Talk:Bipolar disorder/Archive 4

Alternate Psychological Treatment
I think it should be mentioned that Medication is not the only way to treat a patient with a Bi-Polar disorder. Another effective way I've found to work much more effectively than medication is through psychological conditioning. You see, people with Bi-Polar disorders have come to understand them as a reality they cannot avoid, that this affliction will be with them for the rest of their lives. As is the nature of taking a medication, the pills will not force the brain to heal itself, but trick the brain into "balancing out the imbalance" of chemicals in the brain that cause the disorder.

Through regular checkups and mental treatment, a doctor and/or a friend can train the patients brain to overcome the imbalance by itself. From a psychological point of view, the patient feels comfortable in their illness, but what the doctor must strive to accomplish with this method is to surround the patient in friendship, and encourage him/her friends to do the same. The doctor must train the patient into knowing what he/she is doing wrong, and how to overcome the negativity that he or she feels in her life.

The patient must discipline him/herself against negative thinking. That is the true method to success with this treatment. As the doctor, you must become a friend to him/her and never give up on them. The doctor must train the patient to focus on only to good things that come out of each day. But there is a catch; The patient will never make progression if he/she will not put forth a willing effort to change. This can be achieved through trust, hence meaning the doctor must have the patients complete confidence. Once that has been accomplished, the actual treatment should vary between patient to patient.

Some might enjoy reading, and they should be told to focus on the reading. Not the reading in particular, but the notion of reading being a good thing, and making it their entire world. They have to learn to be comfortable in their world, and they have to know being slothful about this treatment will hinder it's effectiveness significantly, almost to the point of not being able to work at all. The patient has to do this for themselves, but if he/she does, through the doctor and the patients friends the occurence of good thoughts will rise significantly. Eventually it will become normal for the patient to be feeling good thoughts, and they will begin to feel comfortable in that world.

Alot of the time the patient has his/her mood swings under times of stress. They will come across a situation where they might be thinking "ARGH what am I supposed to do?". As a confidant, the doctor or friends must confirm with him/her always that there is nothing wrong with doing the right thing at any time. If they become a beacon of truth and compassion, it reflects greatly on people around them because they set an example, something people want to look up to.

Positivity breeds positivity by nature. Even if it does not, wherever they are for it not to, patience will deliberate all things. And, of course, the patient must be aware at all times that this method will not succeed all at once. It will be hard in the beginning, but I have seen it work, and it gets easier with every passing day.

There's alot of karma behind this method, so I'm doing my best to try and keep it strictly scientific because not everyone believes in it. But I strongly feel this method should be included in the wiki under treatment. Not in this wording, perhaps, but I cannot edit it myself, so someone else would have to do it. —Preceding unsigned comment added by 70.49.144.191 (talk) 02:19, 26 January 2008 (UTC)

Holistic healing
I reverted this edit, because it was entirely unsourced, placed undue weight on holistic healing (since it was several times longer than the section on medication), and seemed to possibly violate NPOV. If sourced info is available, it might be more appropriate in the Treatment of bipolar disorder article. --Dawn bard (talk) 20:55, 1 February 2008 (UTC)

Allow me to ask you this
How is it someone like Pavlov came to build his theory from scratch, and do enough experimentation and analysis to claim it undeniable fact?

It was the problem that caught his interest, and it piqued him enough to spend his time researching it. So just because I have never documented any of my personal research, how does it prove I haven't been doing it? If I were to see someone with bi-polar, and he or she began to have mood swings, is it not likely that someone with an inquisitive nature, such as myself, would want to investigate what kind of thought patterns control that behaviour?

I simply found people who have Bipolar, or claim to have it, and have found evidence that supports my treatment method, the root causes Bipolar depression is so long lasting. Yeah, alot of it is based on Karma, but why has the very concept OF karma come into existence?

Oh my, could it possibly be someone just might have been as inquisitive as me to watch and observe people reacting to each other? And could it be this article supports the need for this argument to be included?

"The use of antidepressants in bipolar disorder has been debated, with some studies reporting a worse outcome with their use triggering manic, hypomanic or mixed episodes, especially if no mood stabiliser is used. However, most mood stabilizers are of limited effectiveness in depressive episodes."

I don't really mean to sound like a jerk, because I do agree it should go in that other section now that I think of it. But seriously, if a woman can be convinced she's pregnant and start going through the reproductive cycle even while nothing grows in her womb, and people can summon superhuman strength at a whim in times of need, how is this any different?

And more importantly, how does my article violate the NPOV? If it is in fact biased towards a natural point of view, then how does the existing one prove to be any different if it does not support both sides of the argument? —Preceding unsigned comment added by Rom Manic (talk • contribs) 03:53, 2 February 2008 (UTC)


 * Dear Rom Manic, has any of your material been published in a peer-reviewed journal? If so. that would be a good place to start. Reliable sources are required to reference material that is likely to be challenged. cheers, Casliber (talk · contribs) 04:16, 2 February 2008 (UTC)


 * I wouldn't even know where to begin, Casliber. I mean, I've got nothing written down, it's all just observations I make a mental note of.  And to fully prove that theory I would need to create a suitable environment for it to happen, which might take years to fully heal someone.  It shouldn't, but it might, and it's time I just don't have.  I need to be working, then establish myself in that manner.


 * But I could teach someone. If someone was interested enough to learn how to administer this treatment, I could teach them every bit of information they would need to know.  If you are interested, and would be willing to spend the time or are in a better position than I am to perform the task...I would be most interested.


 * Much of the information you placed in the article has elements of Cognitive behavioral therapy and supportive therapy within it. There is some evidence for effectiveness in various mental illnesses, and there is some role for psychotherapeutic techniques in bipolar disorder which has been tested in trails. As yet there is little in the article. I intend developing the article later and will place some sourced material in the article. cheers, Casliber (talk · contribs) 05:59, 2 February 2008 (UTC)


 * Casliber, that would be absolutely awesome. But, say, I were able to complete an experiment, where would one go to publish the findings, National Geographic?  It would please me so much to see this method widely accepted and being a healer became a profession.


 * Also, I think it should be noted that Bipolar can be cured, and this should be changed (o wait...)


 * "Bipolar disorder cannot be cured, instead the emphasis of treatment is on effective management of acute episodes and prevention of further episodes by use of pharmacological and psychotherapeutic techniques." —Preceding unsigned comment added by Rom Manic (talk • contribs) 16:46, 3 February 2008 (UTC)


 * Rom Manic is completely correct in his statement that none of the bipolar spectrum disorders can be cured.  At the most, medication can be used to stabilize the bipolar's mood swings and some therapies have indicated they can help, to a greater or lesser degree, to improve various facets of coping.  Spotted Owl (talk) 09:32, 10 February 2008 (UTC)


 * If you didn't notice, I'm contesting the argument that Bipolar cannot be cured through psychological conditioning. It's proven, but because I didn't use references, it suddenly violates NPOV rules.  —Preceding unsigned comment added by Rom Manic (talk • contribs) 06:23, 12 February 2008 (UTC)

(outdent) ok, getting published in a peer-reviewed journal would be a giant step in the right direction. A psychiatrist would have to verify the people treated actually did qualify for a diagnosis of bipolar disorder in the first place. WRT bipolar spectrum, the milder the classification, the more chance of confusion with personality disorders, particularly of cluster B spectrum. Here's where it starts to get really tricky as there is evidence of SSRIs improving affect regulation in BPD, but concern they may worsen the course of a bipolar illness. Also, various psychotherapies are cornerstones of intervention with personality disorder, so is important to distinguish vs. mild bipolar which responds to talking therapy....cheers, Casliber (talk · contribs) 06:35, 12 February 2008 (UTC)


 * Thanks, Casliber. I owe you one, buddy.  I've got the documentation ongoing now, but once I try an experiment I'll be sure to keep you informed.


 * As you put it, Cheers :P —Preceding unsigned comment added by Rom Manic (talk • contribs) 17:52, 14 February 2008 (UTC)

topic relocated to current discussion area
I noticed that this article is kind of a mishmash of Bipolar I and Bipolar disorder in general, and that there are separate articles for Bipolar I and Cyclothymia, but not Bipolar II (which currently redirects to this article). I think it would make sense to have a main "bipolar spectrum disorders" article with the more general information from this article (history, etc) and a brief discussion of the subtypes (with links), and move details on the subtypes to their respective articles, including DSM-IV-TR and ICD-10 diagnostic criteria. Anyone else agree? Steve CarlsonTalk 17:44, 11 November 2007 (UTC)


 * In this vein, I created a Bipolar II disorder stub and suggested a merge of Bipolar spectrum into this article. Steve CarlsonTalk 08:36, 12 November 2007 (UTC)


 * STRONGLY DISAGREE

I have copied my response from the Bipolar_spectrum Talk page. Actually, there is, necessarily, going to be a multiple of articles that must necessarily arrow out from the Bipolar spectrum disorders article as starting with the spectrum article is the only way to adequately deal with Bipolar. I might suggest that, if anything, Bipolar disorder actually be a description of the spectrum, covering the history of recognition of the disorder's breadth over time, as well as a general covering of treatments. Each sub-type of the spectrum of bipolar disorders, as well as an article about the treatment of them, and even, perhaps, an article about the difficulties in differential diagnosis, plus the confusing overlay of the many co-diagnoses that are so often found in Bipolar patients.


 * As someone with generations of Bipolar I and Bipolar II in friends and family, married to a psychiatrist for 20 years and having worked closely with doctors treating the disorders for 5 years, plus having closely and continuously kept up with ongoing research studies, I feel kinda qualified to comment on this.


 * Bipolar spectrum deals with everything as follows:


 * what doctors call Depression, but which lasts for decades, a lifetime - and is not connected to any loss or source of sadness - it just is.
 * Actually, in all the bipolar spectrum, even tho mania is what one hears most about, depression is the over-riding, most prevalent state of emotion.
 * Agitated depression and vegetative depressions are found in abundance. If you treat an agitated depression, seeing the only "symptom" which is free-floating overwhelming anxiety, with valium, the next day your patient will be suicidally depressed - even tho the anxiety will have, of course, disappeared.


 * Bipolar I is the only disorder originally recognized as such and was officially labeled Manic-Depression. Little or no attention was given to the depression, but the readily recognized Manic Symptoms, ranging from rapid speech reflecting the racing brain, grandiose (and ludicrous) plans to become very wealthy, spending money like there was no tomorrow, maxing out credit cards, by outrageous behavior very out of the usual for the patient and sometimes extreme sexual promiscuity or sexual encounters far from the usual norm for the patient.   As the mania progressed, uncontrollable speech, delusions and psychosis could develop.  Involuntary hospitalization was the only possible treatment.   This degree of the disorder is referred to Hyper-Mania.


 * Lithium was the first and for a long time was the only medication available to control the mania, but did nothing for the depression since the tricyclics weren't around yet.  Which was most unfortunate, for patients can go for years without a manic break, yet still have problems with irritability, social dysfunction and a heightened risk of suicide.   Bipolars at any point on the spectrum are routinely denied life insurance.


 * Treatment begins with Lithium, progresses to Depakote (both of these require relatively frequent blood tests so toxicity does not develop), then to anti-psychotics if the other treatments fail or have too many side effects. Of course, antipsychotics have their own side effects, especially tremendous weight gain in the new-generation "safer" ones.


 * In Bipolar II, a more recently recongnized form on the bipolar spectrum, has manias most with a stretch of a few days or more of elevated enthusiastic very happy mood with tons of energy used in a very goal-directed productive manner but they will not need any sleep, tho as the days go by, a periodic nap of 3 hours at the most.  I have had therapists tell me that their idea employee would be this type of patient (as long as the Hypo-Mania lasted).


 * A patient may have even as little as 5 or fewer such episodes in their entire lives, yet years of depressive problems at other times. Or they may be Rapid Cyclers with several episodes of greater or lesser degree of being "upbeat" a year, Ultra Rapid Cyclers and even the now recognized Ultra-Ultra Rapid Cyclers that may cycle several times a week or even during a single day.  And they generally are kept continuously antidepressants.  But the tale-tell characteristic of these patients is IMPULSIVENESS which leads to problems in all facets of their education, employment, friendships and more intimate relationships.


 * Depending upon circumstances in their lives at the time, they may enter a period of extreme irritability, frequent emotional outbursts, whether of torrents of tears or yelling rages. Impulsiveness alternates with the inability to get organized enough to plan, execute plans and they can become unable to be gainfully employed.


 * For Bipolar IIs, Lamictal, a relatively new anticonvulsant, is the drug of choice, the first one to try, because it controls impulsiveness and helps the patient direct their own life towards goals and follow thru to a successful conclusion, plus it has an anti-depressant effect.   The antidepressants most often prescribed are an old tricyclic called desipramine and the atypical Wellbutrin (also marketed to stop smoking).


 * In short, the bipolar spectrum of disorders is impossible to deal with in one article. This particular article should be expanded to point out that someone diagnosed with a bipolar illness is much more likely to have ADD/ADHD, Borderline PD and other PDs, dual diagnosis (which means co-existing with drug & alcohol abuse as the patient attempts to "self-medicate").   And there are more.


 * In recent MRI studies, those with bipolar illness have been found to have specific brain differences from the general population. The reason anti-convulsants are thought to be effective has evolved from a theory that the impulsiveness originates in the too-rapid firing of certain brain cells, over-riding the brain structures vital in normal inhibitory effects...  Bipolar requires smaller doses than in persons with epilepsy.  Spotted Owl (talk) 01:09, 5 February 2008 (UTC)
 * Spotted Owl (talk) 09:41, 10 February 2008 (UTC)

I love being bi polar. Its a free high!!!!! —Preceding unsigned comment added by 70.23.242.84 (talk) 01:36, 19 February 2008 (UTC)

Nutrition
Should nutritional therapies be included from quality articles and studies (i.e. peer reviewed, double-blind, randomized, controlled-trials)? I think, absolutely. If there is general agreement, will do... Gnif global (talk) 12:48, 23 February 2008 (UTC)

Ultra-ultra rapid cycling bipolar disorder is associated with the low activity catecholamine-O-methyltransferase allele.Papolos DF, Veit S, Faedda GL, Saito T, Lachman HM. Program of Behavioral Genetics, Albert Einstein College of Medicine/Montefiore Medical Center, NY 10461, USA. demitri@connix.com

Bipolar spectrum disorders are recurrent illnesses characterized by episodes of depression, hypomania, mania or the appearance of mixed states. Great variability is evident in the frequency of episode recurrence and duration. In addition to regular circannual episodes, a spectrum of cycle frequencies has been observed, from the classical rapid cycling (RC) pattern of four or more episodes per year, to those with distinct shifts of mood and activity occurring within a 24-48 h period, described as ultra-ultra rapid cycling (UURC) or ultradian cycling. RC has a female preponderance, and occurs with greater frequency premenstrually, at the puerperium and at menopause. Tricyclic antidepressants and MAOIs, both of which increase functional monoamines norepinephrine, dopamine and serotonin, are known to precipitate mania or rapid-cycling in an estimated 20-30% of affectively ill patients. We have recently reported a strong association between velo-cardio-facial syndrome (VCFS) patients diagnosed with rapid-cycling bipolar disorder, and an allele encoding the low enzyme activity catechol-O-methyltransferase variant (COMT L). Between 85-90% of VCFS patients are hemizygous for COMT. Homozygosity for the low activity allele (COMT LL) is associated with a 3-4 fold reduction of COMT enzyme activity compared with homozygotes for the high activity variant (COMT HH). There is nearly an equal distribution of L and H alleles in Caucasians. Individuals with COMT LL would be expected to have higher levels of transynaptic catecholamines due to a reduced COMT degradation of norepinephrine and dopamine. We therefore hypothesized that the frequency of COMT L would be greater in RC BPD ascertained from the general population. Significantly, we found that the frequency of COMT L was higher in the UURC variant of BPD than among all other groups studied (P = 0.002). These findings indicate that COMT L could represent a modifying gene that predisposes to ultra-ultra or ultradian cycling in patients with bipolar disorder.

[PubMed - indexed for MEDLINE] Psychoactive1 (talk) 14:30, 12 March 2008 (UTC)

Link between BD and ADHD
If you search the net for "bipolar and ADHD", these points become visible:


 * Bipolar shares some symptoms with ADHD.
 * A lot of people who have BD have also ADHD, and vice versa.
 * Many people with BD are misdiagnosed with ADHD.

For example: http://www.medscape.com/viewarticle/544698

"The incidence of ADHD in children who are later diagnosed in adulthood with bipolar disorder (BD) is indeed quite high. Compounding this situation is the high rate of co-occurrence of these 2 disorders. In some series, 93% of children with diagnosed BD have comorbid ADHD, whereas 59% of adolescents with adolescent-onset mania have ADHD. The association becomes less pronounced in adults with diagnosed mania, of whom only 10% have comorbid ADHD.

Symptoms common to both, especially in younger children, include hyperactivity, inattention, irritability, and rage, with the severity of these symptoms being more intense in children with BD. Overall impairment is more profound in individuals with both disorders, although environmental accommodations, including the provision of structure, help less to alleviate symptoms in BD than those ascribed to ADHD."

See also:  .

Should we place a link to ADHD somewhere in this article? I can't do it myself, cause it's semi-protected. V In The Know (talk) 00:34, 11 April 2008 (UTC)


 * dear V in the Know, semiprotected means you could edit it in but I wouldn't advise it. The paper referred to above is a letter and personal experience, and the link between the two is controversial, as are the rates of diagnosis in children of both BAD and ADHD, both being highly variable. The article is quite hefty and is on my to-do list some day (should be sooner rather than later) Cheers, Casliber (talk · contribs) 05:25, 15 April 2008 (UTC)

Critical or skeptical views?
This article doesn't mention any studies or professional opinions which state disbelief in the existence of the entire disease. I'm not sure that any such thing exists at all, but one sure would recon that there'd be some "opposite views" considering this? Or? —Preceding unsigned comment added by 80.221.62.248 (talk) 11:41, 17 April 2008 (UTC)


 * There are controversies in the subcategorisations in diagnosis, and arguments over overdiagnosis - no-one in mainstream medicine doubts the diagnosis as such. Much of this can and will be sprinkled throughout appropriate sections. Cheers, Casliber (talk · contribs) 14:31, 17 April 2008 (UTC)


 * OK! I just thought that, given that there is no known neurological explanation, and apparently no objective manner of measure of detection, that at least some one would have come up with the idea that perhaps it does not exist at all!128.214.177.200 (talk) 21:40, 20 April 2008 (UTC)


 * So the millions of people that act alternately depressed and manic every day or week or month or year are just faking? :P JRDarby (talk) 05:46, 22 April 2008 (UTC)


 * Of course not!! But look at the history of medicine, especially psychology and psychiatry. It's full of hypotheses and diagnoses that were very popular explanation at some time but which are considered to be bunk today. Have a look at http://en.wikipedia.org/wiki/Quackery 80.221.62.248 (talk) 18:37, 22 April 2008 (UTC)


 * The controversies, as noted above, lie within subcategorizations and over-diagnoses. What you propose could apply to any mental illness;  any skepticism would be better aimed at the diagnostic process itself and not at one particular disorder. DeeKenn (talk) 05:06, 22 April 2008 (UTC)

You know, this is so absurd. Why do people believe in diseases like this? Life can provide tons of reasons for someone to be depressed or enraged, but how is that an illness? It's not. The notion that a person is supposed to spend his life happy and optimistic is utter bs. —Preceding unsigned comment added by 24.7.54.224 (talk) 03:50, 22 June 2008 (UTC)

Neurology news on bipolar disorder
Metabonomic analysis identifies molecular changes associated with the pathophysiology and drug treatment of bipolar disorder http://www.nature.com/mp/journal/vaop/ncurrent/abs/4002130a.html

80.221.62.248 (talk) 20:25, 22 April 2008 (UTC)

Culture-bound syndrome
The section "controversy" contains mention to culture-bound syndromes but does not link to wikipedia's page on the subject. The page is protected; will someone please link it? 24.20.131.232 (talk) 05:50, 11 May 2008 (UTC)

Pendulum
A great resource for information about this disease:
 * Pendulum - Bipolar portal
 * I suggest to add this as a link. Patio (talk) 11:14, 16 May 2008 (UTC)

Stating the obvious
"Bipolar disorder is not a single disorder" ...hence the prefix bi, meaning two or more. Does it need to be in the article as it is indeed stating the obvious?--User:Db1987db (talk) 23:14, 20 May 2008 (UTC)
 * I don't think thats true actually. Though I also think that depends on perspective. The bi is there to describe the two differing sides to the one disorder as far as I know. Chitchin13 (talk) 02:12, 21 May 2008 (UTC)

Prevalence of acid reflux
Through out my battle with bipolar disorder, there seems to be a strange commonality of acid reflux. Just about every person in my focus group has or has had acid reflux. It might just be a very odd occurrence or happenstance, but I believe there might be allot behind this very real issue. Maybe its just the medication or stress.... "tell me what you think" Bold text —Preceding unsigned comment added by Rhhardin (talk • contribs) 19:59, 20 June 2008 (UTC)

Medication: Role of drug maker's promoting 'bi-polar' diagnosis should be mentioned
Under the Medication section

The current last paragraph: "The use of antidepressants in bipolar disorder has been debated, with some studies reporting a worse outcome with their use triggering manic, hypomanic or mixed episodes, especially if no mood stabiliser is used. However, most mood stabilizers are of limited effectiveness in depressive episodes".

Would benefit from having something like the following sentance added at the end of this section:

"Many drugs used for bi-polar patients are presecribed off-label. The issue of off-label marketing is controversial in the drug industry. Nearly every company is under either civil or criminal investigation for alleged efforts to expand the use of its drugs beyond the specific illness or condition for which they are approved."

This is from Drug Files Show Maker Promoted Unapproved Use By ALEX BERENSON Published: December 18, 2006

Drug Files Show Maker Promoted Unapproved Use

I would also suggest adding a comment such as: "Major drug companies, such as GlaxoSmithKline, actively promote bi-polar diagosis and corresponding drugs"

You can use www.Bipolar.com Bipolar.com as a citation. As stated on the Bipolar.com page: Bipolar disorder support and information brought to you by GlaxoSmithKline. ... Millions of people have bipolar disorder. It used to be called manic depression.

Hthu (talk) 18:28, 29 June 2008 (UTC)HTHU

Archived from the Wikiproject Psychology template
The diagnosis section contains the statement "Both within and between individuals with the illness, energy, mood, thought, sleep, and activity are among the continually changing biological markers of the disorder." This is a big stretch of the term biological marker, with is generally used to refer to a molecular or genetic marker that can be tested for physically, say with a blood test or other physical means. Since at this point there are no genetic or chemical markers that are tested to diagnose bipolar disorder, the use of the term is innaccurate and implies a greater biological understanding of the illness than we currently have. A better term here might be simply the word characteristics or physical manifestations. There are also several sentence fragments in the article which noone has bothered to clean up. The highest concordance rate from twin studies given needs a citation. Overall the article is probably not up to the same quality as most Wikipedia articles and considering the importance level it's been given, I'd rate this one more in the class of a C-.

67.142.130.33 20:37, 20 March 2007 (UTC)xlarax

EDIT REQUEST:

Simple grammatical deletion of the one word "a" before the plural "mixed states" was made below. Thank you!

Original text, with correction, will read as: "Bipolar disorder, often referred to as manic-depression in the general literature, is a psychiatric condition defined by periods of extreme mood. These moods can occur on a spectrum ranging from debilitating depression to unbridled mania. Individuals suffering a bipolar disorder generally experience fluid states of mania, hypomania or what is referred to as mixed states in concert with clinical depression. These clinical states typically alternate with a normal range of mood, which is termed euthymia. Bipolar disorder can range in severity from a mild annoyance to a serious lifelong disability."

MsTikl1 05:46, 10 May 2007 (UTC)MsTikl1

Stigma Associated With Bipolar Disorder

I am new to Wikipedia and a reliable source. I have been diagnosed with Bipolar I Disorder and am highly functioning. This article will be improved drastically by including a topic focused on current stigma and prejudice placed on individuals labeled with this illness. I am certain that there is current documentation to support my statement. Stigma associated with mental illness, particularly Bipolar disorder and Schizophrenia can be more disruptive than the biological issue itself. I have been watching this article closely and have noticed many positive changes. I am fairly certain that there are high functioning bipolar people currently focusing their energy on this article. If my post is inappropriate please do not be offended. I just registered and do not have the time to adress this further. My energy and talent is being channeled on other areas relating to stigma within bipolar disorder. If you are bipolar and focused on recent edits to this article please contact me. We may be in a position to benefit each other. Thank you for your consideration. Bipolarbrad (talk) 09:42, 24 April 2008 (UTC)

Tidying
Not sure what a good way would be to clear up or archive this talk page a bit, so can see what the active issues are, if possible? EverSince (talk) 03:38, 12 September 2008 (UTC) (including the random looking stuff in the big yellow wikiproject box at the top?) EverSince (talk) 03:49, 12 September 2008 (UTC) Guess could archive any discussions that haven't had any action for, say, 2 months... EverSince (talk) 23:04, 12 September 2008 (UTC)

I'll attempt the above in due course if no objections. Including moving the wikiproject psychology comments into archive somehow (can anyone advise on doing that? And on why the table of contents for this talk page is located within the wikiproject psychology box, and if it should be?). I'd also like to add the tag from template messages to the top of this talk page, to maybe help new commentators and keep the talk page organized. EverSince (talk) 08:02, 21 September 2008 (UTC)

Help, the wikiproject psychology template has eaten the table of contents and I can't for the life of me work out how to get it out back to the main talk page. EverSince (talk) 07:01, 22 September 2008 (UTC) Done it now by adding a tag, complete mystery why it needs it here and not other talk pages? Now going to archive as per above. EverSince (talk) 08:34, 22 September 2008 (UTC) Ok there was a weird section within the wikiproject psych template, that was appearing in the TOC and had its own edit button, and yet when you clikced on it, it said it did not exist. I've archived what was in there therefore, but please put it back if I shouldn't have. EverSince (talk) 08:57, 22 September 2008 (UTC)

Ok I'm done. I'd like to also move this "Tidying" section to the archive I've just made...I'll do that in due course unless anyone can advise that I shouldn't do that 'cos it's not as old. EverSince (talk) 09:12, 22 September 2008 (UTC)

Cognitive Impairment
I think the balance is off for this section of the article. Maybe the title itself, it implies something along the line of mental retardation while the article says it is more along the line of a simple defect in thinking. Along the line of balance I think the other side of the point, creativity, is too small and also should be something else. The mania side can also account for hyper functionality, which is a term I probably made up to prove my point. Yes it can induce creativity, but I think there is also a link between bipolar and IQ, positively. I myself am not thinking clearly but I hope someone like Ms. Poptart gets something out of this Chitchin13 (talk) 02:12, 21 May 2008 (UTC)
 * In general bipolar people are inteligent and when (hypo)manic quite creative as well, but there may be proverbial exceptions that prove this rule of thumb. I guess there are at least as much differences as with "normal" human beings, but who is able to give a full proof of this hypothesis? Patio (talk) 14:07, 29 May 2008 (UTC)
 * Cognitive deficit != mental retardation. Deficits like (for example) distractability, difficulty in everyday planning, and memory problems can coexist side by side with high intelligence, creativity and complex problem-solving ability. However, regardless of the many people who combine high IQ and bipolar disorder, and the clear positive correlation between bipolar disorder and creativity, there is no evidence of a positive correlation between IQ and bipolar disorder in the population as a whole, and some evidence of a negative correlation between IQ and bipolar disorder, although the cause-and-effect relationship, if any, is unclear. -- The Anome (talk) 01:14, 6 August 2008 (UTC)

Suggested section
A section on the geriatric care of manic depressive patients may also be useful. (Speaking as someone who is on the receiving end of between four and ten phone calls a day to get stream of consciousness monologues from my bi-polar 67-year-old mother.) —Preceding unsigned comment added by 69.157.187.222 (talk) 21:38, 13 September 2008 (UTC)


 * Good point. I started a subsection on it, based on a fairly recent review study. Added it after the children subsection for now, though it's not really specific to diagnosis (lot of overlap/unclearness with the sectioning, guess it's inevitable to some extent...) EverSince (talk) 12:31, 23 September 2008 (UTC)

I believe that memory problems and attention problems are linked back to the sufferers personality to begin with also a lot to do with medication. If I am medicated in the morning I feel slow, yes I have a very high IQ and very good at Math also solving complex calculations inside computers in cars etc. However some people have had the effect of alcohol or drugs that may impair there memory also most sufferers would be highly intelligent as far as education is concerned by when it comes to day to day living stuff they may appear disorganised and struggling to function. Deep deep down though their elusive mind maybe rambling thoughts and solving things. It is definately related to bipolar. It is the clear advantage of thinking deeper and higher and understanding on another level which makes us susceptible to such dramatic emotional shifts. People with lower IQ generally have clear advantages in social gatherings and have the ability to function in everyday society. Even though bipolar people are smarter then general the world as a whole would not function with just us. I believe this section doesn't not have enough back up. Ther have been numerous studies taken but no real data to back it up other then- sufferers are likely to be medicated which will slow there thinking and also there attention span is associated with there mood. This is a joke, in all my time as having bipolar 1 I can justify that meds are terrible at this and that more studies need to be looked at. Most bipolar people are eccentric and while we are very smart on one plane we aren't on the next. The is section needs to be removed. —Preceding unsigned comment added by Hymey (talk • contribs) 22:39, 25 October 2009 (UTC)

To do
I thought I'd just note that there's now a to-do box at the top of this talk page that anyone can add to/act on/cross off. And also if I've removed/changed anything I shouldn't have in my hypomanic go at the article, please reinstate it of course. EverSince (talk) 16:55, 23 September 2008 (UTC)


 * I know this was written a while ago, but wow! so funny. Should there be a requirement that all those working :on the article AND who are currently experiencing bipolar disorder (along with all the lovely medication side :effects that go with it) lay low..?


 * bpage (talk) 20:30, 8 January 2010 (UTC)

Disorder?
Does 'disorder' have to be in the title? LamaLoLeshLa (talk) 20:08, 24 September 2008 (UTC)
 * Yes, that is its proper name. "Bipolar" on its own is merely an adjective. Cheers, Casliber (talk · contribs) 20:18, 24 September 2008 (UTC)

Definitions etc.
Caveat: being trained in maths and logic, I can be rather pedantic about details, but feel that in this instance the pedantry is justified.

I must praise the author(s) of the article for correctly (IMO) calling Bipolar disorder a 'psychiatric diagnosis' rather than a single 'disease'.

Anyway, the article uses the phrase 'abnormally elevated mood'. I struggle to find an adequate definition of mood, or what it means for mood to be abnormally elevated in this context (most google searches unearth university and other psychiatric pages that are happy to talk about mood disorders and mood stabilisation, but not what mood actually is.) For example, the Mood (psychology) page does not provide an adequate description in this instance and perhaps a separate Mood (psychiatry) page is justified. The Mood disorder page only indicates that mood/emotional disturbance (whatever mood means) is hypothesised as the underlying cause, and there is rather a lack of clarity. Maybe wikipedia is accurately reflecting a lack of clarity in psychiatric circles from which these terms are drawn, but this ought to be pointed out somewhere.

Any ideas? —Preceding unsigned comment added by Chalisque (talk • contribs) 13:55, 5 October 2008 (UTC)


 * I think this is very important but also that it does to some extent reflect a lack of clarity about the core constructs and cut-offs, and the blurry partitioning of the everyday and clinical usages. Some other pages touching on it also - Dispositional affect, Affect (psychology), Affective neuroscience and (barely) emotion. I agree it should be covered more...maybe here for now could include a bit more on the questionnaires/assessments used for conceputalizing/screening/diagnosing... EverSince (talk) 17:18, 18 October 2008 (UTC)


 * In true bipolar, it is pretty unmistakeable. There are problems, though, when you get to so-called milder forms and entities like ultra rapid cycling. Anyway, this will be another major overhaul at some stage. Cheers, Casliber (talk · contribs) 20:41, 18 October 2008 (UTC)


 * Intuitive recognition of stereotypes isn't quite the issue, though, and there is ongoing research/debate as to the psychological dimensions involved in mania, the extent to which it involves true "elevation", mixed states, underlying negativity etc. EverSince (talk) 22:08, 18 October 2008 (UTC)


 * One of the losses in the past 40 years has been psychological interpretation of manic episodes, however a full-blown episode is something to see and one where...anyway, they are pretty full-on. Cheers, Casliber (talk · contribs) 22:20, 18 October 2008 (UTC)


 * Well, I wasn't meaning "interpretation" particularly, and I don't think severity is again quite the issue (and you do'nt need to tell me how it can seem clinically); the query seemed to be about underlying construct definition/validity/assessment issues. Thanks EverSince (talk) 01:28, 19 October 2008 (UTC)

Psychosis Related to Bipolar Disorder
I noticed while reading the article that while many subjects concerning Bipolar Disorder were very detailed, there seemed to be little to no information concerning the development of psychosis during mood cycling. It might be helpful to give a brief explanation of this manifestation of the disorder with, possibly, a link to the article about psychosis. As well, information regarding the prognosis of those suffering from Bipolar disorder with psychotic features should be discussed in this article as well, along with any other relevant facts. That would be much appreciated.

99.255.70.39 (talk) 15:35, 8 October 2008 (UTC)


 * Good point, psychotic symptoms can be markedly florid in a full-blown manic episode, and I have just read that those who often get psychotic symptoms when manic often also do when in a depressive phase. Will add soon. Cheers, Casliber (talk · contribs) 22:18, 18 October 2008 (UTC)

Hgurling's edits
User:Hgurling, a well-intending new user and quite possibly an expert on the subject matter, has made significant edits to both Schizophrenia and Bipolar disorder. His edits to schizophrenia have been discussed at length, but a comparable discussion is lacking for bipolar disorder. Regardless of his actual identity, Hgurling appears to have significant knowledge about the subject, but he may be unfamiliar with policies such as WP:NPOV. Cosmic Latte (talk) 20:54, 1 November 2008 (UTC)


 * Erm, would be happy to look, but...erm.. am a little preoccupied at present. I think I will be stuck for a week or more. Cheers, Casliber (talk · contribs) 23:21, 2 November 2008 (UTC)


 * I've inserted templates for "bias" and "unreferenced" at the "Life events and experiences" section, since the 180° change of text seem to be confusing to readers (and, of course, that I think it's biased and unreferenced), and I don't feel confident to revert to the old version either, since I'm not sure that the sources used in that version really covers the claims made. I'll take a further look at this if I have the time, otherwise I'm hoping that someone knowledgable will come around. /skagedal... 09:29, 7 November 2008 (UTC)

Childhood
I do remember this article saying something about how having a bad childhood or a life filled with abuse could contribute to becoming bipolar. I've never doubted that, but then it was suddenly removed and now it reads that "conflict contribute very little to the development of bipolar". So what does that mean? I'm just curious as if anyone could tell me the truth... because I have been bipolar since the tender age of twelve and my childhood was not that great. So I wanted to know if abuse really does contribute to developing this disorder or not. A Wikipedia talk page probably isn't the best place for this inquiry, but since it's been removed already...  Lady  ★  Galaxy  03:17, 4 November 2008 (UTC)


 * I think the view that stressful life events contribute to the development of a bipolar disorder is pretty much the "mainsteam view". This is what typical textbooks teach (e.g., Barlow & Durand 2005, Abnomal Psychology). (I can not, of course, say anything about what caused your problems; as you imply, this is not the place for that.) These recent changes to the article are what is discussed above under "Hgurling's edits". Specifically, this edit. Hopefully, someone will take a closer look at this. /skagedal... 10:27, 4 November 2008 (UTC)

I have at times made controversial edits myself, but the stressful events view is not only mainstream, it is in the DSM IV. User:smkatz

Roller Coaster Picture
Is the picture of a roller coaster necessary? —Preceding unsigned comment added by 64.42.217.69 (talk) 15:39, 12 November 2008 (UTC)

Hi I added that, I was trying to find a picture that was an analogy of bipolar disorder, although it may be seen as a bit crude. Remove it if you find it offensive or think that it trivialises the illness or come up another image which is a better analogy (try searching thru wikipedia commons). I think the addition of images in general does add something to the article. What do others think? 194.83.141.120 (talk) 15:45, 17 November 2008 (UTC)

Yeah, I think the roller coaster pic is a bit over the top... Some of the other images on the page seem unnecessary, too, like the brain directly above "Starry Night." 152.3.65.140 (talk) 20:49, 18 November 2008 (UTC)

This following was left on the talk page of 194.83.141.120 by 72.189.98.222 "I feel the picture of the roller coaster is an excellent analogy of the emotions one experiencing the variances of bipolar disorder." 194.83.141.120 (talk) 12:20, 20 November 2008 (UTC)

While that may be true, it seems to me that analogies generally aren't encyclopedic. That image seems to detract from the encyclopedic tone of the page. 152.3.65.140 (talk) 18:48, 20 November 2008 (UTC)

I respect your point but I couldn't find anything on Wikipedia which disapproves of images representing analogies. Its important that while encyclopedic the article is also accessible to the general public and I think images like this help. Any others care to comment? 194.83.139.137 (talk) 11:31, 26 November 2008 (UTC)


 * Well, we could look at it another way: do we have one or more reliable sources that say bipolar disorder is comparable to a roller coaster? I'm removing the image; its inclusion suggests original research. (There are likely better reasons for removing it.) -- Gyrofrog  (talk) 18:09, 4 December 2008 (UTC)


 * A search on Google Scholar for "bipolar disorder" + "roller coaster" get 575 hits, this being the first. Google Web gets over 41,000, and Google Books gets 251, at least two of which use the phrase in their titles, Bipolar and the Art of Roller-coaster Riding and Riding the Roller Coaster: Living with Mood Disorders.  So it seems to be a pretty widely used metaphor. Looie496 (talk) 19:03, 4 December 2008 (UTC)


 * Abnormal Psychology by Barlow and Durrand third edition page 235 has a picture of a roller coaster in relation to bipolar disorder [ http://www.amazon.com/Abnormal-Psychology-Integrative-Approach-InfoTrac%C2%AE/dp/0534633625 ] so I'm putting the image back... —Preceding unsigned comment added by 194.83.139.137 (talk) 15:22, 5 December 2008 (UTC)


 * You seem persistent in keeping a picture you added on the page, when I saw it I didn't think it useful at all and I really find it unnecessary, sure the analogy is true but do we NEED a picture of a roller-coaster to "show" what bipolar is "like"? Earisu (talk)15:53, 23 February 2009 (UTC)


 * I have added a citation to the picture (one of the above-mentioned books, hundreds of other sources would be possible) so that if the issue arises again, it can at least be handled in a more informed way. Looie496 (talk) 17:42, 5 December 2008 (UTC)

The picture of the roller coaster appears juvenile and callous, I think it should be removed. I have a pretty serious case of bipolar I and I have extensively studied psychology before and after my diagnosis. I have to say that when I saw the picture of the roller coaster I burst out laughing. Using the analogy of a roller coaster to describe the mood swings of bipolar disorder is understandable when trying to bring information about the disorder to lay people, but I feel like the picture is absolutely useless in terms of educational value. After I finished laughing at the sheer frivolity of the picture I actually became offended by it. If this were a page on MS and one of the characteristics of MS was to initially have a feeling of pins and needles in one's extremities, would a picture of actual pins and needles be appropriate? I feel it makes light of a very serious disease that is often misunderstood. —Preceding unsigned comment added by 69.114.7.189 (talk) 04:10, 31 March 2009 (UTC)


 * Okay, that's a valid point of view, but I'm puzzled by "using the analogy of a roller coaster to describe the mood swings of bipolar disorder is understandable when trying to bring information about the disorder to lay people". Bringing information to lay people is exactly what Wikipedia is supposed to do -- students and professionals really ought not to rely on it.  I don't have strong feelings about this myself -- it seemed to me that if books like this are published, then the metaphor is okay to use. Looie496 (talk) 16:27, 31 March 2009 (UTC)

In regards to you being puzzled, you cut off the rest of my sentence. Try reading it in its entirety.

I never said that students or professionals should rely on Wikipedia. I did say that the analogy is a good one for lay-people, but the picture is unnecessary for the various reasons I stated above.

There are plenty of books that are still in circulation today that have an antiquated or offensive view on sensitive issues ranging from history to art to science. Just because a handful of books regarding this topic use images that are offensive and simplistic does not mean that Wikipedia or anyone else should perpetuate the problem.

I think the image has proven to be offensive to many, and cheapens the integrity of the site. —Preceding unsigned comment added by 69.114.7.189 (talk) 19:14, 31 March 2009 (UTC)


 * Gosh I had not seen this debate before. I am a bit 'iffy' on the picture. To me (a psychiatrist) the analogy is wrong as a roller coaster more symbolises the mood swings from affect dysregulation of cluster B personality disorders such as borderline type (though I haven't seen it reported as such although many tempestuous biographies use teh term). Many well controlled bipolars would be a flat road with a few big rises and falls quite far apart. Thus, I am probably slightly happier without the image. Casliber (talk · contribs) 19:47, 31 March 2009 (UTC)


 * The only reason I'm not completely indifferent to this is that on the previous go-around I did the work of finding sources to justify the picture -- but I'll just say that if anybody feels bold enough to remove it, I won't complain or put it back. Looie496 (talk) 03:54, 1 April 2009 (UTC)


 * I fully understand - along with the annoying difficulties of getting pictures to decorate these mental health pages. Hopefully a few more folk will chime in with yea or nay. Casliber (talk · contribs) 04:18, 1 April 2009 (UTC)


 * Well, at least it's not The Scream, which used to adorn this page at one time. -- The Anome (talk) 08:54, 1 April 2009 (UTC)


 * Hi I originally added the picture mainly because some pictures were needed, and was supported by this by someone who had bipolar disorder saying they thought it was helpful, but I think there have been more negative responses to this than positive ones, so happy for this to go if this is the consensus. Any other users wish to comment on this so we get a good idea of the majority opinion? 194.83.139.177 (talk) 09:33, 21 July 2009 (UTC)


 * No further comments since April! To try and get more views on this I'm going for the unconventional route of putting a note on the picture something like "Is this picture helpful to the article please comment on the discussion page" - just for a short time say a few weeks to get an idea of what the general reader thinks 194.83.139.177 (talk) 16:16, 14 August 2009 (UTC)

(←)I have removed the roller-coaster picture because, while the analogy of a roller coaster is often used to describe the ups and downs this disorder, the wave form of the pictured roller-coaster is not exactly accurate - it was the type of roller coaster that starts and launches flat (either depressed or normal in bipolar disorder) and has one steep very narrow peak. A more accurate waveform would be either a step waveform (steep slopes, but lots of time spent in both the highs and lows), or some of the waveforms discussed in the M. Bergen reference (which was good and I relocated) here. Separately, I have also changed the Van Gogh comment to link to the long standing and well referenced internal article on his medical condition. 7 23:02, 2 September 2009 (UTC)

Inositol
I am going to temporarily remove the material on inositol from the Alternative Treatments section, on the grounds that it is (a) completely unsourced, (b) partly tangential, and (c) partly doesn't make sense -- serotonin enhancers are generally not good treatments for bipolar disorder. (Unipolar depression yet, bipolar disorder no.) This may in fact be something valid to talk about, but go in it needs at least one source and a better explanation. Looie496 (talk) 17:16, 7 December 2008 (UTC)

In relation to
Nonverbal Learning Disorder.... I know patients with that disorder can develop GAD and Depression, but what about Bipolar Disorder?

I suffer from NLD, and also have a lot of mood swings... —Preceding unsigned comment added by 76.125.103.136 (talk) 06:49, 13 December 2008 (UTC)

Picture
I am bipolar and it's such an oversimplification to a complex thing, and that's just kind of offensive. When I see the picture, it minimizes my condition to a petty cliche. —Preceding unsigned comment added by 141.156.198.224 (talk) 09:37, 24 December 2008 (UTC)
 * I'm assuming the reference is to the roller coaster picture (which has been removed). I agree that this picture is insensitive; more importantly for wikipedia purposes, it adds nothing to the article. The concept of manic and depressive episodes is not easier to understand with it, nor does it illustrate a point well, etc. It should stay out of this context. LH (talk) 09:47, 24 December 2008 (UTC)
 * Actually, there's a pretty good consensus just above to have the picture in there. Moreover, the roller coaster analogy is well-sourced. And Wikipedia is WP:NOTCENSORED for purposes of "sensitivity." Cosmic Latte (talk) 09:56, 24 December 2008 (UTC)
 * I have, however, rephrased the caption so as to make clearer the (sourced) rationale for including the picture. Cosmic Latte (talk) 10:05, 24 December 2008 (UTC)
 * Actually, Wikipedia is censored for "sensitivity", provided that the content in question does not significantly add to the article, and especially if the content exceeds standards of decency: note the last "if and only if" paragraph in that section you cited. (Most pornographic images tend to fall into this category; visual depiction can add to the article in terms of clarification, but many wish to turn an encyclopedia into a smut magazine.) A careful reading of the censorship statements is necessary ... -- Newagelink (talk) 06:25, 10 December 2009 (UTC)

Regarding quality of article to date
Haven't been here in nearly a year (at least 9 months), and I am impressed at the growth of this article in scope and in the quantity of good citations, yet find that the description of Bipolar Spectrum disorders is sadly deficient to the point of conveying completely inaccurate understanding of what bipolar disorder is at all.

Not going to go on at great length for I am not the ones working on this article, parts of which are really great (the fact that bipolar is the most costly medical condition of those disorders of the brain that cause the patient to suffer often severe deficiencies in interpersonal relationships and also cause the bipolar population to most often have intelligent people with an incomplete higher education and a spotty job history.   Bipolars often end up marginally employed and even homeless.

What most struck me was the absence of the present day recognition of the most predominant symptom of both Bipolar I and Bipolar II has not yet been included - that the emotional state that all bipolars spend most of their lifetime in is Depression, often a atypical depression often described vegetative depression. The depression has nothing to do with sadness as such, no common source of sorrowing triggers the depression, and the depressive periods can last continually, relentlessly, for a year or more of the retreat of incredible sleepiness with a near inability to stay awake UNLESS environmental influences intervene (such as family things like ferrying children about, shopping, holidays and trips).

Bipolar II is distinguished from what is presently called "Major Depressive Disorder" if even ONE episode of hypomania has occurred (usually a period of GREAT productivity and optimism without any sleepiness or sleeping for up to 3 days - after which, periodic brief naps (say maybe 3 hours) will keep the episode going for up to 5 to 7 days.   The episodes can be triggered by such things as a great opportunity presenting itself, and the quality of work produced is high.

"Hypermania" produces such dysfunctional behaviors to the point of being quite seriously out of touch with reality and beyond the range of probable possibilities that the psychotic episodes are what first brought strong psychiatric attention to the disorder. For a long time, Bipolar II was not recognized for a considerable period of decades.

30 years ago, Bipolar "rapid cycling" was considered to be present when there was more than one mood swing during a year. More recently it has been recognized that multiple swings of mania or elevated "feeling great & optimistic" normal states, then back to depression could occur as frequently as several swings a month, week and even during the period of a single day.

I think it important to do a good, if snugly concise, section on the differential diagnostic confusions, especially since borderline personality disorder, CPTSD as well as ADD/ADHD are significantly found as existing as a co-diagnosis, while also having many similar symptoms and signs as Bipolar.

Next, even though it should have its own topic of bipolar disorder in children, since (as in autism, asperger's and others that attract emotionally involved parents and "politically active" patients), the mere inclusion of the sudden incredible popularity of the diagnosis - even in toddlers - along with the treatment with antipsychotic meds, along with the complications of high possibility of tremendous weight gain (and Diabetes, "adult" onset which does not even need weight gain to develop.  Including more than a brief paragraph and a reference to a separate topic page is most definitely recommended as childhood mental conditions become battlegrounds of highly POV groups arguing regarding causation and treatment.

A mention needs to be made that the Health Service in England instructed all affiliated physicians to BEGIN bipolar treatment with lamitrogine, even tho it is vastly more expensive than lithium (tho safer). Only if lamitrogine fails to achieve a good response are they directed to add another medication or another change in treatment. Lithium carbonate and valproic acid (a rapid action form was first branded Depakene) and disodium ____ (?) my memory fails me (a slow release form of valproic acid, first branded Depakote) BOTH require careful monitoring of blood levels and regular blood tests to search for organ and/or system damage.

The other antiseizure meds do not need blood level monitoring and are far safer. Lithium and valproic acid are vastly cheaper than any of the others. However, Lithium and lamotrogine are the only two bipolar meds that control mania outbreaks PLUS serve as effective antidepressants.

As for antidepressants. The old-generation tricyclic desipramine and the "fits no other classification atypical AD" buproprion HCL (brand names Wellbutrin for depression and marketed under another name as the "stop smoking" drug aid) are the ONLY so-called "safe antidepressants" that provide a good response and are even capable of being sole medication control in some.

Otherwise, what is most important to know about antidepressants is that Prozac and all the rest that have followed it can trigger what is often a patient's first manic episode, with the patient sometimes ending up hospitalized (if not fired from their job or possibly even arrested). Most primary care providers have succumbed to demand and need to write prescriptions for depression, while being the least able to diagnose psychiatric illnesses. In addition, only a very tiny sliver of psychologists are adequately able to diagnose chronic depression and/or bipolar II, or even detect an emerging mania.

Well, that pretty much wraps it up. Great work, guys! Keep it up and this could eventually have a chance at FA status. Spotted Owl (talk) 03:15, 27 December 2008 (UTC)

Need to add that I feel it important to mention rage likely to manifest in hypermania, sometimes alongside grandiose ideation. In the psychosis, paranoia can emerge.

and (finally) I have found the most telling symptom for me of bipolar (I or II) is impulsiveness. During Bipolar I mania, the impulsiveness can extend to maxing out every credit card, borrowing to turn the fantasized future into reality. True, that is not in the DSM-IVR diagnositic criteria, but I have decades of up close and personal experience with both bipolar I's and bipolar II's.  In diagnosis, there are symptoms (distress the patient experiences) and signs (what a psychiatrist can observe and test for). Impulsiveness is a behavior and it is thought by some that the reason anticonvulsants work is that they "calm" the brain, lessening acting impulsively, giving the patient time to think things over. (Wellbutrin is also used to treat ADD/ADHD as the drug calms down the propensity to act immediately on impulse).

Spotted Owl (talk) 03:32, 27 December 2008 (UTC)


 * Rage is better talked about as irritability or aggression. The impulsiveness was once described by a colleague as "increased goal-directed activity with impaired judgement". Not sure if that came from a text. I do plan to work on this next year when I have more time. Cheers, Casliber (talk · contribs) 12:48, 27 December 2008 (UTC)

I just have to correct Spotted Owl here in saying that with Carbamazepine/Tegretol you do need blood work once a year in the U.K. in America and Canada, however, it's once a month to start off with. Also, regarding Lamotrogine (thats the spelling I have on my old packet), it sent me extremely Manic, a trait which happens in many patients. It seems it either works for you or makes you incredibly sick. I think that doctors should evaluate the patient and decide individual treatment instead of being 'instructed' to hand out one medication to start. —Preceding unsigned comment added by Shoegalsho (talk • contribs) 10:55, 12 April 2009 (UTC)

Mixed bipolar
Isn't this missing? It is real, and is in DSM.

Best, Shlishke (talk) 04:21, 8 January 2009 (UTC)

bipolar is an extremely subjective thing, and i believe that people should only contribute unless they know a great deal about people actually diagnosed with it. Because even doctors can be wrong - BlueRedNathan Bear —Preceding unsigned comment added by BlueRedNathanBear (talk • contribs) 14:09, 2 February 2009 (UTC)


 * I think the original poster may have been referring to mixed states. -- The Anome (talk) 15:06, 13 February 2009 (UTC)


 * I do believe the original poster was referring to Mixed State and it is indeed an important aspect of the the illness and deserves mention.Lindygrey (talk) 18:14, 5 October 2010 (UTC)

Proposed additional external links
I propose the addition of two more links to the "External links" section of this article:
 * Bipolar Disorder page from the U.S. National Institute of Mental Health website
 * NICE Bipolar Disorder clinical guidelines from the U.K. National Institute for Health and Clinical Excellence website

Both are detailed articles from major national government-run medical organizations that are widely recognized as among the leading authorities in their field. The first is aimed mostly at the lay reader; the second -- the full version of which is 592 pages long, and contains a systematic review of the entire topic -- is aimed at medical professionals.

At the same time, I would like to change the linking policy listed in the comment there.

I realize that the current restriction to the DMOZ link alone was intended to prevent the external links section silting up with competing links to personal and community bipolar sites, but either of these is far superior to the typical page linked from DMOZ, which is the only external link currently offered. If these links are OK with the community, I would suggest that the guidelines be altered to allow only links to sites operated by authoritative academic or governmental medical research bodies -- and also the present DMOZ link.

Does anyone have any objections to this change? -- The Anome (talk) 12:42, 12 February 2009 (UTC)


 * I have never seen those DMOZ links before and I have been around a while. Not thrilled about the links on the DMOZ page. I'd prefer the gov't links myself. Casliber (talk · contribs) 13:31, 12 February 2009 (UTC)


 * OK, given that the only comment made seems to be positive, I'm going to roll the change out now. -- The Anome (talk) 00:00, 13 February 2009 (UTC)

Associated Genes
I noticed that a citation was needed for the association of TPH1 with BP and went out looking for something. What I found here http://www.mememoir.org/e/gene/e/121278.html was that TPH1 is now deprecated in favor of TPH2. This site, interestingly, is a wiki. I don't have the technical expertise to judge its worth. Is it a worthwhile reference? --Halcatalyst (talk) 02:41, 24 February 2009 (UTC)
 * No, a wiki would not be a good reference. I did a bit of reading, and based on the most recent reviews, it seems that there is strong evidence for a role of TPH2 in unipolar depression, but the study implicating it in bipolar disorder has not been replicated. Looie496 (talk) 04:54, 24 February 2009 (UTC)

Bipolar II and full-on manic episodes
There has been a stream of edits regarding the frequency of manic episodes in Bipolar II patients, which is I think based on a confusion between retroactive and prospective frequency, because of the weirdness that the manic episode will effectively change their diagnosis retroactively. (Is this an example of Cambridge change, I wonder?)

To try to fix this, I've added the following text to the Bipolar II section, based on my (non-expert) interpretation of the diagnostic criteria:


 * "Patients with a Bipolar II diagnosis under the DSM IV criteria cannot, by definition, have had any history of full manic episodes, since the presence of even one such episode would have lead to their receiving a Bipolar I diagnosis. However, a Bipolar II diagnosis is not a guarantee that they will not eventually suffer from such an episode in the future."

That is to say: Bipolar II patients, looking retroactively, are certain to never ever have had manic episodes (i.e. a zero rate of occurrence), but, looking prospectively, sometimes may (i.e. a small but significant rate of occurrence).

-- The Anome (talk) 12:33, 29 March 2009 (UTC)


 * This is making something simple fairly complicated. In this clause:


 * Bipolar II disorder is characterized by hypomanic episodes rather than actual manic episodes, as well as at least one major depressive episode. Patients with a Bipolar II diagnosis under the DSM IV criteria cannot, by definition, have had any history of full manic episodes, since the presence of even one such episode would have lead to their receiving a Bipolar I diagnosis. However, a Bipolar II diagnosis is not a guarantee that they will not eventually suffer from such an episode in the future.

You could probably remove the need for the bolded bit with the handy adverb 'to date'. I am very tired at present and it will need some rejigging but can be done fairly readily. Casliber (talk · contribs) 13:01, 29 March 2009 (UTC)


 * I agree, it could be worded better. The possibly-redundant wording was intended to stop the to-and-fro edits between the viewpoints that Bipolar II patients never have (i.e. have had) manic episodes, and that they infrequently have (i.e. will have) manic episodes: althout apparently contradictary, both statements are true in their respective appropriate, but unstated, contexts. This definitely causes confusion in readers, because editors keep on making the same mistakes over and over again trying to "correct" the "false" statements they read. The confusion needs to be addressed somehow in the text, without relying on the reader to make the conclusion from logic alone. -- The Anome (talk) 13:07, 29 March 2009 (UTC)


 * Update: having written the verbiage above, I've had another hack at the wording in the article. Is that any better? -- The Anome (talk) 13:30, 29 March 2009 (UTC)


 * OK, I see where you are coming from and I was possibly suggesting a little too mch hacking. It is a little better now but I think can be improved. I am just swinging down my watchlist and will revisit this. Casliber (talk · contribs) 19:55, 29 March 2009 (UTC)

"Multidimensional" definition
Hi,

Towards the bottom of the article the word "multidimensional" is used as a term of art. I have also seen bipolar being discussed in terms of "axes."

Might these words have a quick parenthetical definition, i.e., clarification from plain meaning, when introduced?

Best, Shlishke (talk) 22:42, 1 April 2009 (UTC)


 * [Note: I'm not an expert, just an interested observer.] Regarding axes, you might want to take a look at Diagnostic and Statistical Manual of Mental_Disorders. In this terminology, bipolar disorder is an Axis I disorder, but it can often also be found associated with other less serious problems such as OCD or substance abuse. However, my understanding is that "multidimensional" is generally meant in the sense of bipolar disorder being complex and multifaceted, affecting every aspect of personality, rather than any formal idea of it inhabiting some kind of mathematical space. -- The Anome (talk) 11:06, 2 April 2009 (UTC)


 * It is not a word which means particularly much in psychiatry and we don't use it much these days - yes it is tied up with the multiaxial system of DSM but there are big issues there too. Casliber (talk · contribs) 11:35, 2 April 2009 (UTC)

Bi-polar disorder and manic depression are two different conditions
My sister has bi-polar disorder. I have been helping her deal with the therapy and everything else almost her entire life, and I believe this article is really good and goes into a lot of depth. However, the only reason I wanted to say anything is because I have been informed that Manic Depression is not the same thing as Bi-polar disorder, and it seems that as a result of referring to bi-polar as manic depression for decades up until about 20 years ago, a lot of people still believe it to be the same thing. The media, films and other forms, do nothing to help remove the misunderstanding. There is also a lot of stigma attached to it. My sister's psychiatrist has tried to explain things to me whenever I asked, and from my humble understanding, Manic depression and bi-polar are two different disorders in the same group of mood disorders, and I don't believe that Manic depression should redirect to bi-polar disorder, but should be directed to the manic depression disambiguation page or a separate article instead. Lyrical Israfel (talk) 20:39, 14 April 2009 (UTC)


 * [Note: I'm not an expert, just an interested observer] To the best of my knowledge, the terms are synonymous in modern usage in the UK and U.S. See the following:
 * from the Royal College of Psychiatrists: Quote: "Bipolar disorder used to be called ‘manic depression’"
 * from the National Institute of Mental Health: "Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person’s mood, energy, and ability to function."
 * from the UK National Health Service: "Bipolar disorder, previously called manic depression, is a condition that affects your moods, which can swing from one extreme to another."
 * Older terminology used the term "manic-depression" to mean the whole of what is now known as the bipolar spectrum: see and  for more details. This is, as far as I know, no longer common practice.
 * -- The Anome (talk) 23:34, 14 April 2009 (UTC)

Oh thank you so very much for the references! I was unsure if people were still calling it that, though from what I'd gathered that was a previous name for it. Thanks for your reply! I feel better about it after reading what you recommended above. Lyrical Israfel (talk) 01:55, 15 April 2009 (UTC)


 * You're welcome. Please note again that I'm not a doctor and that nothing on Wikipedia should be taken as medical advice (or indeed as reliable or fit for any purpose; see the General disclaimer and in particular the Medical disclaimer.) If you need advice, please consult your doctor. -- The Anome (talk) 09:13, 15 April 2009 (UTC)

Request to add a new book on Bipolar Disorder
Hi, I was wondering if it is possible to add a new book to the "Further Reading" page? If so the information is as follows

"I just want my Daughter back - coming to terms with Bipolar 1" By B C Levinson ISBN number 144213979X EAN number  978144213979X Published April 2009 Available on Amazon.com

Description is as follows:

I JUST WANT MY DAUGHTER BACK is a powerful narrative of a mother who lives with the turmoil of having a child with Bipolar 1- and the wide range of emotions that consume her and her family as this illness takes over. Through trial and error, both mother and daughter discover how determination and love in spite of a surprising twist in the road; can give way to a hopeful new beginning. Families suffering through the effects of mental illness quickly find themselves identifying with the writer’s experiences, as they discover ways they, too, can come to terms with Bipolar 1.

Thank you for your time and consideration. —Preceding unsigned comment added by Biploarsmom2 (talk • contribs) 02:21, 30 May 2009 (UTC)


 * Perhaps there is scope for a section detailing a few carefully chosen books on the subject, but the danger would be that everyone might want to add their own choice and make it over long. Notable books could be included, for example, Martin Townsend's The Father I Had which concerned his father's bipolar depression and which received an award, and any similar titles which have received recognition. Any such section would have to be well researched and referenced, and discussed here first. TheRetroGuy (talk) 15:57, 18 May 2010 (UTC)

Not sure
In the Mixed Affective disorder section there's a part which I don't know what to call but I know it probably doesn't belong in an encyclopedia. (This message, written by 97.121.152.72, was inserted into the middle of the previous message.) Looie496 (talk) 02:50, 11 August 2009 (UTC)

Bipolar depression
I see nothing in this article or the related articles specifically dealing with bipolar depression. Symptoms of major depressive episodes in bipolar disorder tend to be different from in unipolar depression, more often showing features of atypical depression in bipolar disorder (hypersomnia, overeating, lethargy). Here's one cite I gleaned from Google Books:
 * Bipolar depression is often characterized by hypersomnia, inhibition, lethargy, and apathy (mainly behavioral symptoms) whereas unipolar depression is defined by desperation, pessimistic thoughts, and other cognitive signs (Goodwin and Jamison 1990). Although it is true that cognitive symptoms are not absent in bipolar depression, they may be more true of unipolar depression.

El-Mallakh, Rif S.; S. Nassir Ghaemi. Bipolar Depression: A Comprehensive Guide. 2006. p. 218.

As the article is currently organized, I don't even know where information specifically about bipolar depression might go.--NeantHumain (talk) 16:20, 17 August 2009 (UTC)


 * I think you're right, and I don't see why the material couldn't go into the "Major depressive episode" section. Looie496 (talk) 20:39, 17 August 2009 (UTC)
 * Agree --> Bipolar_disorder. Casliber (talk · contribs) 20:58, 17 August 2009 (UTC)

Famous People
Maybe we should do famous people who had it! Like Kurt Cobain of grunge group Nirvana... PaperMate123 (talk) 08:34, 25 August 2009 (UTC)
 * Maybe so -- but the experience is that once such a section gets started, people fling names into it right and left, usually without sources, and it makes the article a lot more difficult to maintain. Looie496 (talk) 16:35, 25 August 2009 (UTC)


 * Additionally how many other mental illnesses warrant such a section? A fixation on famous people shouldn't be encouraged. —Preceding unsigned comment added by 82.25.104.165 (talk) 00:30, 2 November 2009 (UTC)

"PSA" link needs to be updated
Hi, do a search for PSA on the page, in reference to a public service announcement after a TV show. It links to a disambiguation page and the link can be updated to go directly to: http://en.wikipedia.org/wiki/Public_service_announcement (I'd edit it myself, but the page seems to be protected) 206.248.158.128 (talk) 16:46, 15 November 2009 (UTC)


 * Good catch. I fixed it. Dawnseeker2000   17:08, 15 November 2009 (UTC)

smoking and bipolar
I believe that there is mis information on this page and the citation from article 104 does not imply that smoking helps someone who has bipolar disorder- which is stated here. The article actually states: "Cigarette smoking is prevalent among bipolar patients, particularly those who have frequent or severe psychotic symptoms. Some experts speculate that, as in schizophrenia, nicotine use may be a form of self-medication because of its specific effects on the brain; further research is necessary."-

We do know that the effect on memory and learning may be applicable here but i would also strongly suggest that the effect on stress levels in this condition which is exacerbated by stress is strong. Therefore I would suggest this article should not suggest smoking helps your condition but can aggravate anxiety and stress levels for your mental health, remembering the damage to your body also the interlinkage between the two.There is evidence about smoking and its effect on mood and as far as i know there is none to indicate it makes you actually calmer or less stressed - its a withdrawal relief effect and nothing else that gives a temporary illusion of calming effect and is not sustainable. Nicotine is the chemical responsible for this and this does not have to be take with tobacco, if the argument is that the nicotine mood enhancing effects are beneficial to mental health. —Preceding unsigned comment added by 194.176.105.56 (talk) 14:14, 23 November 2009 (UTC) <!-Autosigned by SineBot-->


 * When I was a patient in a unit to help treat my manic episode, I could not find but one other patient who did not smoke. Listen, the med techs knew, the nurses knew, the doctors knew that if you DIDN'T allow patients to smoke there would be lots of yelling, aggravation and profanity.  Smoking was the calming agent.


 * bpage (talk) 20:37, 8 January 2010 (UTC)

Neural Processes
The section on neuronal processes and lack of consistent findings in MRI studies lacks a required note on the used scanning techniques. The lack of consistent findings is explained by (1) possibly limited structural change in BPD and (2) heterogeneity. Another common reason for not finding consistend results in MRI scans is because MRI scans, like all neurological research techniques, have a limited spatial (and temporal) resolution. Consistent differences in BPD might well be too small in size or too specific in structure to be picked up in an MRI scan, since the scan is only designed to look for anomalies in tissue structure, and not the functional, neuronal organization. I believe it would be good to add a note about this, because it now seems that if there is any kind of anomaly, MRI would pick it up, which is not the case. - 14-01-2010 by Paul


 * I think you should feel free to add such a note, as long as it doesn't get too complicated. Regards, Looie496 (talk) 17:25, 14 January 2010 (UTC)
 * Well I would but the article is locked, and I'm not a wikipedia wizard (maybe I should become one) and I don't know how to edit (partly) locked articles. —Preceding unsigned comment added by 145.116.1.123 (talk) 22:54, 17 January 2010 (UTC)
 * To edit an article that is semi-protected, you would have to have an account that has existed for at least four days and made at least 10 edits. If you don't want to go through that, just put the text you want here, and I'll put it in the article, assuming it makes sense to me.  Regards, Looie496 (talk) 00:59, 18 January 2010 (UTC)

Cannabis use and Bipolar Disorder
The Institute of Psychiatry at the University of Oslo in Norway conducted a study concerning cannabis use in Bipolar and Schizophrenic patients. The results showed that 'in bipolar disorder subjects, cannabis use was associated with better neurocognitive function, but the opposite was the case for the schizophrenia subjects... The findings suggest that cannibis use may be related to improved neurocognition in bipolar disorder and compromised neurocognition in schizophrenia'.

Psychological Medicine 2009 Nov 6:1-11; "Opposite relationships between cannabis use and neurocognitive functioning in bipolar disorder and schizophrenia."

--Katroar (talk) 21:29, 14 January 2010 (UTC)


 * Not to disparage that study in any way, but we prefer to rely as far as possible on secondary sources such as review papers rather than on primary research publications, because the primary research base contains very many contradictions and unreplicated findings. (See WP:MEDRS.)  Regards, Looie496 (talk) 16:26, 15 January 2010 (UTC)

Criticism
This was hard to weed through -- it read like a Psychology textbook (and not a general-interest encyclopedia) in places. But I didn't see anything criticizing the diagnosis, or the increasing prevalence of this disorder, despite all of the remedies available. Do you think some skepticism would be called for to provide some balance to this article? 209.55.85.8 (talk) 04:29, 31 January 2010 (UTC)
 * I personally agree with you, but it would have to sourced to an authoritative review article. Regards, Looie496 (talk) 16:10, 31 January 2010 (UTC)

Evolutionary purpose
So bipolar is partially heredity which means its continued existence must serve some purpose. I've read somewhere that the immediate relatives of bipolar people are far more likely to be prodigious in their creative output, which from a gene-centered view of evolution, would perpetuate the bipolar gene/combination of genes through the ever-churning conveyor belt of natural selection. Anyone heard about this?--Louiedog (talk) 04:57, 12 February 2010 (UTC)

Being hereditary does not automatically mean something serves a purpose. There are plenty of clearly negative diseases/illnesses which have strong hereditary elements (not implying bipolar is one of them). Evolution has no grand plan, has no direction, has no 'quality control'. So random useless (or damaging) stuff can still hang around. Just look at HERVs. There may be an evolutionary benefit to Bipolar, but it is a fallacy to assume there is. 220.253.112.74 (talk) 23:38, 17 February 2010 (UTC)

Omega 3 fatty acids
Yesterday edited the article to say "Clinical studies have shown that Omega 3 fattyacids have beneficial effects on bipolardisorder.", using as source http://bipolarcircle.com/index.php/Treatments/omega-3-fatty-acids-in-bipolar-disorder-a-preliminary-double-blind-placebo-controlled-trial.html. I reverted on the basis of inadequacy of the source. Today Fiatlux5762 put the material back in, with edit summary "This study showing the beneficial effects of Omega 3 is important information to people with BP disorder." Looking for better sources, the best I find is a 2008 Cochrane review that concludes "AUTHORS' CONCLUSIONS: Results from one study showed positive effects of omega-3 as an adjunctive treatment for depressive but not manic symptoms in bipolar disorder. These findings must be regarded with caution owing to the limited data available. There is an acute need for well-designed and executed randomised controlled trials in this field."  So I don't think the addition is justified. I am not going to revert again because it is my policy never to revert the same thing more than once, but can I ask others to take a look at this? Looie496 (talk) 20:05, 12 February 2010 (UTC)

I will modify the contribution source material to detail that the study cited was conducted by Stoll AL, Severus WE, Freeman MP, Rueter S, Zboyan HA, Diamond E, Cress KK, Marangell LB. Brigham and Women's Hospital, Department of Psychiatry, Harvard Medical School, Boston, Mass, USA in 1999. I have 15 additional studies just through 2006 that demonstrate various levels of beneficial effects on bipolar disorder to include decreased aggression typically associated with mania. The written policies of Wikipedia are to present information without bias. Thus, the addition of information regarding potential benefits from Omega 3, or any other treatment that shows promise, is clearly warranted. I will be happy to work on an adjustment to the language of the contribution if that is clearly warranted but the contribution should be allowed. Thanks. —Preceding unsigned comment added by Fiatlux5762 (talk • contribs) 02:46, 15 February 2010 (UTC)

Copyright problems with diagnostic criteria
The American Psychiatric Association has not released its Diagnostic and Statistical Manual of Mental Disorders into public domain, but claims copyright. The Wikimedia Foundation has received a letter of complaint (2010030910040817, for those with access) about the use of their diagnostic criteria in this and a number of other articles. Currently, this content is blanked pending investigation, which will last approximately one week. Please feel free to provide input at the copyright problems board listing during that time. Individuals with access to the books would be particularly welcome in helping to conduct the investigation. Assistance developing a plan to prevent misuse of the APA's material on Wikipedia projects would also be welcome. Thank you. Moonriddengirl (talk) 13:53, 11 March 2010 (UTC)


 * Here the main issue was lack of proper citing to the DSM. There was also a lot of repetition, requiring some copyediting. I've fixed both problems in Talk:Bipolar disorder/Temp. Eubulides (talk) 20:24, 11 March 2010 (UTC)
 * Thank you very much. Since I can't perform a proper history merge here, I've just pasted your new content on top of the previous article with attribution in edit summary. --Moonriddengirl (talk) 16:26, 12 March 2010 (UTC)

Current diagnostic criteria for bipolar disorder
Given the extensiveness of the concerns in the subarticle and in the face of an official complaint, it has been deleted. I am sorry to those editors who have worked to provide such fine coverage of this subject, but this content seems to have been present in the subarticle from the beginning. I hope that somebody with background in the subject can provide a suitable replacement for it. --Moonriddengirl (talk) 20:18, 14 March 2010 (UTC)

Bipolar Disorder
My wife suffers from bipolar disorder. What I would like to know is what can I do to help her when she in one of these depressive moods. Bill —Preceding unsigned comment added by 98.197.253.143 (talk) 23:11, 20 March 2010 (UTC)


 * Sorry, but Wikipedia contributors are not permitted to give medical advice. Looie496 (talk) 18:40, 22 March 2010 (UTC)

Edit request from Chrisjcarter, 9 April 2010
PolygenicPathwaysPolygenic pathways contains a database of genes and risk factors implicated in Bipolar disorder

Chrisjcarter (talk) 19:00, 9 April 2010 (UTC)

Not done: That site wouldn't qualify as an acceptable external link. Please read WP:EL. Thanks, Celestra (talk) 19:25, 9 April 2010 (UTC)

Bipolar and Asperger’s syndrome
I don't see how this section is relevant at all. Was anybody at risk from confusing the two? The cited source doesn't seem noteworthy or even accurate, and the text on the wikipedia article is copied verbatim from the source without quotation. Any objections to removing? FergusRossFerrier (talk) 19:56, 13 April 2010 (UTC)


 * Done diddly done. FergusRossFerrier (talk) 15:42, 20 April 2010 (UTC)

Suggested new section
I was completing an assignment for my Positive Psychology class at Vanderbilt University that involved editing/updating a Wikipedia article, and I have material that can be added to the Psychosocial therapy section of the main Bipolar Disorder article. Unfortunately, I didn't realize I needed to be an established registered member in order to do this, so could somebody who is one look over this information and consider adding it into the main article for me? It would be inserted as a new paragraph after the first one already presented under the Psychosocial section. "Current ongoing studies are also being conducted to examine the efficacy of mindfulness-based cognitive therapy. This practice utilizes concepts such as mindfulness, centering oneself in the present moment rather than the shortcomings of the past or worries about the future, and utilizes others calming practices found in the ancient practice of meditation . Pilot studies on the efficacy of this practice have found benefits to bipolar individuals through a reduction in the stress, anxiety, and depressive rumination that often precede mood episodes as well as reduced suicidal ideation  . While this data is tentative and requires further study, these potential benefits warrant further investigation and a comparison of overall efficacy to traditional psychotherapeutic techniques." Please reply/comment and let me know whether this is possible or if I am asking about this in the wrong forum.


 * Note: I moved this section to the bottom because it was inserted unsigned into a section above, in such a way that nobody would ever have realized it is new.  The author is . Looie496 (talk) 21:11, 28 April 2010 (UTC)

Disorder?
Sorry to put this here but it sounds like a lot of people I know have some form of this bipolar "disorder". Why is this thought to be a disorder in the first place? — Preceding unsigned comment added by 178.0.96.2 (talk) 21:14, 25 June 2011 (UTC)

Edit request

 * I am addressing a "citation needed" tag in this Wikipedia article.


 * The 2nd paragraph under "Manic episode" of Wikipedia article currently states:


 * In order to be diagnosed with mania according to the Diagnostic and Statistical Manual of Mental Disorders (commonly referred to as the DSM) a person must experience this state of elevated or irritable mood, as well as other symptoms, for at least one week, less if hospitalization is required.[citation needed]


 * The Mayo Clinic web site has a very similar statement, including a reference to the "DSM" in its "Criteria for a manic episode" section.


 * I cannot edit the article as I do not have enough edits to qualify for this "semi-protected" article.


 * Perhaps someone with more Wikipedia experience will appropriately edit the Wikipedia article (without violating copyrights) and cite the reference I provided here. :)


 * Please forgive me if I violated any Wikipedia community protocols with this post.

Kinoble (talk) 08:24, 18 July 2010 (UTC)