmindeclipse (talk • contribs) 06:53, 17 November 2010 (UTC)

Agreed - see the published NPOV challenge above as to why this article may be so remarkably free of controversy. Xcrivener (talk) 12:45, 17 November 2010 (UTC)

I cannot add this since page is protected

Please add the book for further reading that talks about bipolar I, II, III (not covered here) and all sorts of other stuff. This book should have been listed in this wikipedia article for the last 10 years. Also covers anti-depressents bad for remissed manic patients.

Why Am I Still Depressed? Recognizing and Managing the Ups and Downs of Bipolar II and Soft Bipolar Disorder Jim Phelps —Preceding unsigned comment added by 173.162.221.82 (talk) 16:59, 9 December 2010 (UTC)

What is in the book that is unique? Many books are written and if we included only a small number of them we'd have ahuge further reading section. Casliber (talk · contribs) 19:28, 9 December 2010 (UTC)

This book sounds like it may be better suited as a reference. See if you can find some material in the book that is useful to improve the article, and I think it would make a great reference. Try gathering some information to add somewhere within the Management section as it sounds like it might directly relate. Any of us would be happy to add it for you :) Talgris (talk) 18:57, 30 December 2010 (UTC)

This book sounds dubious at best. Bipolar III is not a recognized diagnosis in the DSM-IV-TR. There are significant differences between bipolar I and II, that's why separate diagnoses exist. The only other type of bipolar is bipolar not otherwise specified, but it is intentionally not called bipolar III. Cyclothymic disorder is a disorder related to bipolar, but it isn't recognized as the same thing by the DSM-IV-TR. The bipolar disorders are depicted on a spectrum (similar to autism in terms of how the diagnoses are organized in the DSM). Relleka (talk) 06:50, 3 March 2011 (UTC)

In children

In the last few weeks I have been improving the subarticle bipolar disorder in children. While I have not fully finished I believe that it had reached a good level both on coverage and sourcing, so I have summarized it and included it in the main article. While it is similarly long it mainly uses 2 recent reviews instead of primary sources. --Garrondo (talk) 08:10, 14 January 2011 (UTC)

Recurrence

The first part in the recurrence subsection is fully unreferenced (some parts have been tagged for 3 years), and additionally quite essay-like, and probably not really that important. I move it here so if somebody finds refs for it in the future and is able to refractor it, it can be reincluded:

Text eliminated

The following behaviors can lead to depressive or manic recurrence:

• Discontinuing or lowering one's dose of medication.
• Being under- or over-medicated. Generally, taking a lower dosage of a mood stabilizer can lead to relapse into mania. Taking a lower dosage of an antidepressant may cause the patient to relapse into depression, while higher doses can cause destabilization into mixed-states or mania.
• An inconsistent sleep schedule can aggravate symptoms. Too much sleep can be an indicator that depression is returning. It has been found that too little sleep can lead to mixed states/mania.
• Caffeine can cause destabilization of mood toward irritability, dysphoria, and mania. Anecdotal evidence seems to suggest that lower dosages of caffeine can have effects ranging from anti-depressant to mania-inducing.
• Inadequate stress management and poor lifestyle choices. If unmedicated, excessive stress can cause the individual to relapse. Medication raises the stress threshold somewhat, but too much stress still causes relapse.
• Drug use from self-medication can have a destabilising effect.

— Preceding unsigned comment added by Garrondo (talk • contribs) 12:50, 16 January 2011‎ (UTC)

Communication and Parent Effection

I think the two should be merged as they're the same thing, no matter how you cut it. What people may wish to do is at the least make a much more inclusive and well thought out, plus a well defined sections within the spectra/spectrum section that codify the various types in a very distinct manner. I.E., type I:II:III being shown for their differences from each other and their biggest symptomatic differences (going from three, to two, then to one). Then, at the end of their definitions and sections (as there seems to be an alarmist note among many people, who think parents are wandering around and grabbing a term for their child to make themselves feel, well, blameless--I agree with this as I've seen it in action; particularly in schools) maybe add a final section that talks about misdiagnoses and the need for a psychologist/psychiatrist to make a true determination.

Like my last sentence above, I think it goes without saying that almost ALL of the articles (medical based wiki entries-perhaps even drug entries, but mentioning your pharmacist as well)) on here could be helped by either a pre-wiki entry section (with a big red box; get a doctor panel to write one) or at the least a post-wiki entry that tells people that misdiagnoses happen all the time when it's used as a blame-game-machine eradicator or by pre-med students. Worse, it can bring harm upon their child for being so paranoid. Parents must be made to know that while they can get many an illness diagnosed (like chicken pox, or hand-foot-mouth disease) or an opening for dialogue with their doctor on the next appointment. They must realize that MANY illnesses overlap in symptoms; even the mental ones. They need to also know that out of ALL the medical problems you can have the mental illness ones must be treaded upon lightly.

Bipolar is having it's problems with this effect, but ADHD is in a completely ridiculous state right now--doctors are to blame in this too!!! Some teachers I've known thought ADHD was a clear and defined, if you're just hyperactive! I REALLY hate seeing children on mind altering medication if they don't need it, badly. We've got very little data on how these drugs affect the cognitive growth years of life. Hopefully it does nothing.

Diversions help employees (Phys.org link):Current studies show that even adults can go for around 2-3 hours and then they lose attention, big time. It also showed that introducing a 15-20 minute break helped to "reset" the brain and get ready for more focused tasking. This study didn't look at children, but it could be that there needs to be more breaks not as in playtime, but to get the child focused onto something else for a bit then coming back; breaks that allow your mind to escape school (sports or an activity would be more useful as they relieve physical procurement that sitting at a desk for a few hours might cause; but, the sports focus you on the game). Anyway this is slightly beyond our topic, so...

Anyway, I think it should be merged as Bipolar Spectrum is a shell with links; not useful at all compared to the Bipolar Disorder wiki link. —Preceding unsigned comment added by 24.10.251.58 (talk) 12:08, 27 February 2011 (UTC)

References

I previously contributed text regarding Omega 3, which was based on the study "Omega 3 Fatty Acids in Bipolar Disorder A Preliminary Double Placebo-Controlled Trial" Andrew L. Stoll, et al. Brigham and Women's Hospital 1999, Department of Psychiatry, Harvard Medical School, Boston, Mass, USA. Along with the text I provided a reference to the "full text" of this study, which is online at:

http://bipolarcircle.com/our-articles/38-treatments/77-omega-3-fatty-acids-in-bipolar-disorder-a-preliminary-double-blind-placebo-controlled-trial.html.

This URL reference is to a website which I operate but my purpose in adding the link was to enable people to read the actual text, and to review the graphics, of the study.

The new Wiki text now significantly waters down the results of the 1999 study and the new references point to URL's where the Wiki reader is NOT allowed to read the text of the study without paying a subscription fee. I'm going to try taking the high road by "assuming" that the reason for the reference change is Wiki's idea to "improve" the quality of the references rather than an attempt to keep the public in the dark about the actual details of these studies by insuring that the actual text is not freely available.

Please allow me to be frank about what I am saying. "Frankly, my dear I don't give a damn" where you link to on the Internet so long as the actual text of the study can be freely read. If Wiki has "evolved" to nothing more than an online pointer to subscription services then it has become a worthless resource. Find somewhere to reference that I can read the real information instead of your editors "interpretation" of the information. Please.

Fiatlux5762 (talk) 15:56, 1 March 2011 (UTC)

It would be helpful for you to read WP:MEDRS. This gist is that for medical articles we try to avoid using primary research publications as sources, but rather to rely on review articles that integrate the primary research. So the question is whether there is a scholarly review that discusses the findings -- and if there is, we would want to cite the review rather than the original paper. And an underlying principle is that Wikipedia is not for advertising, and that applies to academic advertising as well as commercial advertising. Looie496 (talk) 18:08, 1 March 2011 (UTC)

I read WP:MEDRS especially the part that says editors should attempt to follow the guidelines "though it is best treated with common sense, and occasional exceptions may apply. Any substantive edit to this page should reflect consensus. When in doubt, discuss first on the talk page." It seems pretty clear to me that common sense dictates that providing a reference to source material that requires the reader to subscribe to an online publication before they can read the material defeats any benefit the reference offers. Indeed, if an underlying principle of Wikipedia is that it is "not for advertising" then links to subscription services are without a doubt prohibited and you need to fix them. That leads me back to what I said above, find a source on the Internet that actually provides the information (the content) of the study you are referencing. Also, there was no discussion on here prior to your reference changes as is required by Wiki. Have you read any of the rules you purport to enforce? — Preceding unsigned comment added by Fiatlux5762 (talk • contribs) 00:15, 2 March 2011 (UTC)

At first I was puzzled about what you are referring to, but looking back over the history I see that you are referring to a revert of your edits that I made back in Feb 2010, which I had completely forgotten about. I'm pretty confident that I'm interpreting Wikipedia's policies correctly, but there are other editors who watch this page, and perhaps some of them would like to weigh in -- let's see. Looie496 (talk) 18:04, 3 March 2011 (UTC)

There is no requirement to use content that is freely available without a prescription. Verifiability does not mean it is easily verifiable. But you should be able to go down to a University Library and find the reference in question.Doc James (talk · contribs · email) 18:23, 3 March 2011 (UTC)

Very well. I think this topic is important enough that I will open a Dispute Resolution case. I know doctors have unlimited funds but for everyone else it really does matter whether or not information is freely available or must be paid for.

18:40, 3 March 2011 (UTC) — Preceding unsigned comment added by Fiatlux5762 (talk • contribs)

First look at WP:PAYWALL: You can try to change the verifiability policy but you will hardly have any luck with it.--Garrondo (talk) 15:09, 7 March 2011 (UTC)

Topic: On References & Sources (Same As Section Above This)

The above needs to made clear I think somewhere when editing or otherwise. I haven't ran into many of these type of referenced links, but it's a concern that should have Wikipedia's FULL attention. We will slowly degrade this endeavor, frankly, to a useless point unless you've got the money or we've hashed a backdoor link; this "backdoor (computing)" could be closed at anytime and may risk Wikipedia's standing, integrity, and perhaps even it's legality. This is true with all links, but they don't use a loop-hole to get the information. The information is there for all to see.

This is something that must be watched. Even more so now that Net Neutrality is failing to sustain a free and open Internet with free information (except for the your ISP fee or Tax Dollars used). It's an excellent point that was brought up and I believe that it bears repeating. References or hyperlinks(for URLs) must retain a free-to-all nature. If we don't follow that we will slowly make this website an utter waste of time and unusable as a fact or information source, that can be taken seriously.

This is highly redundant, but again it needs to be repeated--ad nauseum. —Preceding unsigned comment added by 24.10.251.58 (talk) 14:38, 2 March 2011 (UTC)

References do not need to be free, they need to be good references. You can verify the content by taking a trip to your local University. Or in a limited number of cases simply asking someone with online access. Doc James (talk · contribs · email) 18:28, 3 March 2011 (UTC)

Doc, when you say "good references" I'm reading good for the corporations selling the information" instead of good for electronic readers of the Internet. People don't search for information on the Internet so they can get in their car and drive to a local university or library. We don't really need to hitch up our mule either because the Internet has this wonderful thing call "FREE" information that can actually be used in the comfort of our own homes. Yes, we do know and fully understand that medical doctors have unlimited resources. Please don't "assume" that everyone who wants to read about Bipolar Disorder is a highly paid doctor.

Fiatlux5762 20:07, 3 March 2011 (UTC) — Preceding unsigned comment added by Fiatlux5762 (talk • contribs)

This is why we have Wikipedia. Those who have access to these online payed resources are than able to summarize them an provide a free synopsis on Wikipedia. Doc James (talk · contribs · email) 00:35, 7 March 2011 (UTC)

High Quality Reviews vs The Actual Content

Yes, Doc high quality reviews are totally appropriate for the people who wish to read other people express their opinions and interpretations about the findings of a study. However, absolutely nothing is as valuable as holding the ACTUAL TEXT of a study in the readers hand and being able to formulate one's own opinions about the study and its findings. If you wish to offer high quality reviews - in addition to the actual text of the study - that would be the best choice of all. This link http://bipolarcircle.com/our-articles/38-treatments/77-omega-3-fatty-acids-in-bipolar-disorder-a-preliminary-double-blind-placebo-controlled-trial.html has the text of the study. Why do you object to referencing the original text of the study? — Preceding unsigned comment added by Fiatlux5762 (talk • contribs) 20:24, 3 March 2011 (UTC)

This is a primary research study of 30 people. Not appropriate per WP:MEDRS. Primary research often does not put finding in appropriate context. Doc James (talk · contribs · email) 16:54, 4 March 2011 (UTC)

That's not what it says Doc. The text says "Reliable primary sources may occasionally be used with care as an adjunct to the secondary literature, but there remains potential for misuse. For that reason, edits that rely on primary sources should only describe the conclusions of the source, and should describe these findings clearly so the edit can be checked by editors with no specialist knowledge. In particular, this description should follow closely to the interpretation of the data given by the authors or by other reliable secondary sources. Primary sources should not be cited in support of a conclusion that is not clearly made by the authors or by reliable secondary sources, as defined above (see: Wikipedia:No original research)."

It does NOT say that primary sources cannot nor should not be used. It says they should be used with care. — Preceding unsigned comment added by Fiatlux5762 (talk • contribs) 21:28, 6 March 2011 (UTC)

Fiatlux, these articles are generally so big that we have to prioritise standard common treatments, and the page is at its upper limits restricting ourselves to core material. Subpages, such as Treatment of bipolar disorder are very useful for categorising and giving a fuller description of treatments not covered in Review Articles. Casliber (talk · contribs) 23:36, 6 March 2011 (UTC)

Please fix link to "subtypes"

Please fix or remove the link to subtypes in the "Challenges" section, it goes to an article about programming languages that has nothing to do with what is meant in this Bipolar disorder article section. -- 77.189.83.240 (talk) 13:59, 4 March 2011 (UTC)

Good catch. Delinked. Casliber (talk · contribs) 23:34, 6 March 2011 (UTC)

Sister Illnesses / Travelling Companions

OCD, ADHD, ADD, Anxiety Disorders, Phobia Disorders, Panic Disorders, Alcoholism, Drug Addiction, Shopaholic, Smoking Addict, Gambling Addict, Hypersexuality, Sex Addict, etc. These are but some of the "sister illnesses of travel companions" that can show up and travel with bipolar disorder. The sister illnesses/travel companions can show up at the beginning, but usually show up later in the illness as a sign. The illness is here. It is undiagnosed and you need to deal with me now.

I think something about this should be posted to warn people who are looking for info and new to the illness so they know to watch for this warning sign. — Preceding unsigned comment added by Bree25 (talk • contribs) 07:28, 26 March 2011 (UTC)

This is a murky area - certainly manic episodes often exhibit symptoms overlapping with most if not all of the above. We need to Bipolar_disorder#Differential_diagnosis section to reflect how one differentiates between them, but we need to stick to broad consensus, which means Review Articles. I've been meaning to spruce up this aritcle for years now...maybe it's time (groan) Casliber (talk · contribs) 21:50, 26 March 2011 (UTC)

Gifted?

From the article (the Environmental section): "Many gifted and talented children (and adults) are mis-diagnosed by psychologists, psychiatrists, pediatricians, and other health care professionals. One of the most common mis-diagnoses is Bi-Polar Disorder. This type of mis-diagnoses stems from an ignorance among professionals about the social and emotional characteristics of gifted children which are then mistakenly assumed by these professionals to be signs of pathology. [44]"

Now, apart from that being in the wrong section. This "gifted" individual has written a bunch of incorrect assumptions and strange hyphen-ations. The professionals may have missed a diagnosis of narcissism! 118.90.90.152 (talk) 08:58, 3 May 2011 (UTC)

I removed that passage. The assertion is doubtful, the wording is not neutral, and the source for the reference was a web page, which is not good enough. Looie496 (talk) 22:06, 3 May 2011 (UTC)

Blatant Contradiction in Second Paragraph

In the Second paragraph, before the table of contents, the following is stated as though factual: "Genetic factors contribute substantially to the likelihood of developing bipolar disorder, and environmental factors are also implicated."

This is a potentially very misleading statement. For, when you scroll down to the subsection titled "Genetic" under the section "Causes" it immediately contradicts the first statement in saying that:

"Genetic studies have suggested many chromosomal regions and candidate genes appearing to relate to the development of bipolar disorder, but the results are not consistent and often not replicated."

                  ***AND***

"Although the first genetic linkage finding for mania was in 1969,[28] the linkage studies have been inconsistent.[29] Meta-analyses of linkage studies detected either no significant genome-wide findings or, using a different methodology, only two genome-wide significant peaks, on chromosome 6q and on 8q21.[citation needed] Genome-wide association studies neither brought a consistent focus — each has identified new loci.[29]"

Both these quotations are shockingly direct contradictions of the summary. I am tempted to remove the first sentence myself, but I will only add a "citation needed" mark. I hope that this sentence will be changed shortly. Clearly genetic evidence is meager as best. —Preceding unsigned comment added by 24.41.31.131 (talk) 23:55, 7 May 2011 (UTC)

There is a difference between knowing that genetic factors come into play and knowing which genes are involved. If the relatives of people with a condition have an increased tendency to develop the condition, which cannot be explained by commonality of environment, this is straightforward evidence that genetic factors are involved. But it tells one nothing whatsoever about which specific genes are involved -- that's a much more difficult issue. Looie496 (talk) 00:57, 8 May 2011 (UTC)

There is no evidence outside of environmental commonality. And if there is, than it should be cited, which is not. It shouldn't be hard to find such evidence for a neuroscientist like yourself. I would appreciate it if you could let me know where any such evidence exists. Thanks for the quick response. —Preceding unsigned comment added by Cspj123 (talk • contribs) 00:29, 10 May 2011 (UTC)

Sorry, I missed that response. I know very little about the genetics of bipolar disorder. My only point was that the things you cited do not actually contradict each other: it is entirely possible to know for certain that a condition has a genetic basis without knowing the slightest thing about which specific genes are involved. But I don't know anything about the specific evidence related to either point with respect to bipolar disorder. Regards, Looie496 (talk) 01:06, 21 May 2011 (UTC)

The situation with genetics and bipolar is pretty much the same as with schizophrenia - we often see it run in families, but not according to any true dominant/recessive way. Lots of studies have shown interesting segments and associations here and there but their practical application to how we diagnose and treat bipolar disorder is effectively nil. This whol article needs an overhaul...but that is too much like, well, like work.... Casliber (talk · contribs) 03:49, 21 May 2011 (UTC)

Some examples of high quality reviews for said "overhaul"

• El-Mallakh RS, Elmaadawi AZ, Loganathan M, Lohano K, Gao Y (2010). "Bipolar disorder: an update". Postgrad Med. 122 (4): 24–31. doi:10.3810/pgm.2010.07.2172. PMID 20675968. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• Nierenberg AA (2008). "An analysis of the efficacy of treatments for bipolar depression". J Clin Psychiatry. 69 Suppl 5: 4–8. PMID 19265634.
• Ukaegbu C, Banks JB, Carter NJ, Goldman LS (2008). "Clinical inquiries: what drugs are best for bipolar depression?". J Fam Pract. 57 (9): 606–8. PMID 18786334. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• Benazzi F (2007). "Bipolar II disorder : epidemiology, diagnosis and management". CNS Drugs. 21 (9): 727–40. PMID 17696573.
• Healy D (2006). "The latest mania: selling bipolar disorder". PLoS Med. 3 (4): e185. doi:10.1371/journal.pmed.0030185. PMC 1434505. PMID 16597178. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: unflagged free DOI (link)

The last may be useful in a section on society and culture... Doc James (talk · contribs · email) 05:52, 8 January 2011 (UTC)

Sociopathic?

What many refer to as bipolar disorder is actually a lack of explanation for sociopathic/psychological responses to the social situation one is subjected to... As a matter of fact, the way our brains actually work is a constant bipolar dispostion... The function is much like the lights on a police car... At one end of the bar of lights is psychosis and at the other end is mania then in the middle you have logic.... The lights in our heads are constant and in a recipricol effect to everything around US... Stating "bipolar disorder" is somewhat retorical to completely observing, explaining and or understanding how our minds work or respond to our surroundings...Ryans.lewis3365 (talk) 14:08, 30 May 2011 (UTC) Sociopath isn't in wikipedia...Ryans.lewis3365 (talk) 14:11, 30 May 2011 (UTC)

Wikipedia articles need to be based on reputable published articles or books, not on our own personal ideas. (And sociopath is indeed in Wikipedia, as a redirect to antisocial personality disorder, which is the modern term.) Looie496 (talk) 17:17, 30 May 2011 (UTC)

Bipolar disorder

Bipolar disorder - all inclusive to include all conditions of bipolar personality disorder, should not include depression as a necessary element. Especially hypomania. Lethargy, Irritability, and lower serotonin levels yes, but not necessarily depression. Those in the mental health profession commit violative acts by denominating all with this unique balance as monsters. The only criteria in which to judge a man or woman is by his or her actions that are violative. For woman or man to develop to the fullest of their potential, freedom of expression is a necessary discomfiture the community must accept to avoid instilling psychosis in these people or others that enjoy the freedom of expression. — Preceding unsigned comment added by 184.96.241.224 (talk) 20:41, 17 July 2011 (UTC)

Wikipedia articles need to be based on reputable published articles or books, not on our own personal ideas about what is right and wrong. Looie496 (talk) 22:03, 17 July 2011 (UTC)

You might also want to see Wikipedia's verifiability policy and policy on original research. -- The Anome (talk) 22:08, 17 July 2011 (UTC)

Edit request from Joelklee, 4 August 2011

People with bipolar disorder exhibiting psychotic symptoms can sometimes be misdiagnosed as having schizophrenia, a serious mental illness.

Joelklee (talk) 04:33, 4 August 2011 (UTC)

Please change "People with bipolar disorder exhibiting psychotic symptoms can sometimes be misdiagnosed as having schizophrenia, another serious mental illness." to "People with bipolar disorder exhibiting psychotic symptoms can sometimes be misdiagnosed as having schizophrenia, a serious mental illness." The key is changing the word "another" to the word "a". The existing sentence states that bipolar disorder is a "serious mental illness". Yet the first paragraph of the article states that bipolar disorder "is a psychiatric diagnosis that describes a category of mood disorders." The first paragraph goes on to state that there is a "bipolar spectrum" which describes the range of the mood disorders. When an individual is exhibiting symptoms in the milder range of the bipolar spectrum, it seems unlikely to me that their condition would be classified as a "serious mental illness".

I realize that the sentence could be interpreted to mean that "bipolar disorder exhibiting psychotic symptoms" is a "serious mental illness" (which would clearly be true) but the sentence seems ambiguous to me and one of the interpretations is arguably incorrect. I think it is clearer to simply state that "schizophrenia" is a "serious mental issue".

I defer to the judgment of a wiser wikipedian in this matter.

Thanks.

Done Jnorton7558 (talk) 04:56, 4 August 2011 (UTC)

I don't see the problem with "another serious mental illness". BPAD is considered to be a mental illness, and usually has serious consequences. 14.201.65.122 (talk) 11:35, 16 August 2011 (UTC)

Edit request from Unklekrappy, 25 September 2011

Bipolar disorder or manic–depressive disorder, also referred to as bipolar affective disorder or manic depression,

Bipolar disorder (formally known as manic-depressive disorder) which may also be referred to as bipolar affective disorder or colloquially manic depression,

DO NOT INCLUDE in edit>>>(see these sources for verification) http://wiki.answers.com/Q/When_did_the_term_bipolar_disorder_succeed_the_term_manic-depression http://bipolar.about.com/od/definingbipolardisorder/a/manic_depression_changes_names.htm http://www.newharbinger.com/PsychSolve/BipolarDisorder/tabid/108/Default.aspx

Unklekrappy (talk) 11:58, 25 September 2011 (UTC) --Unklekrappy (talk) 11:58, 25 September 2011 (UTC)

I do not understand what you are requesting? Doc James (talk · contribs · email) 12:02, 25 September 2011 (UTC)

Change this ->Bipolar disorder or manic–depressive disorder, also referred to as bipolar affective disorder or manic depression,

to this->Bipolar disorder (formally known as manic-depressive disorder) which may also be referred to as bipolar affective disorder or colloquially manic depression, Unklekrappy (talk) 12:28, 25 September 2011 (UTC)

this->(formally known as manic-depressive disorder) should actually say (FORMERLY known as manic-depressive disorder)...stupid spell check Unklekrappy (talk) 12:31, 25 September 2011 (UTC)

Yeah, I'll pay that as Manic Depressive is definitely marked historical now. Casliber (talk · contribs) 13:33, 25 September 2011 (UTC)

Neanderthal DNA

Evolutionary origin of bipolar disorder-revised: EOBD-R (Accessible PDF)

• "Given evidence of Neandertal contributions to the human genome, the hypothesis is extended (EOBD-R) to suggest Neandertal as the ancestral source for bipolar vulnerability genes (susceptibility alleles). The EOBD-R hypothesis explains and integrates existing observations: bipolar disorder has the epidemiology of an adaptation; it is correlated with a cold-adapted build, and its moods vary according to light and season. Since the hypothesis was first published, data consistent with it have continued to appear."

Slartibartfastibast (talk) 18:19, 9 November 2011 (UTC)

Ah yes, Medical Hypotheses, the absolute epitome of a nonreputable source. Looie496 (talk) 22:51, 9 November 2011 (UTC)

Extraordinary claims require extraordinary evidence. Politically incorrect claims require impossible evidence. Genes inherited from neanderthal admixture have also been tentatively linked to autoimmune disease, autism, schizophrenia, etc. Also, the technology to sequence ancient hominid DNA is very new. Slartibartfastibast (talk) 04:01, 10 November 2011 (UTC)

Edit request on 15 December 2011

I believe the article on Bipolar should have the following text (a) added under Management (the 4th section). Many people use the internet and computer programs to monitor or understand bipolar disorder. This information is important to note in anyone's understanding or coping with the illness.

(a)In the 1970's people who had bipolar started using Dr. Peter C. Wybrow's paper mood charting method. The National Institute of Mental Health has written, "Keeping a chart of daily mood symptoms, treatments, sleep patterns, and life events can help the doctor track and treat the illness most effectively. Sometimes this is called a daily life chart. If a person's symptoms change or if side effects become serious, the doctor may switch or add medications." http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml

Doctors and researchers still use paper charts to track information like a patient's sleep, mood, and medications. Alternatives to paper charting are now available through web sites and application software running on PC's and mobile devices. Some web sites are: moodtracker.com, medhelp.com, and psycheducation.org. Some examples of application software are: ChronoRecord, bStabel, and T2Mood Tracker.

Individuals who bring their doctors a journal or log of their tracked moods and sleep may receive better treatment and improved quality of life. [(footnote) Bauer MS, Crits-Christoph P, Ball WA, Dewees E, McAllister T, Alahi P, Cacciola J, Whybrow PC. Independent assessment of manic and depressive symptoms by self-rating. Scale characteristics and implications for the study of mania. Arch Gen Psychiatry 1991; 48:807-12.]

Janellehale4 (talk) 00:09, 16 December 2011 (UTC)

Is there a review article or major textbook to support the text in question per WP:MEDRS ? Doc James (talk · contribs · email) 02:43, 16 December 2011 (UTC)

Jungian approach to bipolar disorder

Found the following essay online; 'A JUNGIAN ESSAY ON BIPOLAR DISORDER (MANIC-DEPRESSION)', and as it includes reliable references to journals and books I wonder if we could include a brief mention the "Jungian" perpective somewhere in the main article with the reliable citations? Naturally I am not suggesting we dupliacte the article, but rather weed the cited sources out of it and place them with a short summary of the ideas. 124.187.109.140 (talk) 04:31, 26 January 2012 (UTC)

I have difficulty getting anything from that essay -- what would you propose to say (assuming it needed to be reduced to one or two sentences)? Looie496 (talk) 06:07, 26 January 2012 (UTC)

I'd have to look into the sources and get back on that one. The first source would be Zoja, L. ‘Analytical psychology and the Metapsychology of feeling’: Journal of Analytical Psychology, Vol 32, Number 1, Jan 1987. The paper is apparently about manic depression and refers to two archetypal themes Puer and Senex as equivalent to mania and depression respectively. I have read other Jungian literature (eg. in the works of James Hillman, for example) that pairs these two Jungian archetypes with mania and depression. On that basis perhaps a terse definition of the puer and senex archetypes as Jungian terms corresponding with mania and depression would be a start? It appears the standard Jungian conceptualization of puer and senex is that of a coexistent bipolarity appearing in psychological health, and in neurotic manifestations as extreme oscillation between puer and senex or as unipolar manifestations (ie. only puer, or only senex). In the later case the therapeutic task is to bring puer and senex back into balance by working with the patient's mental imagery.. That captures the basic theme elaborated by several of the Jungian authors. I believe Jung elaborated on mania and depression through his various collected works, and also wrote a paper in 1903 entitled, 'On Manic Mood Disorder'. I have not read the latter.

I'm not exactly sure how that could be worded but if you think its worth a sentence or two on the general theme above I could gather a few reliable citations.124.187.109.140 (talk) 07:44, 26 January 2012 (UTC)

Ok, here's a quickly constructed paragraph that avoids bricolage/original research, and sticks to the consensus as i have found it in Jungian literature. It will have to be improved and perhaps shortened. Keep in mind I wrote this hastily, you are welcome to improve it:

"Jungian authors have likened the mania and depression of bipolar disorder to the Jungian archetypes ‘puer’ and ‘senex’.[1][2][3][5] The puer archetype is defined by the behaviors of spontaneity, impulsiveness, enthusiasm or mania and is symbolized by characters such as Peter Pan or the Greek god Hermes.[1][2][3][5] The senex archetype is defined by behaviors of order, systematic thought, caution, and depression and is symbolized by characters such as the Greek god Saturn-Kronos.[1][2][3][5] Jungians conceptualize the puer and senex as a coexistent bipolarity appearing in human behavior and imagination, but in neurotic manifestations appears as extreme oscillations and as unipolar manifestations.[1][2][3][4][5] In the case of the split puer-senex bipolarity the therapeutic task is to bring the puer and senex back into correlation by working with the patient’s mental imagery."[1][2][3][4][5]

Sources;

[1] Hillman, J. Ed. ‘Puer Papers’, Spring Publications (1979)

[2] Hillman, J. 'Senex and Puer' Spring Publications (2005)

[3] Zoja, L. ‘Analytical psychology and the Metapsychology of feeling’: Journal of Analytical Psychology, Vol 32, Number 1, Jan 1987

[4] Zoja, L. ‘Growth and Guilt’ Routledge Press, (1995)

[5] Vitale, A. 'Saturn; The Transformation of the Father' Spring Publications, (1973) 124.187.109.140 (talk) 08:56, 26 January 2012 (UTC)

OK, have tentatively placed a mention of the Jungian approach in the BD treatment page. Other editors can go over it and improve as they see fit. As for the current entry I'm not sure where a mention could go, if indeed it is compatible to be included here at all. 124.187.109.140 (talk) 00:05, 27 January 2012 (UTC)

Good article

So, following a crazy idea at Wikipedia_talk:WikiProject_Disability#Crazy_idea, a bit of chat at User_talk:The_Anome#Bipolar_Disorder, and, to be entirely fair, a reasonable amount of looking at the article recently I'd like to propose that we put this article forward for Good Article review - does anyone have any thoughts on this? For or against? Fayedizard (talk) 22:51, 17 February 2012 (UTC)

Looks feasible and worthwhile. I will start looking at it as well. --Mirokado (talk)

Awesome, I'm going to mention this article to the other wikiprojects involved. Then maybe nominate after the weekend when we'll all have had chance to look for any problems.... :) Fayedizard (talk) 08:07, 18 February 2012 (UTC)

Reference treatment is fairly good but (at least) handling of shared citations is inconsistent. I will be making some changes for consistency and will use various templates which provide consistency checking. Once these updated refs are consistent it will be easy to convert them all to another (source or presentation) format if that is what we decide we want to use for the GA review. --Mirokado (talk) 22:03, 18 February 2012 (UTC)

The missing years (tagged) need to be corrected. There is also a missing APA citation (tagged with Full), I have asked the original author for help. There are some missing page numbers (also tagged) which may not be such a problem for GA but should be fixed if possible.

There were several citations with unused ref=harv parameter, which was not active since author= has been used instead of last=,first=. I corrected one by replacing it by a cite pmid before I realised there lots more, I think is is easier for now just to remove the incorrect parameters so I have done that. Certainly for an FA review the citations will need more tidying up. --Mirokado (talk) 01:15, 19 February 2012 (UTC)

Awesome - I've added chapter and year to the goodwin references. :) Fayedizard (talk) 10:16, 19 February 2012 (UTC)

Some things to consider:

• Need to make sure only Review Articles are used for sourcing, unless there is a very good reason.
• Fix all tags.
• Make all references format the same - decide whether you want to do "Smith J, Jones F," or "Smith, John; Jones, Fred;"

I'll offer some more ideas as I go. Casliber (talk · contribs) 10:45, 19 February 2012 (UTC)

Since both FW and I are updating citations using cite pmid etc, and that both saves time and is more reliable, I will convert all the relevant citations to use those templates (easy using regular expressions). This will sort out a lot of the inconsistency problems involving initials, use of author or last,first and so on. That means using "Other, A. N." etc for journals. I don't see it as a problem if remaining book and web citations etc follow the convention of full first names as well, that is very normal for books for example. It would be quite easy to convert remaining |first=Fred to |first=F. etc if anybody really wants to do that. --Mirokado (talk) 23:20, 19 February 2012 (UTC)

Done that. Please can we decide what we would like to do with the citations with specific page, chapter etc numbers, particularly for citations used more than once. There was no consistent pattern before we started the latest round of updates. I prefer using {{sfn}} and friends, because that provides some consistency checking, consolidates identical inlines automatically and links inlines to their citation. --Mirokado (talk) 23:52, 19 February 2012 (UTC)

Yeah, I like {{sfn}} - if you guys get started on that, I can double check some Big Picture stuff like meds etc. Casliber (talk · contribs) 00:45, 20 February 2012 (UTC)

Nice Regex-fu... and Hi Casilber, nice to meet you :) I'm new to {{sfn}}, but it looks cool and I'd like to learn, you might have to forgive my learning curve, in meetings all day today but should be back tonight - how do we feel about putting a GA nomination in, in the next 24 hours? Fayedizard (talk) 09:59, 20 February 2012 (UTC)

Errrg, not so fast, some tidying up is needed first. It is best to do everything you can possibly think of before review. Being hit with a ton of fixes in a review can be.....not good. I'm just copyediting something else but I (and anyone else is welcome to as well) need to review the meds section (plus others). THe meds section is repetitive and can be tightened up, and is massively imbalanced currently with all this material on lamotrigine....Casliber (talk · contribs) 10:13, 20 February 2012 (UTC)

(ec) Let's sort out the issues we have identified before submitting, and give Casliber a chance to "check the big picture". If you would like to familiarise yourself with sfn, the first thing to do would be to convert the Goodwin & Jamison (2007) inlines. The citation is already prepared and you can see the other G&J inlines for examples. I suggest you install the User:Ucucha/HarvErrors script which provides error messages for any problems. --Mirokado (talk) 10:23, 20 February 2012 (UTC)

I love {{sfn}}! (and the script is awesome, also) - Goodwin & Jamison (2007) done, very happy to wait for a nomination :)

Yes it is rather cool. The |loc= parameter is for things like chapter and introduction. For page numbers we use |p= for a single page and |pp= for a range. --Mirokado (talk) 17:16, 20 February 2012 (UTC)

Hi guys, so just wanted to check in to see where we are and to see what you guys think could do with being done before sending the article to GA. Is it worth me going through the references to extract them all to a listing (as in Speech_generating_device) or are there other things I could be doing? Fayedizard (talk) 12:08, 27 February 2012 (UTC)

Yikes, I've only reviewed about 2/3rds of the medication section. We've got to make sure we have Review articles (or national guidelines) all the way through, and only use non-review articles in exceptional circumstances. References need cleaning up - I like "Smith, John; Jones, Fred; etc. Casliber (talk · contribs) 13:14, 27 February 2012 (UTC)

No problem (or pressure of any kind) will happily distract myself with stephen_hawking :) Fayedizard (talk) 15:57, 28 February 2012 (UTC)