Bipolar Diagnosis Linked to Childhood Adversity

Given the ties between traumatic childhood experiences and the diagnosis of ‘mental illness,’ should we continue to focus on a genetic and biological approach to treatment?

Peter Simons
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A new study, published in the British Journal of Psychiatry, found that experiences of neglect, abuse, and bullying in childhood were linked with later diagnoses of Bipolar Disorder. The researchers, led by Dr. Palmier-Claus at the University of Manchester, statistically analyzed data from 19 studies, allowing them to combine the results of 34 years of patient records. They found that people diagnosed with Bipolar Disorder were 2.63 times more likely to have experienced traumatic events in childhood than people without the diagnosis. This suggests that whether or not there is a genetic component to the disorder, the impact of experiences such as neglect and physical and sexual abuse cannot be ignored.

Studies suggest a strong link between traumatic childhood experiences and mental health disorders. Photo credit: Pixabay
Studies suggest a strong link between traumatic childhood experiences and mental health disorders. Photo credit: Pixabay

Last month, the National Institute of Mental Health (NIMH) announced that it is funding a $15.4 million effort led by the pharmaceutical industry to attempt to identify the neurobiological basis for Schizophrenia and Bipolar Disorder. Leaders from Janssen Biotech, the makers of haloperidol, citalopram, and risperidone, are partnering with researchers from Johns Hopkins and the Salk Institute to attempt to find theorized biological markers that could be targeted with medication.

The group acknowledges that our current medical treatments for these disorders have limited efficacy and that previous efforts to locate biological markers have been unsuccessful, yet they insist that further study will eventually locate elusive biomarkers underlying specific mental illnesses.

In fact, the very existence of categorizable mental illness diagnoses has been questioned. In 2013, prior to the release of the DSM-5, the director of the NIMH, Thomas Insel, stated that the weakness of the DSM “is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.”

Insel’s response to this lack of validity was to increase the funding for neurobiological research in a desperate attempt to find categories of mental illness with obvious biomarkers that could be targeted with medication.

However, the current study, which demonstrates the impact of past experiences on the formation of mental illness, adds to a growing body of literature that indicates that this search may be fruitless. The researchers conducted a statistical synthesis, examining 19 prior studies that included participants diagnosed with bipolar disorder, a measure of childhood adversity, and a comparison sample.  Those diagnosed with the disorder were found to be 2.63 times more likely to report having experienced childhood adversity than the control group. The results also suggest that those who experienced emotional abuse were at an even higher risk and were about four times as likely to be diagnosed with bipolar disorder.

Perhaps efforts should focus on preventing childhood trauma, as that has been linked far more often to mental illness than neurobiology. Perhaps instead of devoting more and more resources to an uncertain search for biomarkers, resources should be devoted to providing support for those who are experiencing poverty, abuse, and trauma.

 

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Palmier-Claus, J. E., Berry, K., Bucci, S., Mansell, W., & Varese, F. (2016). Relationship between childhood adversity and bipolar affective disorder: systematic review and meta-analysis. British Journal of Psychiatry,209(4), bjp.bp.115.179655, doi: 10.1192/bjp.bp.115.179655 (Abstract)

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Peter Simons
MIA-UMB News Team: Peter Simons comes from a background in the humanities where he studied English, philosophy, and art. Now working on his PhD in Counseling Psychology, his recent research has focused on conflicts of interest in the psychopharmaceutical research literature, the use of antipsychotic medications in the treatment of depression, and the general philosophical and sociopolitical implications of psychiatric taxonomy in diagnosis and treatment.

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37 COMMENTS

  1. Thank you, Peter, for writing this piece. I absolutely agree funding should be going towards ending the psychiatric industry’s profiteering off of covering up child abuse and trauma, not into searching for “the neurobiological basis for Schizophrenia and Bipolar Disorder,” since “the weakness of the DSM ‘is its lack of validity.'” Since, “the prevalence of childhood trauma exposure within borderline personality disorder patients has been evidenced to be as high as 92% (Yen et al., 2002). Within individuals diagnosed with psychotic or affective disorders, it reaches 82% (Larsson et al., 2012).”

    And since, today’s “bipolar” drug cocktail recommendations:

    http://www.mayoclinic.org/diseases-conditions/bipolar-disorder/basics/treatment/con-20027544

    Which include combining the antidepressants and antipsychotics are known to result in “psychosis,” due to anticholinergic toxidrome:

    https://en.wikipedia.org/wiki/Toxidrome

    These are the central symptoms of anticholinergic intoxication syndrome, according to drugs.com:

    “Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”

    And these symptoms are indistinguishable from the “positive symptoms of schizophrenia,” to the doctors. Plus, since anticholinergic toxidrome is not listed as a billable DSM disorder, it is almost always misdiagnosed as one of the billable disorders, like “bipolar” or “schizophrenia.”

    And the neuroleptics alone can create the “negative symptoms of schizophrenia” as well, via NIDS:

    https://en.wikipedia.org/wiki/Neuroleptic-Induced_Deficit_Syndrome

    And, “This can easily lead to misdiagnosis and mistreatment. Instead of decreasing the antipsychotic, the doctor may increase their dose to try to ‘improve’ what they perceive to be negative symptoms of schizophrenia, rather than antipsychotic side effects.” And increasing the amount of neuroleptics, of course, will lead to anticholinergic toxidrome poisoning.

    It’s highly likely, in my humble opinion, that both “bipolar” and “schizophrenia” are actually iatrogenic illnesses created with the psychiatric drugs, especially when given to someone dealing with child abuse, bullying, or other trauma. Since child abuse, bullying, and trauma are not “brain diseases,” they are actual societal problems that should be dealt with by arresting the abusers, rather than defaming, drugging, and dismissing the victims of such crimes.

    It’s a shame Insel’s 2013 claim he would redirect funding away from the DSM disorders does not seem to be happening.

    • As someone that has suffered from bipolar disorder for over two decades, and untreated 99.9 percent of that time, I have a unique perspective.

      First, I was never abused as a child, sexually or otherwise. Second, I was never put on any medication at all as a child. My first attempt at medications was late teens, long after my symptoms had been presenting and making my life a living hell.

      So, I can say with certainty, both of the assumptions being made here (that its abuse related, or the effect of medicating something else at a young age etc) are wrong.

      Perhaps your view is skewed the wrong way. Consider this, the things that go along with having bipolar disorder, the behaviors one presents at different times, would make them greater targets for abuse and bullying. Rather than the abuse causing the illness, it is the illness that invites the abuse.

      There is an intense feeling of isolation with this illness. By pushing these sorts of misguided hypotheses, it reinforces to those suffering from this that there is no help for them out there. It comes across as though you in the psychological professions are being dismissive of what we go through. Trust me when I say that living like this is akin to being in hell every single day. Far too often, those like yourselves that are supposed to help end up being seen as the devil. Pieces like this…are why.

      • As someone who is exactly the opposite- diagnoses bipolar at 13. on numerous medications ever since then, and in remission for over 5 years OFF all medications except a mild dose of anticonvulsant for migraines that can act as a mood stabilizer (Topamax) you need to understand that just because your experience was a certain way doesn’t mean everyone’s is.
        I was an avid defender of medications, until I became completely stable- and try to start weaning off some. Crazy withdrawal effects made it nearly impossible to get off several- but I managed, even with doctors and family members actually trying to convince me that I needed HIGHER doses. Here I am, years later, off the meds and guess what? Not ill. I have bipolar disorder, but it does not require lithium, anti-psychotics, anti-depressants, heavy duty sleep meds, and the other meds that DE-STABILIZED me for HALF OF MY LIFE.
        I can work a full time job for the first time in years. I completed my B.S. in Psychology after 16 YEARS. I am working on my MSW at last. Because I STOPPED THE MEDS and stopped letting people tell me who I was and who I wasn’t, who I could be and who I couldn’t be. I developed coping skills and learned how to regulate emotions, sleep, and dealt with severe childhood trauma that (imagine!) began to become extremely severe around age 9-11, right when I started showing the symptoms of bipolar. In fact, a therapist I saw in the beginning tried to tell my family that I should try therapy firs,t but they didn’t want to hear that, so they took me to a psychiatrist and she gave me the bipolar diagnosis and put me on meds- and I was never able to get anyone to take me off of them again.
        Your experiences are not equivalent to every experience of everyone with bipolar disorder. I was on Seroquel for eight years, and it destroyed my daytime cognitive function so much that I couldn’t even care enough to wonder whether I truly needed it. Nobody questioned it; they assumed, since I was bipolar, that it was just a necessary side effect for such an ill person. But it turns out I wasn’t that ill- just in need of some brain re-training, to develop new neuro-pathways where damage had been done- literally, in need of brain healing and the development and maintenance of strict routines to keep my delicate brain chemistry balanced. What I DIDN’T need was doctors deciding what was best for me based on other patients experiences, without regard to what I was trying to tell them, or what my experiences were.
        My success in life- after cutting back and then stopping almost all meds- is living proof of the high functioning that is possible for bipolar patients, even the most several ill (I had numerous hospitalizations, psychotic episodes, even ECT over the 15 year period prior to my 6 year remission period) with proper LONG-TERM treatment. Long-term being the key- it wasn’t easy, and it wasn’t quick. It took hard work and it takes continual work- more than just popping a handful of pills and conking out and being numb for the next 12-24 hours, which is why insurance companies will never recommend it and some patients with never accept it.
        But it should always be at least presented as a possibility. Instead, meds are MANDATED. No one even mentioned remission to me as a possiblity- EVER. Not once. I was never even told I COULD get well, or that I COULD taper off meds, EVER. I decided to take control of it when I found out that my lifespan could be so horribly shortened by being on all these meds, and the horrific long-term side effects- not to mention that I began to notice that my symptoms were unrelated to whether I was closely following a certain med regime.
        Question EVERYTHING. I was a sheep for most of my life, and I regret it more than anything. I wish I could have my youth back; I wouldn’t be a 34 year old JUST graduating from college. I wouldn’t have lost my 20s to failure and despair, thinking I would never be anything more than an overmedicated space cadet. I wouldn’t have resigned myself to being a useless, drooling disabled zombie for more than a decade. I would have fought back a LONG time ago, and found out that a bipolar diagnosis entailed far more than JUST a chemical imbalance- there are factors that cause the imbalance, and those factors can be treated with more than just pills!

        • It is unfortunate that you completely misunderstood my point. Im pretty sure I made no mention of medications being the fix here, in fact I would have thought my comment about being unmedicated most of the time would have sufficed to indicate I wasnt talking about that at all.

          You should be commended, however, for finding the balance that works for you and making it through and achieving your educational goals. However, your comment does illustrate the same issue that the…writer…of this article has, and that is you were so focused on making your own point you missed the other information thats there.

          Yes, absolutely, abusive childhoods can leave all sorts of lasting scars. There is no one on earth that would argue that point (I hope). The point, however, is not whether thats a possibility, its that if something also exists when you remove that factor, then there is something else at play.

          It would be like saying ‘Hmmm… well, research shows everyone that has ever had cancer has drank water in their lives. Clearly, water causes cancer.’ Thats basically the attitude this writer as about bipolar disorder. Well, in this case there are also plenty of people that never ‘drank water’, I.E. were abused, that still developed this illness. Meaning, there is more here at play than he wants to believe.

          Essentially, this guy, and so many others, seek to dismiss the hell those of us with serious mental illnesses go through by saying ‘Its cause you were bullied. Get over it. Nothing is actually wrong with you.’ THAT is the problem here, that attitude, and I have a problem with that. Thats why so many like me do not get treated. Thats why so many like me do not reach out. That is why so many like me end up committing suicide.

          Next time, perhaps this ‘writer’ will think a little more before posting something like this.

          • I don’t think anyone is saying or implying “Get over it” because they are saying that traumatic experiences can cause “bipolar” symptoms! Trauma is a BITCH, and it is tough as hell to get over. Imagine being forced to go to school every single day, when the majority of people at the school call you “retard” or “dummy” or “fatso” or far worse things, physically abuse or threaten you, refuse to let you sit with them or play with them, threaten others who try to make friends with you… and remember that TEACHERS are sometimes the biggest bullies of all, and kids often have zero recourse if they get stuck with an abusive teacher. The point is not that you need to “get over” being abused, it’s that a person with an abusive background will be more likely to be helped by interventions intended to resolve that background, rather than being told “it’s all because of bad brain chemistry.” I’ve worked a ton with foster youth, and I can tell you, saying they have a “chemical imbalance” is every bit as insulting to them as you seem to find the idea that your symptoms result from abuse that you don’t identify as having ever occurred.

            The point is, “bipolar” is just a description of a bunch of emotions and behaviors that tend to occur together – there is no proof and not really much evidence that it is uniformly or even commonly caused by faulty brain chemicals. That does not mean it CAN’T be caused by such faults, but it is unscientific and foolish to ASSUME that such behavior is always caused by this and dismissing abuse history and social context as secondary or even irrelevant, as many if not most psychiatrists tend to do.

      • Luke,

        “Far too often, those like yourselves that are supposed to help end up being seen as the devil.” Wow, that’s a first, I’m “the devil”? I’m not “the devil,” nor am I a mental health professional taking payment to help you or anyone. I’m a decent and ethical person trying to educate people of the actual harms of the psychiatric drugs.

        I’m just an independent mental health researcher, for the past eleven years, who needed to medically explain how I’d been made sick, so I could clean up my medical records, and prevent mental health ‘professionals’ from attacking, defaming, and drugging my children, based upon their bogus claims that their theorized DSM disorders are of genetic etiology.

        I’m sorry you suffer from the symptoms of “bipolar,” Luke, I do know the symptoms are very real. But you should know the psychiatric drug cocktails given to “treat” the symptoms of “bipolar,” do indeed cause the symptoms of “bipolar,” and “schizophrenia,” including when one is withdrawing from these drug cocktails.

        And it was not me who was abused as a child, it was my child who was abused. But in 2005 some decent and disgusted nurses in my PCP’s office finally realized my PCP had railroaded me, with a bad drug cocktail and lies off to psychiatrists, to cover up her husband’s “bad fix” on a broken bone of mine. And I did pick up medical proof of her husband’s crimes later.

        And my mistake in 2001, when this happened, was to trust in a pastor for a second opinion doctor, a pastor who may have been a child molester, at a minimum his Bohemian Grove attending best friend was, according to my child’s medical records handed over in 2005. And this book does describe this as a systemic problem for the bishops of that religion, I would be one of the apparently many “widows” described in the preface:

        https://www.amazon.com/Jesus-Culture-Wars-Reclaiming-Prayer/dp/1598868330

        An ethical Methodist pastor later explained to me, after being kind enough to read my medical records and research, that I’d dealt with “the dirty little secret of the two original educated professions.” And the medical evidence has come in showing that the psychological and psychiatric industries have been profiteering off of covering up child abuse for the religions and wealthy for a very long time.

        I believe this should stop, and I agree with sggriff that it’s morally repugnant for the psychiatric and psychological communities to continue to gaslight people into the psychiatric system for profit with their lies of proven “lifelong, incurable, genetic mental illnesses.”

        https://en.wikipedia.org/wiki/Gaslighting

        Such behavior is “mental abuse,” for profit, not “mental health care.” Paternalistic, or Satanic, fraud within the psychological and psychiatric industries has been rampant for decades, the medical evidence is showing this, it should be put to an end.

        • Are you the writer of the article? Then how was I ‘calling you’ anything. Even if you were, I did not even call that guy anything, I said ‘being seen as’.

          I used the term as hyperbole, clearly, as there is not such as the devil, just as their can be default be no such thing as an ‘ethical pastor’. Someone whose job it is to deceive large numbers of people cannot be ethical.

          Your use of quotes around serious mental illnesses shows your dismissive attitude of them. THIS is a major issue. You, just like the writer, and so many people here clearly do not understand what this life is like. Also, once more I point out that I have been UNMEDICATED for all but the briefest of times in over two decades with this. The point here being all of you misguided people that assert that ‘the drugs themselves caused it’ and ‘the childhood trauma’ caused it…I am a perfect example of how both of those assertions are completely inaccurate as an across the board reason. Can there be cases in which those assertions are correct? Sure there can be. I havent denied that. Nor have I said not to treat those things with therapy, again as I do not use medication either…you would think you people would get that. My point is merely those are NOT THE ONLY FACTORS IN THIS. Continuing to assert that they are, only damages those who need help. Which, again, judging by the attitude of the people here, Im pretty sure no one on this blog actually cares about any of that.

          By the way, sorry about your “broken bone”. Hope it “healed correctly” and you are “doing well”.

          • We are not saying that each and every case is exactly the same where people experience extreme emotional and psychological distress. Everything lies on a continuum. You cannot judge everything by your situation alone. We do not dismiss the pain and distress of anyone. But I would say that your situation is not that of a majority of people who have been labeled as being “Bi-polar”.

        • I’ve actually been diagnosed a few times over, by different doctors that were unaware of previous diagnoses. I did that on purpose, as I realize (particularly with something as multi spectral as biopoal) it is a very difficult diagnosis to make. The initial time was in my late teens, after an initial diagnosis of ‘depression’. I was given prozac at the time, and immediately became much worse. After a few other incidents within that first week, including a black out episode in which I nearly murdered a neighbor with my bare hands, I was taken back to the doctor and got that first diagnosis as bipolar. Many years later, I once again sought help and after some testing, was again diagnosed as bipolar, this time ‘type 2’. Then once more, many years later through my county health department saw three different people working together on three different days (so they could observe various moods) and once again was diagnosed as ‘fairly classic, bipolar 2’ though the counselor that was part of that observation did say that I am an expert at pretending to be normal.

          So basically, over the course of twenty plus years I have had a medical doctor, a psychiatrist, two counselors and psychologist all with many years of experience all agree on the same diagnosis observing me at many different times in my life.

          • Thanks for your response.

            You know that a manic reaction to Prozac is a side effect and not necessarily an indication of having bipolar disorder? Was that ever considered?

            I certainly am not doubting your story but I wish I had a nickel for the folks who were given iron clad BP diagnoses only to find out they weren’t valid.

        • For some reason the site isnt giving me an option to reply to your newest post.

          Anyway, yes, that is the reason for the additional blind diagnoses over the years. Again, many many years apart, different doctors and counselors that I intentionally did not give the previous information to just for that reason. All of them came to the same conclusions on their own.

          • Luke, diagnosis is a curious thing in psychiatry isn’t it? Since the DSM has little, some might say NO validity, as it’s categories are a matter of opinion and consensus, a show of hands by members of a committee, the arrival of a diagnosis may well be a matter of chance. That so many professionals came to the same conclusion over a protracted period in one case may also be chance. Sure there are things that cluster in certain behaviour groups, in bipolar for instance, an increase in `goal directed behaviour’, followed by periods of `low mood’ when the person has little interest in life. However, there can be many ways a professional may try to establish that this is a pathological state. First, there is a desire to find a DIAGNOSIS and this can lead to loaded questions, often with yes/no answers, for instance, `have you ever felt life was not worth living?, Yes or No.’ Many people may have had a thought like that and it was fleeting and inconsequential but honesty impels them to answer `yes’, with no room for qualification. This is then added to a list. I’m sure you are right that you withheld information but as a former psychiatric professional we were trained to look beyond the words, seeking pathology to support one or other diagnosis. One sees the same phenomenon with people visiting clairvoyents. The lay person is no match for the professional.
            But I wasn’t just a fairly skilled interviewer, I too, was diagnosed with bipolar, after a sudden suicidal crash, like you, a week or so after taking Prozac, immediately followed by ECT. I don’t remember much of the interview after 14 ECT treatments, but I suspect the vague euphoria from the Traumatic Brain Injury that was ECT, the `history’ of the suicidal collapse, a couple of suicides in my grandfather’s family and my own behaviour as an artist and writer, all contributed to a diagnosis from a psychiatrist who always diagnosed bipolar. What happens is that every incident in one’s life can be pathologised in psychiatry. For instance, as an artist and writer, I had on occasion worked long into the night pursuing an idea. This was rare but with questions designed to find symptoms of `mania’ it came up as positive. It is in fact a very normal occurrence with creative people and in my case was quite mild. A depressive episode 30 years earlier due to severe workplace bullying was a `sign’ of long term `instability’, though that too, could be seen as a normal response.
            My point is that because psychiatrists have little training in `normal’ behaviour and a lot in abnormal behaviour, they see `illness’ where there is nothing but a person in some emotional difficulty for whatever reason. Today’s psychiatrists and many counsellors, actually believe in the biological/genetic paradigm and their view is biased towards it such that they cannot see anything else. THAT is the problem. I’m not saying you DON’T have bipolar, or that you have to pull yourself together, or that you don’t suffer, just that maybe, if you have a bipolar 2 diagnosis, which was made up by the APA, you might need to be very critical of the criteria and why you have been given it.
            As for child abuse, this does not just include sexual and overt emotional abuse, beatings, bullying, starvation and neglect. There are many subtle sources of stress in childhood. Things like the threat of divorce, moving house a lot, having to start again at different schools, temporary loss of a parent, especially of the mother particularly if she is ill and the child thinks she might die, very early emotional deprivation for any reason, anything in fact that makes a child feel unsafe. Even though parents may love their children, nobody gets everything right, and for some, given enough of these things, the balance can be tipped. I personally believe that almost all `mental illness’ is a) not `illness; b) is caused by childhood and environmental conflicts, and c) should not be treated by medical practitioners AT ALL. If there is a physiological problem that manifests with behavioural problems that IS a physical illness, it should be treated by the appropriate specialty, e.g. thyroid issues see an endocrinologist, temporal lobe epilepsy see a neurologist etc.

          • Luke, it’s interesting you were never coerced or forced to take many drugs, given your many “bipolar” diagnoses, since that is the opposite of the experience of so many who were diagnosed as “bipolar.” Why is it so few of your psychiatrists ever insisted on you taking the recommended “bipolar” drug cocktails, since that is what their training demands they do?

  2. ” This suggests that whether or not there is a genetic component to the disorder, the impact of experiences such as neglect and physical and sexual abuse cannot be ignored.”

    Actually, it suggests that whether or not there is a genetic contribution, the impact of these experiences is MUCH MORE IMPORTANT than whatever genetics are involved. Because we’re seeing a factor of 2.6 times increase in BPD diagnoses, and no genetic study has ever shown anything remotely close to that kind of association. In other words, the biological determinists are barking up the wrong tree and need to shut up. But it is interesting that the authors are unable to draw this obvious conclusion, and as usual, soft-pedal the effects of trauma, abuse and mistreatment in deference to the biological paradigm that is supported by so much money and prestige. The truth is there but they don’t want to look!

    — Steve

  3. My children and I have been diagnosed with mild autism spectrum disorders, formerly known as Asperger’s Syndrome. I’ve done a fair bit of reading about this.

    One thing that I’ve learned is that the social awkwardness associated with my disorder attracts bullying. Tony Attwood has suggested that children with this disorder be provided with mentors to help steer them through social minefields, such as recess and lunch.

    Isn’t it likely that bipolar kids, or kids with bipolar potential, are similarly attracting bullying due to their issues?

    Also, might not they be more likely to perceive situations as bullying or abusive when they’re not? I’ve certainly seen that in my family.

    Granted, preventing bullying is important. I was distressed as a mom that the schools’ approach was to attempt to locate bullies and punish them. It seemed to me a more prudent approach to assume that there would be bullies and provide protection for my kids in advance.

  4. Clearly you have an agenda! All competent doctors agree that experiences contribute to depression and all competent doctors agree that medications are an important PART of the treatment as are different types of therapy. You simply don’t like drugs. But for MOST people with depression, drugs are needed (and effective). On the manic side of bi-polar, clearly this has a genetic method and is BEST treated with drugs. Modern research seems to be trying to disprove the need for drugs in the manic side. But your “scientific” study is flawed! Please notice that I am NOT saying that only DRUGS are important. But clearly your agenda is to cast doubt on the use of DRUGS and you are doing a great disservice to the “nervous” people of the world.

    • Uhhmmm…please quote the actual research regarding serotonin levels….even the American Psychiatric Association acknowledges that the chemical imbalance theory of depression was only ever a theory with no evidence to support it. A past president of the APA went as far as to say it was an urban myth that no serious psychiatrist had ever believed, but it was a convenient way to get patients to take their drugs.

      There is no way of measuring serotonin levels in the brain of a living person.

      Some “anti-depressants” that are thought to lower serotonin levels work (as well as a placebo), as do some that raise serotonin levels, and both types can be equally effective in the same patient. Other “anti-depressants” that do not target serotonin at all are equally as effective…but again, they are only about as effective as a placebo.

      If you have research that proves the serotonin theory of depression I am sure the scientific world and the drug companies would love to see it – please share!

    • My understanding is that the idea that depressed people consistently or even more commonly have low levels of serotonin was substantially disproven back in the 1980s, before Prozac even came to the market. Read “Anatomy of an Epidemic” and catch up with the actual research!

  5. This article brings up some difficult memories of my own, and makes me shake my head at the mental health care system. Diagnosed with severe depression in the late 1980’s, I fell through the gaps of the system for the better part of two decades with little to show for it. I was on as many as four drugs at once, even though they rarely helped. (Despite this, I was also told I’d always need meds.) Since I didn’t respond to therapy, either, psychotherapists routinely accused me of exaggerating — or outright faking — my difficulties (holding down jobs, social issues, etc.) and scolded me by saying “other people have problems, too.”

    Through nearly two decades, with well over a dozen professionals and multiple hospitalizations, no “expert” ever bothered doing a thorough case history. Not even one. Had they done so, they would have uncovered severe trauma I suffered at a very early age. (In my attempt to rationalize it as a small child, I had convinced myself back then that everybody suffered early life trauma, that it’s a normal part of life and you’re supposed to just move on. As the years went by, I thought of it less and less.) Instead, my doctors drilled it into me that only the present mattered, and going anywhere beyond the recent past was just a lazy excuse to avoid dealing with the present.

    I HAD NO IDEA, until my 40’s, that trauma could affect a person so adversely. That’s when a more competent doctor connected the dots, and we were able to address the trauma (the ACTUAL problem) with precise therapy — no meds required. I’ve made incredible improvement since and now function at my highest level ever, but it still makes me shake my head at all the years that were lost because no professional took an in-depth history. What a horrible waste of life.

    Like the writer, I think the mental health care system is a mess: far too much drug dispensing in general, and terribly misguided approaches to psychotherapy, particularly on the more severe cases.

  6. Everyone has a wide range of humanity within them, from deepest shadow to brightest clear light–that is, from pole to pole. We all navigate our arc of emotions, responses and behaviors as we see fit for ourselves. How others respond to anyone’s process is their business. In addition, adverse childhood experiences, of which there are various natures, affect people in a variety of ways.

    What is called “bipolar” is what I would call an ungrounded, unfocused, kind of messy process. That can occur for a variety of reasons. It can also be remedied fairly easily, but not with a stigmatizing and nonsensical label.

    Cleaning up and integrating ones creative process with expanded awareness is powerful and effective healing. It’s also universal. Life on the planet has been rather traumatic for just about everyone I know, so everyone could use a shift in their process. That’s how we heal and grow.

    “Bipolar” is a catch all for “unstable,” I think, which happens to everyone from time to time. It’s also usually an unstable environment causing it, and the one noticing this becomes the scapegoat, so the dysfunctional system is preserved.

    The rest is meaningless, since everyone is bipolar, it’s a continuum of awareness. That’s how I see it, in any case.

    • Been there already. And been healing without drugs or therapy for years now and moving right along in life. Nature has a way of correcting imbalance when we allow it to.

      I respect your opinion, but I disagree with it. I also think it’s ok to have divergent perspectives. No need to be insulting, and I don’t fight about it. You think what you think and I think what I think. I believe that’s ok, to have diversity here.

      In any event, best of luck to you. I hope you find relief soon.

    • It sounds as if you judge everything by your own experience as if your experience is the end all and be all of everything. Most of us who come to the website know of what we speak since most of us are survivors of the system. But most of us do not work from the belief that our experiences are the tool by which all other things must be judged. We share our experiences and what has worked for us and you can take what works for you and leave what doesn’t work. You don’t have to believe anything that we share but we do ask that you be respectful. I agree with Alex, it’s all a continuum.

      • Except what you just said you dont do, is precisely what you all are doing. You people dont believe this is an actual illness, well it is. You people dont believe people can just be born with this sort of thing, well we can. You people want to complain about the system and the drugs and chidlhood trauma being triggers, well, Im not disagreeing that those can be factors. However, while I have continuely accepted those as valid, every one of you people has been condescending and dismissive of my actual points. I dont care whether you feel that drugs can help or not, that is not even remotely close to the point Ive been making. My point has always been that there are more factors at play here than the very simplistic approach this writer of this article is making. For people that claim to be open minded, you all certainly jump to conclusions without considering actual facts.

        • Sorry, I have not dismissed anything you’ve said except your insistence that “bipolar” is a disease, and I’ve given solid, logical explanations why I don’t agree with using that term. I have agreed that there may be people who have a “chemical imbalance” but have asserted that it is impossible to determine that based only on a person’s behavior or emotions. I’m sorry if we are not agreeing with your philosophical views, but philosophy is not science. You can say “It IS a disease” all you want, but it does not change the fact that NO ONE has any proof that people with “bipolar” have anything specifically in common biologically, as the only definition of “bipolar” is their behavior. I am not sure how you can accuse others of not being “open minded” when you’re not able to accept that the definition of “bipolar disorder” is subjective and behavioral and does not require or establish any kind of biological problem in order to be diagnosed.

          — Steve

  7. I’ve no idea why this site does not allow replies after a certain point regardles of that, moving on.

    Steve, I could easily use the same reverse logic on you. No one has yet established that it does not carry a biological marker. The assertion made in this ‘article’ however I can say, from personal experience, is NOT accross the board accurate. Meaning…there is clearly more at play here than the very simplistic ideas you people are putting forth. Once more, you cannot claim there is a direct link and people with bipolar disorder only get it because they are ‘abused as a child’ or whatever when you have people that have bipolar disorder that do not go through any of that. Again, you people fail to understand this. There is more going on than any science currently knows, we just havent gotten there yet to be able to understand it fully. Your continued stance of refusing to consider other possibilites as causes, despite evidence that people have this without having gone through childhood abuse or trauma or what have you is the exact definition of being close minded.

    So, once more, my points that I have been making all along. The ‘link’ between abuse and bipolar disorder may well exist. The abusive situations, however, may be a result rather than a cause, and could use more studying. However, that is clearly not the single cause and there is far more to it that we do not yet know. Repeatedly stating things like this article and many people down here have done simply causes far more harm to those with this ilness. It is insulting and dismissive, and the exact reason so many of us choose to end our lives.

    • Luke, it is not the responsibility of anyone to establish that there is NOT a biological marker. As a scientist by training, I can tell you that it is the responsibility of the one claiming a connection to show that it exists. There has been plenty of research attempting to find such biological markers over many years, and it has yielded very limited results. Interestingly, the same is actually true for physiological issues like heart disease – even though there appears to be a significant level of “heritability,” there is not a specific gene or genetic combination reliably connected even with many measurable disease states that are much more objectively diagnosable than “BPD.”

      We both agree that the situation is very much more complicated than “he was abused as a child and that’s why he acts this way.” What I’m asking you to agree with is the counter proposition: that the situation is very much more complicated than “He has a chemical imbalance and that’s why he acts that way.” In no way have I ever stated that I did not believe there were a range of possible causes – to the contrary, my very point is that you CAN NOT determine one cause for a set of behaviors, and that research into the range of possible causes is the way to go, rather than ASSUMING that all people exhibiting “bipolar” symptoms are suffering from the same problem or need the same kinds of interventions.

      If you are really listening, you should be able to hear that many different people had a wide range of different experiences with the mental health system – some (like you) seem to have found it very helpful, while others feel it has destroyed their lives. That should be evidence enough that there is no “one size fits all” solution to these issues. It is a logical inference from that observation that different people with the same behavioral manifestations may have different problems requiring very different solutions, and that forcing the “standard solution” down someone’s throat (sometimes literally) can lead to disastrous outcomes.

      You call for more open-mindedness, and I think with some fairness. I’m calling for you to do the same. There are parts of this we absolutely agree about – why don’t we build on those instead of each person taking terns invalidating those they feel have invalidated them?

      — Steve

      • I hope we’re not establishing that boundary-less and abusive behavior can be excused by anything, regardless of whether or not one has exprienced trauma, family abuse, or has some kind of physical issue which impacts emotion and behavior. We are still responsible for our actions and simple decent respect can be learned at any time, even later in life, although that can be a bit of a challenge.

        But it’s more challenging and will cause hardships to not be aware of personal boundaries as one goes through life. That’s just asking for trouble. No one is going to care from where this stems, people naturally have an aversion to experiencing a violation of their boudaries and personal space.

        There is NO excuse for abuse, even from those that have experienced it themselves. People have had all sorts of trauma and life hardships, doesn’t make them hateful or bullying toward others.

        Some people employ their empathy gained from their experience, given that they know how it feels to be on the receiving end of abuse, and make it a point to be more loving about what they offer to others, than they themselves received, to not repeat the cycle. I wish more people would take that example and break the abuser-victim-enabler cycle once and for all.

    • You’re right of course, no one has found a biological markers for any `mental illness’ despite millions of dollars being spent on the search for at least 50 years. This despite the fact that genetic research is now so advanced that even a gene for predicting lung cancer if the person smokes, has been identified. Despite the fact that even where genes are identified as having direct links like Huntington’d disease and Cystic fibrosis, nothing can actually be done. So I query whether finding the `science’ is of any real benefit anyway. Perhaps some of those millions might be better spent in alleviating the poverty and socila deprivation whnce much mental `illness’ arises. As I’ve said I respect your beliefs, and recognise that you’re suffering, but insulting those who disagree does your position no credit. If you find it “insulting and dismissive” when people disagree with you, and extend that to suggest this as “the exact reason so many of us choose to end our lives” you are implying that those who disagree are pushing you and some unnamed others to suicide, I think you go too far. That is a bullying tactic, and as a fellow sufferer, is beneath you.

  8. A statistical link between childhood adversity and Bipolar Disorder is not surprising. But that could never be the entire story, because Bipolar Disorder does not even exist.

    Certainly child exploitation, of the type the middle-class family has been built around, is going to be the biggest factor in getting someone into the mental health system so that they can be given such a bogus diagnoses.

    We should be able to stop it from happening to children simply by making doctors comply with mandatory reporting in suspected cases of child abuse. This would put an end to the fix my kid industry. Now the culpability would all fall back onto the parents.

    Nomadic

  9. OMG! Only had time to read article title and register AND I have long felt that intense trauma is a bi-polar experience….contrasts that are overwhelming and sometimes impossible to integrate into a coherent reality but then labeled an illness (though not even acknowledged as socially contracted one). SOOOOOO glad mad in america exists and I’ll be back to read up and participate.