Environmental Factors Drive Mania


Harvard researchers investigated 6,214 cases of major depression for factors that would predict transition to bipolar disorder.  Clinical characteristics such as age of onset or atypical symptoms did not predict manic episodes. Risk factors included younger age, black race/ethnicity, and a less than high school education. A history of social phobia, anxiety disorder, child abuse, and recent problems with social support were also associated with increased risk. Results will appear in an upcoming Journal of Clinical Psychiatry.
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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. “However, prior psychopathology was associated with the transition to bipolar disorder: history of social phobia (odds ratio [OR] = 2.20; 95% confidence interval [CI], 1.47–3.30) and generalized anxiety disorder (OR = 1.58; 95% CI, 1.06–2.35).”

    I wonder if these people were treated with SSRIs?

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    • Based on my knowledge and experience bogus diagnoses like social phobia are given when the victims start showing the stress/trauma symptoms and seek help and validation for dealing with the abuse. Social phobia is a misdiagnosis pretense that the fear of an abuser in one’s environment is all in the victim’s head and since it was created in bed with BIG PHARMA to push certain drugs, it is very convenient too. It’s true that the victims can get a variety of bogus stigmas like ADHD, depression, paranoia, anxiety and other denials of the abuse while the trauma and physical stress symptoms become increasingly worse as the victim finds there is simply nowhere to turn for help with her and her child’s real problems, growing fear, trauma, etc. Perhaps SSRI’s and benzos may aggravate the initial symptoms, but it is really the crazymaking invalidation and denial of the real cause of the symptoms that drive the victims to despair and destruction made far worse due to the huge betrayal and abuse/retraumatization experienced in the mental “health” system.

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        • Mjk,

          Thanks for your validation and support. It sounds like you value spirituality and I think that is great. As I said on Dr. Steinberg’s blog, I think you are very intelligent, creative and funny with your wonderful play with words while coming up with many insightful truths in the process.

          Invalidation is one of the worst of abuses also called gas lighting, crazy making and emotional abuse!! So our support and validation of each other as fellow humans is critical to our health, humanity and survival.

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          • Donna,

            You’re welcome and thanks for the positive response & encouragement. 🙂

            It’s nice to know when someone appreciates our efforts & freely given contributions, for one another’s benefit.

            We’re awesome!

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  2. I have the same question, of whether they were treated with SSRIs. This seems like a low conversion rate from depression to bipolar, compared to other studies of conversion rates for depressed patients. It would be interesting to see the medication usage.

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  3. As I have said in several places on this web site, abused women and children suffering trauma symptoms are deliberately misdiagnosed with the latest fraud fad bipolar stigma to discredit, disempower, silence and destroy the victims to collude with their more powerful male oppressors in many cases. This also allows the toxic cocktails of so called mood stabilizers and atypical antipsychotics to be forced on the victims. Moreover, psychiatrists are known for their pathological lying and abuse of vulnerable patients to reinforce their major role as agents of social control to label them subhuman in the guise of psychiatric diagnosis. Such harm is exposed by Dr. Paula Caplan in her books and a current web site exposing the lack of science and huge harm of psych diagnoses especially to women from a very sexist profession.

    Here is an article about Dr. Carole Warshaw, psychiatrist, major domestic violence expert, exposing how abused women and children are routinely misdiagnosed with bipolar and other wrong diagnoses for their abuse related trauma symptoms that cause much harm in many ways she explains while failing to address the real problems. Mr. Whitaker you are making the assumption that most if not all diagnosed with the latest fraud fad garbage can diagnosis now replacing schizophrenia as psychiatry’s sacred symbol (Szasz) actually have bipolar symptoms when nothing could be further from the truth. In fact, this is clearly stated on a web site where Robert Whitaker, Dr. Loren Mosher and others on interviewed.

    Anyway, here is the hyperlink for the article quoting Dr. Carole Warshaw:


    Dr. Judith Herman says pretty much the same thing in her classic work, TRAUMA AND RECOVERY, except the bogus insult diagnosis for abused women and children used to be borderline personality disorder. Dr. Herman says most in the mental “health” profession know that most of those they see have suffered abuse/trauma of some kind.

    It is for this reason I do not hold out much hope for victims of abuse and trauma with the medical model of psychiatry since they deliberately ignore all such negative environmental stressors to blame the victims with their bogus life destroying stigmas to push their lethal drugs on patent now most amenable to bipolar as Dr. David Healy explains in his book, MANIA. As he explains in this book, his sample patient named Donna now being stigmatized as bipolar would have been labelled with anxiety and then depression in prior respective years because drugs for those label were on patent and being pushed by psychiatry in bed with BIG PHARMA at the time.

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  4. Here is the web site I mentioned above with Robert Whitaker and Dr. Loren Mosher. As you can see in the upper right corner, there is a box showing how interchangeable and/or bogus psychiatric diagnoses can be as with bipolar being substituted for schizophrenia now. However, I am aware that bipolar is being “diagnosed” today on the flimsiest excuses and downright lies falsely accusing people suffering from abuse as bipolar, psychotic, delusional, paranoid, manic, etc. I am not as familiar with the history of schizophrenia other than reading that it too is a bogus social construct covering about 100 manifestations of so called different “illnesses” for the purpose of social control and marginalization, which is also true of the bipolar diagnosis. I wonder if people with emotional distress or trauma who were not suffering so called psychosis, hallucinations, delusions and similar symptoms were “diagnosed” with schizophrenia for the flimsiest reasons as with the case of the bipolar fraud fad.


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    • High Five to the RICH Lady!! She nails it!

      One GIGANTIC important priority:

      Must Not “criminalize” the “industry”. Where is the incentive for that particular “body of life” to alter itself, when it’s being “gunned down”?

      I know what that’s like. And truly, I must say it:

      We have to offer FORGIVENESS, without their apologies – and continue to state our needs (and RIGHTS) for REAL, proper, holistic “treatment” (respect) and CARE, to support our path to achieve recovery, healing and well-being.


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